Rest, Recover, Regenerate Part 1: Overtraining Syndrome
Recovery is an essential aspect of the training process. Put simply, if we aren’t recovering from the stresses we are placing on our bodies, we can’t improve.
We typically discuss various training methods and strategies to help improve sports performance, often overlooking the importance of recovery and what we are doing outside of the gym as a way to maximize what we are doing inside of it.
I’ll admit, talking about recovery may not be as exciting as talking about training or ways to create a program that will lead us to athletic dominance. However, it is an important topic that needs to be covered if you want to get the most out of training and prevent injuries and overtraining.
Over the next few articles, we will take a look at some methods of helping to improve recovery and (hopefully) prevent overtraining. In this first part, I just want to give a little background of what overtraining syndrome is, how it happens and some of the signs and symptoms of overtraining.
Overtraining Syndrome
In a nut-shell, overtraining is the accumulation of stress (both training and non-training stressors) which, when not tended to properly, leads to a decrease in performance with physiological and/or psychological symptoms that may take weeks or months to recover from.
I think she missed the warning signs.
Whenever an imbalance between training/competing and recovery occur, there is a possibility for overtraining. On a small scale, some overtraining is thought to be beneficial, and is often referred to as “overreaching” - a process where the athlete purposefully overtrains slightly with the idea that they will increase recovery at the end of the overreaching phase of training and take advantage of “supercompensation”, which occurs when fatigue dissipates and the new level of fitness is able to manifest itself. The needed period of recovery from overreaching may last a few days to a week, and athletes will show signs of overtraining (decreases in performance, fatigue, delayed recovery between training bouts, poor sleep patterns, etc); however, the athlete should be monitored to ensure that none of these red flags of overtraining get out of control – often athletes will be asked to train to an 8-10% decrease in performance before going into the recovery phase and allowing supercompensation to take effect.
The concept of overreaching is a controversial one, as many coaches don’t want to put their athletes into these overtrained situations, even it is only for a brief period of time. I also tend to err more on the side of caution and feel that putting someone purposefully into an overtrained state should not be the goal of the training program. Additionally, when working with athletes who play in sports that have long competive seasons or play multiple competitions per week (baseball, basketball, hockey, football, etc…), the goal should really be to keep the athlete healthy and free from overtraining, so that they can perform optimally come game time.
Stress and Overtraining
Things like travel schedules, long flights across time zones, poor nutrition/food choices on the road, and stresses imposed on the athletes by their coaches all may add more stress on the athlete, leading to a further potential for overtraining/under recovery. If the stress of training and competition is not bad enough, athletes also have to worry about the stress of their everyday lives. Things like social stress, financial stress, and family stress can all play a role in decreasing ones ability to recover from training/competition.
Athletes of all ages, from high school through the professional ranks face life stresses that need to be taken into consideration when evaluating the overall program and the amount of stress you are placing on a given athlete. Bartholomew and colleagues showed that high amounts of life stress impact ones ability to adapt to a strength-training program, with low-stress individuals showing significantly greater improvements in squat and bench press strength than those with high-stress levels. This study was conducted on 135-undergraduate students who trained twice a week (1.5-hour training sessions) for 12-weeks. This amounts of 3-hours of total training per week, is a far cry from what is expected of an athlete at the college level (between practice, training and competition) and in most cases, high school athletes are even exceeding this amount of training per week.
Inflammation, Tissue Trauma and Overtraining
Several authors have set out to understand the underlying cause of overtraining syndrome and how the overtraining processes is initiated. Some of the proposed mechanisms have been:
- Glycogen Hypothesis, which has looked at reduced levels of glycogen as markers of fatigue and overtraining.
- Central Fatigue Hypothesis, which looks at, reduced levels of circulating tryptophan (an amino acid), which cause it to be taken up in the brain to a greater extent. Tryptophan is a precursor to serotonin, a neurotransmitter which, when elevated has effects on the body such as increased need for sleep and reduction in appetite (both are tell-tale signs of overtraining).
- Glutamine Hypothesis, which seeks to explain the decrease in immune function and increase in illness during periods of overtraining, as glutamine is an important amino acid used for fuel by lymphocytes in the immune system.
- Hypothalmus and Hypothamic-pituitary-adrenal axis implications, where the blood catecholamine, glucocorticoid and testosterone levels are altered.
- Lack of day-to-day variations in training, which expose the athletes to “burn-out” and potential overuse injuries.
Together, all of the above theories explain some aspect of overtraining syndrome, yet a definite underlying cause has not been concluded upon.
Researcher Lucille Lakier Smith has proposed the idea that overtraining may begin with (and be caused by) tissue trauma.
First, it is important to note that some level of tissue trauma is not bad. In fact, a little bit of trauma is needed in order to force an adaptation (hence the name Adaptive Microtrauma). If we don’t impose some level of stress on our bodies, then we have nothing to adapt to, and no improvements are made. The pattern then looks like this:
Train (impose a stress on the body) –> Recover from that stress (heal)–> Train again (breakdown a little more) –> Rinse and repeat
Training leads to trauma, which leads to a local inflammatory process and the release of cytokines. Cytokines are basically like messengers which, transfer information from cell to cell and, when they are found in increased concentrations in the blood, they can transfer information around the whole body, having a more systemic effect. There are various types of cytokines with some having pro-inflammatory properties and others having anti-inflammatory properties. Three important pro-inflammatory cytokines are interlukin-1ß, interlukin-6, and tumor necrocis factor-? (NOTE: interlukin-6 can have anti-inflammatory properties as well).
During phases of training where recovery is not optimal (overtraining) and inflammation is elevated, or during periods of injury, pro-inflammatory cytokines may play a large role in communicating to the body that something is wrong.
Houston, we have a problem!
In the end, these cytokines may lead to the signs and symptoms that we get when we are in an overtrained state. If we are smart, we heed our bodies warning and back off of the training stimulus to allow for recovery to take place.
Signs and Symtoms
As you can see from the diagram above, overtraining syndrome has a negative effect on many of the bodies processes and recovery from severe overtraining can be a substantial task.
Here are a few signs and symptoms to look out for:
Physiological
- changes in blood pressure
- changes in heart rate at rest, during exercise, and during recovery
- increased frequency of respiration
- increased oxygen consumption at submaximal exercise intensities
- decreased lean body mass
Psychological/behavioral
- constant fatigue
- reduced appetite
- changes in sleep pattern
- depression
- general apathy
- emotional instability
- decreased self-esteem
- fear of competition
- gives up when the going gets tough
Information processing
- loss of coordination
- difficulty concentrating
- reduced capacity to correct technical faults
Biochemical Parameters
- rhabdomyolysis
- negative nitrogen balance
- elevated C-reactive protein
- depressed muscle glycogen levels
- decreased free testosterone
- increased serum cortisol
Immunological Parameters
- constant fatigue
- headaches
- nausea
- complaints of muscle and joint aches and pains
- gastrointestinal disturbance
- muscle soreness tenderness
- one-day colds
- swelling of lymph glands
- bacterial infections
- increased susceptibility to and severity of illness, colds, and allergies
Monitoring your training
The question always becomes, “how much stress is too much, and how much is just enough?” Truth be told, the answer is probably going to be found in the individual, as different athletes will adapt better to different training interventions.
Having a training journal and a periodized training program is a great way to ensure that you prevent overtraining, as you can look back at what you have been doing when you start to feel some of these symptoms come on, and in turn, plan properly for future training blocks – which should include blocks of recovery and restoration.
If you are a coach in a team setting, it may be more difficult to properly plan training around the individual. Knowing your athletes is an important aspect of coaching, and many coaches have employed the use of rate of perceived exertion (RPE) scales from the athletes, to help plan training. I talked briefly about this in my article on flexible non-linear periodization a week ago.
A recommendation by Robson-Ansley and colleagues is to have athletes complete a session RPE document following a non-steady state aerobic training session (IE, weight training, interval training, speed work, competition, etc). The athletes are to complete the document at least 30-minutes following training, to ensure that they make a proper appraisal of the days training session, and don’t just rate it has highly fatiguing based on how they felt right after completing the last part of an intense workout.
Conclusion
Overtraining syndrome is a very serious issue that affects many athletes and should be avoided at all cost. Several processes are involved in overtraining syndrome and it appears that tissue trauma due to inadequate rest/recovery may be the potential underlying factor which begins the whole processes. There are many signs and symptoms of overtraining and they can affect psychological, pysiological and performance processes.
In an effort to help athletes better recover from training; the following series of articles will be focused on methods of recovery and regeneration.
Patrick
patrick@optimumsportsperformance.com
References
Meeusen R, Duclos M, Gleeson M, Rietjens G, Steinacker A, Urhausen A. Prevention, Diagnosis & Treatment of Overtraining Syndrome. European Journal of Sports Science March 2006;6(1):1-14.
Bartholomew JB, Stults-Kolehmainen MA Elrod C C, Todd JS. Strength Gains after Resistance Training: The Effect of Stressful, Negative Life Events. Journal of Strength Cond Res 2008; 22(4):1215-1221.
Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress. Med Sci Sport Exer 2000;32(2):317-331.
Smith LL. Tissue trauma: the underlying cause of overtraining syndrome?
Journal of Strength Cond Res 2004;18(1): 185-193.
Robson-Ansley PJ, Gleeson M Ansley L. Fatigue Management in Preparation of Olympic Athletes. Journal of Sports Sciences, Feb 2009;1-12.
14 comments
Great stuff as usual Patrick!
Patrick,
Very thorough and useful information. Thanks for taking the time to write this.
Thank you for the kind words, gentlemen.
Hopefully the next few installements on recovery techniques will be useful.
patrick
Well as we are all very well aware stress is virtually unlimited but our ability to recover is not so fatigue management, with an emphasis on enhanced recovery/regeneration, is extremely important to the training plan.
The discussion of functional and non-functional overreaching seem to be where much of our discussion should be focused. In my opinion the differences in how speed-power and endurance athletes manage fatigue falls into the mechanisms through which they accumulate fatigue in the preparatory and competitive process. Obviously team sport athletes fall somewhere in the middle yet their season makes it that much more difficult to extend peak competitive performance through very long seasons while not overtraining (because of the interaction between the sport competition/training and the physical preparation that accompanies it).
As we discussed on your blog covering ‘Flexible Non-Linear Periodization’ the fear is having the program not be adaptable enough and moving too far away from the processes that drive excellent sports performance. At the same time we have to show a sensitivity to the unique demands, and constantly changing physiological environment, of the athlete.
Great stuff, Daniel.
You’re correct, our ability to adapt to stress is not unlimited. Stress resistance is a pretty dynamic thing, in that it can change depending on the amount of stressors we currently have going on in our lives. A training intervention that may have been well tolerated in the past (IE, lifting 4-days per week), may not be tolerated once we increase stress somewhere else (IE, getting a new job that requires us to work 50-hours per week), ultimately leading to a decline in stress resistance and an imbalance between training and recovery.
The functional/non-functional overreaching debate is an interesting one. From what I have seen, most who are advocates of training to a performance decrement (non-functional overrreaching) seem to be coaches working with athletes who are training for one or two specific competitions per year (IE, olympic coaches who have to get athletes ready for the trials, then the olympics – which may have qualifying rounds over the course of 2-3 days as well). The question then is, “how much can you get away with, and where do you cross the line?”. Obviously moving to far away from a proram that is not adaptable enough (as you stated in your last paragraph) is not a good thing, as then we are not getting better at all, rather, just “going through the motions”. You need something to adapt too – you can’t overtrain, but you can’t under-train either! Some of this may come in working with the athlete for a significant amount of time, in order to gain some idea of what works best for them (however, keeping in mind that stress resistance is an adaptive process – and we need to be sensitive to the constantly changing physiological environment, as you mentioned).
As far as endurance athletes go, that is an entirely different breed. I find most of them just overtrain because they have no idea what they are doing in the first place. Most marathon programs have a taper towards the end of the training cycle, leading up to the event (could be anywhere from 2-4 weeks depending on the program that you follow). I think this is fine for allowing them back off the high mileage they have been doing in training (hitting their 20 and 22 mile weeks prior to the marathon), but I don’t know how much “supercompensation” takes place, as I don’t think many of them have a training program that is anything more than progressive resistance (add a mile each week for 3-weeks, back off in week for, rinse and repeat until marathon time). What I mean by that is, they don’t typically have phases of training where they are looking to develop specific qualities, culminating in a final phase that pushes them towards a bit of overreaching, and then finally a back off period until marathon time. Of course I am talking about recreational runners here though, as I am sure most olympic runners have a highly specific program developed.
patrick
All great points, Patrick. As to the functional overreaching in my own programming this points less to a specific supercompensatory period than it does to the ability to manage and tolerate progressively larger training loads. As I say often the work only gets easier if we are better prepared for it so if we can stabilize that overreaching load, for a “key workout” or for a specific microcycle, then we will be able to hold on to that quality’s residual effects more effectively without having to do as many maintenance workouts (often where the typical thought process and structure is “we condition every Wednesday”). That overreaching load also points to what may very well be more subjectively measured as “easier” speed-power loads through the next training phase. How that overreaching load is accomplished, and for how long of a period, is obviously determined by the athlete’s physical preparedness.
Daniel, how frequently do the girls train in your program (2x’s a week, 3x’s, 4, 5..)? How frequently do you train various qualities (strength, power, work capacity, etc…) in a given week? Is it a deal where all of those qualities are worked on the same day, or one is a main focus, or maybe it is just one quality is focused on for a given period of time (2-4weeks), etc? I think a great blog article for you would be how to set up the training week for the girls volleyball team and how you manage training volume between school, family/life, and volleyball practice and/or competition.
I hear what you are saying about not having a specific supercompensation period. I think that is where people run into problems with overtraining, as they ignore the big warning signs and keep trying to push forward, in hopes that resting at a later date will result in a much lager gain in fitness…only to find they missed the boat.
patrick
Patrick,
This is an important post for so many reasons and it would behoove athletes on ALL levels to process this information. I don’t think the issue is to results in “paralysis by analysis”, but more of a logical reminder to apply established science and really listen to one’s body and not to always “play through” since the result may not be a desirable one.
Great work…looking forward to the next installments
Thank you very much Dr. Cubos. I am looking forward to publishing your interview in the coming week!
patrick
Josue,
Thanks for taking the time to read the blog and reply. Listening to the body is essential! Oftentimes people live by the “wait and see philosophy”, basically hoping that things will just magically clear up. As I have said before, the five most dangerous words in the English language are, “Maybe it will go away”. Catching things in their infancy and really trying to hone in on how well you are (or are not) recovering from your training program is oftentimes more important that trying to add more weight to the bar, increase the number of reps, add another set, or raise the mileage.
Patrick
Most volleyball players training in my program train with me 2x/week for much of the year (many of my more advanced high school athletes who also play for our club will do 1 team session with me and 1 individual or small group session with me). Fortunately I have several collegiate players who have trained with me for quite some time and see me more frequently (3x/week most weeks). The only time I schedule 4+ days/week is April/May through August for my collegiate and more advanced high school athletes (those in my ELITE program that I have actually recruited to participate; this is the scholarship program I have mentioned previously). Obviously the frequency of training affects the lay-out for how we would progress or functionally overreach. My summer program is a full 5x/week program and is heavily influenced by Dan Pfaff.
Speed, strength, and power are the priority so we train those qualities, on some level, in virtually every session (admittedly often in combination so I’m using those terms loosely). For example a lower intensity technical-power day would use a more extensive warm-up (25-30 minutes) followed by circuit style mobility and low intensity power work (e.g. Controlled Med Ball Caber Tosses x 8r [no jump; focused more on mechanics than ballistics and linking our hip/shoulder mobility effectively from the warm-up] – to – a brief kettlebell/dumbbell complex, dynamic mobility lunge series, or other movement series [often addressing more specific patterns for the sport] – to – hurdle mobility or a light skipping series). This type of session leads beautifully into a higher intensity power, strength, or work capacity day and the following session, in this training week or the next, should allow for a continuation of the high intensity work for at least the next 1-3 sessions (if nothing goes “wrong”).
I do not believe in training all qualities in the same session so that never really occurs. The closest I will come to that is for a high density training session where I use the primary quality as a primer for the quality to follow (e.g. power to prime max strength or max strength as a primer for power, etc, where the initial load potentiates the load to follow [it is important that fatigue is not induced with the initial loading]; depending on the specific loading for that session this would often closely resemble the competitive trial method). I do believe that since volleyball does not have as high of a conditioning requirement as many sports that are more sprint interval based my programming does reflect some bias (the word some here is obviously still a rationalization, ha). I do hate the simplicity of “we condition on Wednesdays “ if there is no rationale to support why.
[...] you have enjoyed my “Rest, Recover, Regenerate” series. So far we have covered Overtraining Syndrome, Diaphragmatic Breathing, Contrast Therapy [...]
[...] the body goes through when having to perform at an elite level. All athletes are susceptible to overtraining syndrome, and understanding the demands of the sport and how each individual athlete is able to deal with [...]
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