The Overtraining Syndrome

by Dr. Phil Maffetone

A lot of good published research exists about overtraining. Unfortunately, there is not a lot of agreement on how it should be defined. I'd prefer a more clinical definition so it's useful for all runners rather than a technical one that scientists can debate about.

Overtraining is easy to recognize in its chronic state when exhaustion, poor performance, depression and other clear problems are evident. However, it's more important to identify earlier warnings about overtraining to avoid more serious problems later. I look at the full spectrum of overtraining which can be seen as three phases.
Overtraining comes with many potential structural, chemical and mental problems, often intermingled to create any number of diverse signs and symptoms. As such, calling this problem an overtraining syndrome may be more appropriate.

Most would agree that the overtraining syndrome is associated with too much training volume, and/or too much intensity. I think of overtraining as a state that occurs when there is an imbalance in my simple formula: Training = workout + recovery. Without proper recovery, including rest, even low intensity training may result in overtraining. By including recovery, factors other than training and racing, including any lifestyle stress, become part of the equation. For example, if your work hours are high and you don't get enough sleep, it can impair training recovery.

STAGE ONE

By recognizing the earliest onset of this problem, it becomes clear overtraining is very common. Unfortunately, most runners won't admit to being overtrained until the last stage. The first stage of overtraining may blend with the normal overreaching -a normal part of training where you ride slightly beyond your ability to force your body to adapt and improve. However, a fine line exists between overreaching and overtraining. If overreaching results in an injury, even a very minor one, or one not clearly defined (that elusive knee discomfort that comes and goes), you may have gone beyond healthy training into overtraining.

Other elusive symptoms may begin at the first stage of overtraining: fatigue, blood sugar handling problems (abnormal cravings for sweets and hunger, shakiness if meals are delayed), menstrual or other hormonal imbalances, mental/emotional stress or anxiety, slight dizziness upon standing, or elevating heart rate. While these symptoms may be due to other dysfunction, they often share some common denominators with this stage of overtraining.

Recognizing stage one overtraining may be more easily done by evaluating your aerobic training improvements using a heart rate monitor. For example, if you've progressed from nine minutes a mile at 150 heart rate to eight minutes a mile at the same heart rate, that's good progress. But if suddenly you revert back to a nine minute pace, or slower, at the same heart rate, it typically indicates overtraining.

These early more subtle problems may not adversely effect your race. In fact, late in this first stage performance improvements, oddly enough, are sometimes sudden and dramatic improvement in race times. However, this also may mean the beginning of the end of your race progress as worsening time may follow.

The first stage of overtraining may also be accompanied by abnormal hormone levels, which are easy to measure. Cortisol, a key adrenal hormone, begins to increase, often only during certain times of the day or night. Reduced testosterone and DHEA may accompany the increased cortisol.

Any clue that overtraining has begun should be followed with an assessment of your training and racing schedule. Reductions in volume and/or intensity can usually quickly remedy stage one overtraining. Other lifestyle stress should also be considered and remedied as necessary. If overtraining is not corrected here, you may enter the second stage of overtraining.

STAGE TWO

This stage of overtraining is more recognized. Classic signs and symptoms include an elevation of the resting and training heart rate, and often aggravation of the symptoms from stage one.

Performance reductions are more evident in this stage, as are symptoms such as fatigue, feelings of depression and sleeping problems (typically, you fall asleep easily but wake in the middle of the night with difficulty getting back to sleep).

Hormone imbalance is now usually more dramatic, with an abnormally high cortisol and low testosterone and DHEA. This puts you in a catabolic state, making recovery much more difficult. In addition, immune system function is reduced resulting in more frequent colds, flu or other infections. Allergy or asthma may also be develop or exacerbate.

The second stage of overtraining can last a long time. If the problem is not remedied, typically through reductions in training and racing volume and training intensity, a runner may enter the third stage of overtraining.

STAGE THREE

This is a chronic condition with more serious physiological and psychological ramifications. Often, this includes a career-ending physical injury or other serious chemical or mental problem. In a sense, the body has given up its fight against overtraining stress. Hormone levels are abnormally low, with cortisol reversing its elevated levels. The sympathetic nervous system also is reduced as reflected in an abnormally low resting heart rate. Runners in this stage are usually not racing due to very poor performance and injury, with exhaustion and depression common. Going out to train is no longer fun. Even lactate response is low.

Unlike the first two stages, recovery from the third stage of overtraining is a much longer and more difficult process. Runners often have to cancel a whole season and focus on getting healthy, often with the help of a professional.
Recognition of the overtraining syndrome in its earliest stage is essential to avoid the anguish of this common and unnecessary problem. The remedy may be as simple as reducing training and racing volume, and training intensity. Not only can stress come from running, but other lifestyle factors can add to the overtraining syndrome.

Dr. Philip Maffetone practiced complementary sports medicine and applied kinesiology for over 20 years. His extensive background in biochemistry, kinesiology and exercise physiology has helped him train many world class and professional athletes. He has a doctorate degree in chiropractic and is certified in acupuncture. Some of the athletes he worked with include Mark Allen, Mike Pigg, Priscilla Welch and Lorraine Moller. Dr. Maffetone was named Coach of the Year in 1996 by Triathlete Magazine. His books include In Fitness and In Health and Training for Endurance, and he is currently President of the MAF Group, which publishes the Maffetone Report (877-264-2200, www.philsbar.com).