Lecture Series: Overtraining Syndrome

Overtraining Syndrome has in the past been called; burnout, staleness, failure adaptation, underrecovery, training stress syndrome, and chronic fatigue. European College of Sport Science Overtraining Syndrome Position Statement main points to remember are to avoid the combination of excessive overload plus inadequate recovery and identification of initiating events or triggers. There is a fine line between maintaining peak performance and overtraining, so it is important to know your body’s limits. With overtraining syndrome there is an increased risk of stress fractures and tendinitis.

The more common symptoms of overtraining syndrome in aerobic sports are fatigue, depression, bradycardia, and loss of motivation. The more common symptoms in anaerobic sports are insomnia, irritability, agitation, tachycardia, hypertension, and restlessness. Other possible symptoms are anorexia, weight loss, lack of mental concentration, heavy/sore/stiff muscles, anxiety, and awakening unrefreshed.

Overtraining can affect your performance with early fatigue, increase heart rate with less effort, decrease strength, endurance, speed, coordination, and aerobic capacity, and delayed recovery. Some of the generic physiological symptoms are persistent fatigue, chronic muscle soreness, loss of appetite, excessive weight loss, excess loss of body fat, irregular menses, increased resting heart rate, increased overuse injuries, difficulty sleeping, and frequent colds or infections. Some of the generic psychological symptoms are irritation/anger, depression, difficulty concentrating, increased sensitivity to emotional stress, loss of competitive drive, and loss of enthusiasm. All the physiological and psychological symptoms are similar to eating disorder symptoms; therefore, be careful diagnosing an eating disorder without ruling out overtraining syndrome.

To take a quick tangent, the psychological reaction to injury is described by the Kübler-Ross model aka Five Stages of Grief, which are denial/disbelief, anger, bargaining, depression, acceptance. As a Certified Athletic Trainer I have seen athletes and dancers go through all five stages for any type of injury. How long they stay in each stage is up to them. I worked at a high school in Texas when a football play tore is ACL. It was sad to watch this Senior miss the rest of the football season and his high school career for an injury. I watched him go through the first 4 stages with difficulty, but I never saw him reach the acceptance stage.

There can be a normal, overreaction, and underraction emotional reaction for anyone when injured or overtraining syndrome. The outward sign normal emotional reaction is weakness, trembling, nausea, vomiting, perspiration, diarrhea, fear, anxiety, and heart pounding. The overreaction can be manifested with excessive talking, argumentative, inappropriate jokes, and hyperactivity. And the underraction would be depression, little talking, emotionless, confusion, and failure to respond to questions. The emotional first aid to the normal reaction would be to be calm/reassuring and avoid pity. The first aid to the overreaction is to allow them to vent emotions and avoid telling them they are acting abnormally. And the care for someone with an underraction is to be empathetic, encourage talking to express feelings, avoid being abrupt, and avoid pity.

Let’s talk about overtraining syndrome prevention and treatment, remember everyone responds differently. Make sure to rest and put in your schedule vacations and breaks. This is difficult for dancers since there is no pre/in/post season, it is mostly year round. A topic rarely mentioned in dance is periodization (I will discuss this in a future blog post). A high school dancer can have team practice before school, dance class in school, then technique classes at the studio after school, plus add in performances. With this crazy schedule and not taking Thanksgiving, Christmas, Spring break, or Summer off can lead to overtraining. When resting physically for a dancer that could mean only doing conditioning with the team or on days with no or short rehearsals. Also decrease intensity and volume or bike instead of run. During breaks or days off can be active recovery days. Active recovery is when you do something other than dance, but is fun. I know dancers who hike, which also helps mentally being in the mountains. I’m sure you have seen professional athletes play golf or a sport other than their own.

Another prevention and treatment topic is having good nutrition and hydration. Something I have noticed is that dancers forget to take snack/food breaks on long rehearsal days. Don’t forget to relax mentally by removing stress, meditate, massage, and possibly see a sports psychologist. An important treatment is identifying the factors that led to overtraining syndrome and correct them. Total recovery from overtraining can take several weeks/months, but if it does come back after returning to dance, then you didn’t solve the problem in the first place. It might be necessary to see a sports psychologist to help return to activity, especially identifying trigger factors and coping mechanisms.