Overtraining Syndrome: Signs Symptoms and How to Deal With It

Personal trainers who work with athletes or those involved in long term intense exercise programs need to be aware of a condition called overtraining syndrome. I feel this condition may be under diagnosed in the fitness industry because of hard core, boot-camp type workouts which have grown in popularity over the past few years. Let me now present an overview of what overtraining syndrome is and then give personal trainers some ideas on how to recognize it and minimize its impact on exercise.

What Is Overtraining Syndrome?

Over-training syndrome is a condition that occurs when the body is subjected to high amounts of daily intense physical activity without adequate time to rest and recuperate.  Any physical activity that occurs over a long enough period of time (training for a marathon for example) can cause overtraining, which is marked by a number of symptoms that may appear strange to people.

Note that over-training is different than overreaching which is more of a short term thing.  Over-training takes time – weeks to months before it becomes apparent.  constant overreaching can lead to overtraining however.

Overtraining Syndrome Signs and Symptoms

Overtraining syndrome can be difficult to identify because the signs and symptoms of the disorder can vary between persons.  Laboratory tests check for the presence of various biomarkers. For example, creatine kinase (CK), a marker of tissue damage and C reactive protein (CPR), an indication of systemic inflammation may be elevated in some individuals.

While controversial, some research has noted reductions in luteinizing hormone and testosterone have also been reported in people with overtraining syndrome. Still over evidence links exercise overtraining to reduced semen quality.  This might reduce the ability to conceive.

Obviously, testing for CK, testosterone and luteinizing hormone is beyond the capability of personal trainers.  Fortunately, there are some “visual signs” that personal trainers can relatively easily detect which may give a good indication as to whether the condition is occurring.  In general, people who have a majority of these obvious symptoms are usually diagnosed with overtraining syndrome.

One of the first signs of overtraining syndrome that is usually noted is a change in mood or behavior.  For example, people who are usually outgoing and nice tend to become short tempered and depressed. They sometimes eat less and may also have a reduced sex drive.

Obviously personal trainers would not know about a reduced sex drive unless this issue was brought up.

Both muscle strength and muscle endurance are reduced when exercise over-training occurs.  This often causes the person to work even harder in the gym – which causes them to slide down hill even faster! Related to his, there is often a reduced appetite and lean body mass. The loss of muscle mass is likely related -in part – to both reduced intake of nutrients (loss of appetite) and loss of strength and endurance.

Another very common symptom of overtraining syndrome is an increased resting heart rate.  Normally exercise tends to reduce resting heart rate (RHR) but with overtraining, resting RHR is elevated.

The increased RHR may be due to a reduced cellular sensitivity to adrenalin (epinephrine). As the cells become less sensitive to adrenalin, the body makes more of it to overcompensate –  which in turn results in elevations in resting heart rate (and blood pressure). Athletes and serious fitness enthusiasts should be encouraged to keep a log of their resting heart rate to help identify this condition.

Tip. A normal resting heart rate for healthy adults can range from 60 beats per minute to 100 beats per minute.  Take resting heart rate regularly  – once a week for example – and cut back on exercise intensity and frequency if you notice the heart rate increased by 5-10 beats between checks.

For well over 100 years scientists have known that exercise can impact how well the immune system works. While moderate exercise – a few days per week – can improve the immune system, overtraining syndrome often results in a reduce immune system and more infections. Thus, the person who seems to be getting sick every week or so may be overtraining.

Tip. Because the immune system can alter how well the immune system works, fitness trainers need to think about this fact when they work with people who have autoimmune disorders like arthritis – and even AIDS / HIV.

This is VERY important.

People who are training too much often have trouble sleeping so insomnia may also give the personal trainer an indication of overtraining syndrome.

In extreme cases it may take up to a year to correct over-training syndrome.  Currently the only accepted way to recover from the condition is cut back significantly on exercise, something most active people do not want to do. I suggest, reducing exercise frequency and intensity to about 40% of normal until symptoms subside. Keep track of resting heart rate and cold/flu symptoms to monitor progress.

Overtraining syndrome common signs and symptoms

• Increased RHR
• Decreased immune system
• Inability to sleep
• Mood changes
• Decreased exercise performance
• Loss of coordination
• Loss of muscle strength
• Loss of muscle and cardiovascular endurance
• Reduced appetite
• Constant fatigue
• Exercise -induced rhabdomyolysis
• Elevated blood pressure

Causes of Overtraining Syndrome

Over the years there have been several theories advocated as “the cause” of over training syndrome.  For example, the glycogen hypothesis proposes  that the characteristic muscle fatigue so often associated with the condition is the result of decreased muscle glycogen levels.

The central fatigue theory, speculates that increased tryptophan in the brain causes fatigue. The increased rate of infections – another common sign of overtraining, is sometimes explained by the glutamine hypothesis which proposes that the reduced glutamine levels impede the immune system’s ability to battle infections.

Glutamine supplements are very popular in fitness however before personal trainers discuss this supplement, they should be aware of the glutamine research.

The tissue trauma theory says that muscle damage following intense activity with lack of enough rest is the cause of over training syndrome.

While all major theories explain aspects of this condition, so far, the primary underling reason of the over-training syndrome remain unknown.  It’s likely a result from all of these theories – and other factors that have yet to be discovered.

While overtraining syndrome is typically seen in professional athletes it can impact anyone who takes physical activity to extreme levels. In theory, popular exercise programs (P90X, Insanity, CrossFit) might also contribute to this.   Group fitness instructors who teach several classes a day on a regular basis may be a particular group where over-training  syndrome is under diagnosed. What constitutes “extreme” is different for everyone which makes identifying overtraining syndrome all the more challenging. Only by educating people and keeping an eye out for its more obvious signs can we keep this syndrome from occurring.

What do you think?