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Overtraining Syndrome is where a lack of recovery from training stress results in underperformance, often combined with [[Mood State|Mood Disturbances]] such as reduced [[Motivation]], depression and anxiety. The imbalance between training and recovery is exacerbated by [[Training Monotony]] and other life stresses. Overtraining Syndrome is not limited to high volume athletes, but can affect recreational athletes as well. I believe it would be better to rename Overtraining Syndrome to "Training Induced Depression."
=Introduction=
[[File:Training Benefit.png|right|thumb|300px|As training load increases there is an initial rapid improvement in fitness. Further increases produce diminishing returns until a optimum training is reached. Further training beyond this point produces less than optimal results until overtraining is reached when fitness is dramatically diminished. However, "Overtraining" and "Overtraining Syndrome" are rather different.]]
Overtraining Syndrome where a lack of recovery from training stress results in underperformance. Recovery is often impaired by other life stresses and these life stresses add to the stress of training. Overtraining Syndrome is sometimes called 'burnout', 'staleness', 'state of chronic fatigue', or 'unexplained under performance syndrome'<ref name="OTPhysioReview"/>. The 'Overtraining' part of Overtraining Syndrome is somewhat of a misnomer, as generally the causes lie as much with poor recovery and non-training stresses<ref name="OTAdjust"/><ref name="OTPhysioReview"/>. Overtraining Syndrome is estimated to effect 65% of competitive long distance runners at some point<ref name="OTIncidence"/>. While some levels of Overtraining Syndrome can be easily overcome, extreme Overtraining Syndrome can take years to recover from. The elite marathon runner [http://en.wikipedia.org/wiki/Alberto_Salazar Alberto Salazar] suffered from Overtraining Syndrome that lasted for 10 years<ref name="OTDepression"/>. Stories from China suggest that Overtraining Syndrome has been an issue for at least 1500 years<ref name="OTChina"/>. While there is a lot of research around Overtraining Syndrome, there is no common or consistent terminology, nor is there a clear standard for the diagnosis of Overtraining Syndrome<ref name="OTEcssPos"/>.
=Overtraining and Overtraining Syndrome=
[[Overtraining]] does not always result in Overtraining Syndrome. A short period of mild [[Overtraining]] can be part of [[Overload]] training, which can result in improved performance. Acute [[Overtraining]] tends to produce [[Too Much Too Soon]] and a lack of active recovery can produce [[Overuse]] injuries. However, Overtraining Syndrome involves a decrease in performance and usually has negative [[Mood State]] changes. Because Overtraining Syndrome is the balance between all stresses (training + life stress) and recovery from all stresses, it can affect even lower volume athletes.
==Overtraining Syndrome Subtypes==
''Main Article [[Overtraining Syndrome Subtypes]]''
Overtraining Syndrome has been categorized into subtypes based on the associated symptoms<ref name="OTAdjust"/>. The subtypes are similar to those seen in the [http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders DSM] [http://en.wikipedia.org/wiki/Adjustment_disorder Adjustment Disorder] and [http://en.wikipedia.org/wiki/Major_depressive_disorder Major Depression]. These types include "Overtraining with depression", "Overtraining with anxiety", "Overtraining with disturbances of conduct", and others. Personally, I believe that Overtraining Syndrome should be called ‘Training 'Training Related Major Depression’ Depression' due to the overwhelming similarity with other types of Major Depression.
=Causes of Overtraining Syndrome=
''Main Article [[Causes of Overtraining Syndrome]]''
[[File:Supercompensation-continued-overtraining.png|right|thumb|500px|This chart shows how low life stresses allow for good recovery, resulting in [[Supercompensation]] and improved performance. The same training stresses combined with other life stresses increase the impact of training and reduce the recovery between exercise bouts.]]
While Overtraining Syndrome involves training stress, the real cause is lack of recovery from training and other stresses. Stresses can be categorized as physiological, psychological and social in origin<ref name="OTAdjust"/>. All the causes except [[Training Monotony]] are also symptoms, which make them particularly problematic as they tend to be self-reinforcing, creating a positive feedback cycle. There are several proposed [[Mechanisms of Overtraining Syndrome]], but none have widespread acceptance or scientific support<ref name="OvertraingInSport"/>.
* '''Training monotony'''<ref name="OTEcssPos"/><ref name="OTDepression"/><ref name="OTMonotony"/>. Overtraining Syndrome is an imbalance between training and recovery which can be measured as [[Training Monotony]]. [[Training Monotony]] is simply a measure of similar each workout is. Having a mixture of hard workouts and easy days (or rest days) reduces monotony and allows for good recovery. It seems that athletes can train remarkably hard provided they have sufficient recovery. Therefore, training hard every day or even having easy days that are not sufficiently easy appears to be a primary cause of Overtraining Syndrome.
* '''Poor performance''' due to Overtraining Syndrome can often create additional stress. All too often an athlete responds to Overtraining Syndrome by believing that they are not training hard enough, and so work harder. If an athlete becomes aware of Overtraining Syndrome by failing in competition this can be emotionally devastating<ref name="OTDepression"/>. One study<ref name="OTHighSchool"/> of high school athletes noted the negative sporting experiences can create feelings of inadequacy, helplessness, hopelessness, and lead to major depression.
* '''Infection or illness'''<ref name="OTEcssPos"/><ref name="OTDepression"/>. An illness or infection puts additional stress on the body. If the athlete continues to train with an illness this can dramatically increase the stress of training.
* '''Poor diet'''<ref name="OTEcssPos"/><ref name="OTDepression"/>. Reduced calorie intake also reduces our ability to recover and deal with stress, both training stress and non-training stress. A poor quality diet that is lacking in essential nutrients can also have a negative impact on recovery. To Two particular deficiencies to note are [[Magnesium]]<ref name="OTEcssPos"/> and Iron<ref name="OTEcssPos"/>. A symptom of Overtraining Syndrome is reduced appetite, making the quality of the diet worse.
=Symptoms and Detection=
''Main article: [[Overtraining Syndrome Symptoms]]''
* '''Infection or illness'''<ref name="OTPhysioReview"/><ref name="OTEcssPos"/><ref name="OTAdjust"/>. Like a major depression, Overtraining Syndrome tends to suppress the immune system resulting in more infections, illnesses, and a slower healing of minor cuts<ref name="OTAdjust"/><ref name="OTPhysioReview"/>. However, many of the symptoms of Overtraining Syndrome could be due purely to an illness, so it can be unclear if the illness is a symptom of Overtraining Syndrome or the symptoms of Overtraining Syndrome are actually just symptoms of the illness.
* '''Insomnia or disturbed sleep'''<ref name="OTPhysioReview"/>. Overtraining Syndrome tends to interfere with sleep, which in turn impairs recovery and rest, leading to a positive feedback cycle.
* '''Unexplained [[Weight Loss|weight loss]]'''. Changes in [[Mood State]] can often result in a loss of appetite leading to a drop in body weight. =Alternative explanation of the symptoms =
There are various other problems that could cause the symptoms of Overtraining Syndrome<ref name="OTEcssPos"/>. Because these problems share the symptoms of Overtraining Syndrome, diagnosis of Overtraining Syndrome typically requires a process of elimination.
* Infectious diseases, such as hepatitis or glandular fever (AKA mononucleosis or simply mono).
* Eating disorders such as anorexia nervosa or bulimia.
* Anemia or other severe nutritional deficits.
=Recovery=
''Main article: [[Recovering from Overtraining Syndrome]]''
* Because there is no clear diagnostic for Overtraining Syndrome, it is difficult to determine when recovery has occurred. One metric that should be focused on should be [[Mood State]] and enthusiasm for training.
* A reduction in training load is required, and this often needs to be a dramatic reduction. While complete rest may be warranted, this could be counterproductive<ref name="OTPhysioReview"/>. Given the importance of [[Training Monotony]], it seems reasonable to include greater periods of recovery. Rather than complete rest, I would recommend light training every other day, alternating with complete rest. The light training should be limited in duration, and should only be as much as is enjoyable.
* Rest time should be more than simply not training. Instead, some of the time freed up due to the reduction in training load should be dedicated to focused relaxation, such as gentle yoga[[Yoga]], meditation or times of prayer.
* Extra sleep<ref name="OTPhysioReview"/> is likely to be required for recovery.
* Diet is an important part of recovery. The correct calorie balance and a diet with a balanced ratio of carbohydrates/[[Protein|protein]]/fat is highly recommended<ref name="OTPhysioReview"/>. The change in training load requires that the diet is carefully evaluated.
* There are reports of successfully treating [[Overtraining Syndrome]] with [http://en.wikipedia.org/wiki/Noradrenergic_and_specific_serotonergic_antidepressant serotonergic antidepressants]<ref name="OTMentalStigma"/> and [http://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor SSRI antidepressants] <ref name="OTDepression"/>.
=Prevention=
Obviously , prevention is better than cure, but there is currently no known way of preventing Overtraining Syndrome for an athlete who wishes to training optimally.
* Individual variability means there is no clearly defined way of preventing Overtraining Syndrome<ref name="OTPhysioReview"/>. What works for one athlete may cause Overtraining Syndrome in another athlete.
* It's been said that you can't control what you can't measure. Therefore keeping a record of training is a core part of preventing Overtraining Syndrome. See [[The importance of a training log]]. A GPS watch with a [[Heart Rate Monitor]] to accurately record training stresses combined with a training log the provides a long-term record.
* Measure [[Training Monotony]], which is a key cause of Overtraining Syndrome<ref name="OTEcssPos"/><ref name="OTDepression"/>.
* Establish and maintain a good social network as support group<ref name="OTPhysioReview"/>.
=Training monotony=
''Main article: [[Training Monotony]]''
It is long been recognized the athletes cannot train hard every day. Modern training plans recommend a few hard days per week, with the other days as easier or rest days. A lack of variety in training stress, known as [[Training Monotony]], is considered a key factor in causing Overtraining Syndrome<ref name="OTEcssPos"/><ref name="OTDepression"/>. There is also evidence<ref name="variabledose"/> that increased training frequency results in reduced performance benefits from identical training sessions as well as increased fatigue.
=References=
<references>