By LAURA QUAGLIO
Are you giving workouts your all but getting less in return—or even backsliding? Does it seem like you’re always battling bronchitis, tendonitis, or another “itis”? Or maybe your usual over-the-top enthusiasm for workouts has faded to “barely there.”
These are just a few possible signs of overtraining syndrome (OTS), and you don’t have to be a competitive athlete to develop them.
Here, we’ll explore what OTS is, why it is so difficult to “diagnose,” the series of symptoms that can serve as warning signs, and some ways to help the body heal and return to former performance levels.
*This blog will cover many aspects of overtraining, but to get the full story, the NASM CPT program can provide much more context.
WHAT IS OVERTRAINING?
In the new edition of the NASM Essentials of Personal Fitness Training (7th ed., Jones & Bartlett 2022), overtraining syndrome is described as “a condition in which an athlete or fitness client experiences fatigue, declining performance, and burnout ” (Sutton, 2022).
Overtraining can be associated with any type of sports or fitness program—from running to group exercise to resistance training—and it can happen at any age. In 2007, pediatricians noted an uptick in OTS among children and teens who participate in competitive sports (Brenner, 2007).
As with many things, overtraining can be envisioned as a continuum—ranging from the occasional day of “overdoing it” to a chronic state of under-recovery lasting for weeks, months, or even years. This is one reason some people continue to question its very existence, even as others suffer from its ill effects.
HOW TO AVOID OVERTRAINING
People who have overtrained in the past are more likely to overtrain in the future. To help avoid going down that road, here are a few things to consider before beginning any workout :
- Did you sleep well last night?
- Was your a.m. resting heart rate regular (for you)?
- Have you taken in enough nutrition and fluids today?
If the answer to any of these questions—or multiple questions—is “no,” it’s an excellent day to dial things back. Still not sure if it’s a good day to go all in? Consider these queries, too:
- Are you battling any major life stressors?
- Are you dreading the workout or thinking about skipping it?
- Do you feel more sore or achy than usual?
- Do you have an illness or injury?
Here, a “yes” answer is a good indicator that your body’s not in top form today.
Bottom line: If athletes don’t make time for rest, their bodies and brains will force them to. Or (on a more positive note): The sooner you identify and address symptoms of overtraining, the quicker you’ll recover, so you can get back to doing what you love.
19 POSSIBLE SIGNS OF OVERTRAINING
Most people have felt tired, sore, and stiff after an exercise session, particularly when trying something new or increasing workout intensity, volume, or another variable. Some of these symptoms begin a few hours after a workout session, but they resolve within a few days.
As mentioned, this is the body’s alarm reaction, but it’s not cause for concern. After a bit of rest, recovery, and refueling, the athlete will typically feel refreshed and ready to tackle their next workout (Sutton, 2022; Davis et al., 2020).
Symptoms of overtraining, however, last longer and are more varied. They may include:
EXERCISE-RELATED SYMPTOMS OF OVERTRAINING:
(1) A plateau or decline in workout performance or progress.
(2) A perception of increased exertion during “normal” or “easy” workouts.
(3) Excessive sweating or overheating.
(4) Unusual feelings of heaviness, stiffness, or soreness in muscles.
(5) A lack of feeling “refreshed” after regular rest and recovery.
(6) Recurrent injuries, such as muscle sprains, tendonitis, stress fractures, and chronic joint pain.
(7) A decline in enthusiasm for exercise (or skipping or quitting workouts).
PHYSICAL, MENTAL, AND EMOTIONAL CHANGES DUE TO OVERTRAINING:
(8) Persistent feelings of fatigue, exhaustion, or low energy throughout the day.
(9) A decline in motivation and/or self-confidence.
(10) A lack of enjoyment in favorite hobbies and interests or other signs of depression.
(11) Unusual mood or emotions, such as agitation, anger, confusion, irritability, and restlessness.
(12) New problems with sleeping, including insomnia and poor sleep quality.
(13) Problems with concentration and performance at work or in school.
SYSTEMIC HEALTH CONCERNS OF OVERTRAINING:
(14) A sickly appearance, including changes to skin, hair, and nails (such as acne or hair loss).
(15) An increase in resting heart rate and/or resting blood pressure.
(16) Unplanned/undesired weight loss or weight gain or disordered eating.
(17) Digestive issues, such as constipation, diarrhea, loss of appetite, and increase in thirst.
(18) Reproductive issues, such as a decrease in libido (sex drive) and a change in menstruation (including irregularity or cessation of periods).
(19) Repeated bouts of illness, such as colds and upper respiratory tract infections.
(Budgett et al., 2000; HHS, 2017; Kreher & Schwartz, 2012; Kendall-Reed & Reed, 2020)
Interestingly, while OTS has historically been identified by the first two factors listed—underperformance and a sense of increased exertion—recent research indicates that watching for a cluster or constellation of symptoms can be more helpful at spotting OTS in its early stages (Cadegiani et al., 2020).
Note: Because many of the signs of overtraining can mimic those of health conditions (such as asthma, anemia, depression, and diabetes), it’s essential to talk to a healthcare practitioner about any new or unusual symptoms as they arise.
Athletes may also benefit from understanding a rare but life-threatening condition called rhabdomyolysis, which can result from a single workout that is intense enough to cause muscle fibers to rupture, setting off a dangerous biochemical chain reaction in the body. One of the hallmark signs of rhabdo is brown urine, like iced tea or cola (Cannon, 2019). Learn more here.
TOOLS FOR IDENTIFYING OVERTRAINING
While the above checklist can be a helpful guide (or wake-up call), it is somewhat subjective. Athletes may ignore or deny specific symptoms—or they may believe their health issues are less persistent, frequent, or severe than they are.
This can be especially true for those prone to exercise addiction or whose career or identity are connected closely to their workouts. The point here is that more objective measures can be helpful, as well.
Researchers, healthcare providers, and fitness professionals may suggest lab testing such as blood tests to measure levels of nutrients (like electrolytes or iron), hormones (like cortisol, thyroid, and testosterone), or other factors (like blood count and signs of inflammation).
However, there are some easier ways athletes can quantify how they’re doing in comparison to previous weeks or months. Here are a few.
FITNESS JOURNAL AND/OR APP
Keeping a detailed record of workouts (including amount resistance/weight, timing, and number of sets/reps, etc.) makes it easier to compare current and past performance. If desired, athletes can also record information on sleep, nutrition, injury, illness, and other metrics.
High-tech (apps, smartwatches, tracking programs) and low-tech (a handwritten journal) both work. Participants should select whatever method they are most likely to adhere to.
PERFORMANCE ASSESSMENTS
Engaging in periodic assessments can provide a helpful baseline for comparison. This is something certified personal trainers do when first meeting a client and then repeat regularly after that. It’s ideal to take measures of cardiorespiratory fitness, strength, and endurance.
Examples of simple assessments include timing a 1-mile run or counting how many pushups can be performed before form breaks down (NASM, n.d.). (Find additional performance assessments here.)
You can also find a resource on initial fitness consultations and movement assessments by following the respective links.
RATINGS OF PERCEIVED EXERTION
The rating of perceived exertion associates different exertion levels with numbers on a scale from 1 to 10 (or 1 to 20). Exercisers can use this during any part of any workout. The number chosen should reflect on how the person feels overall. Recording these results can assist in spotting changes in perceived exertion that may be related to overtraining.
HEART RATE AND BLOOD PRESSURE
Resting heart rate is generally lower for more conditioned people; however, it is likely to rise when an athlete is overtraining.
Many fitness watches monitor pulse automatically, making it easy to measure RHR, but it’s also easy to manually measure the pulse at the wrist. (Count beats for 10 seconds and multiply by 6 to get beats per minute.) It is ideal to take measurements just before getting out of bed in the morning.
Overtraining can also cause a rise in resting blood pressure, which you can track at home. A healthcare provider can suggest a reliable brand of monitor and explain ideal targets, as these differ from person to person (Sutton, 2022 ).
Recovery heart rate—heart rate immediately after exercise—may also be impacted by overtraining. This is used to observe how long it takes for an exercise-elevated heart rate to return to normal resting levels.
Fit people generally experience a quicker return to normal heart rate than those who are not conditioned. If this recovery rate begins to take longer than usual, it may be a sign of deconditioning (Sutton, 2022 ).
RISK ASSESSMENT
As previously indicated, overtraining does not happen only due to overdoing it during workouts or underprioritizing recovery. Seemingly unrelated factors can also make a person more likely to become overtrained.
This can include following a monotonous program, participating in only one activity or sport, having a recent illness or injury (even if it has resolved), having recently participated in a competitive event or extreme workout session (such as a black belt test), experiencing a significant life event such as a move, death, divorce, job loss or job change, or even something positive like the birth or adoption of a child.
Environmental conditions such as altitude, temperature, humidity, and even a time zone change can also impact the body’s recovery from training. The more factors present, the more likely the athlete will need to adjust their training program to avoid overdoing it (Kendall-Reed & Reed, 2020).
HOW TO RECOVER FROM OVERTRAINING
The requirements necessary to restore its equilibrium will differ from person to person. Of course, it will take longer for a person to recover from overtraining syndrome than from a short period of overreaching.
When overtraining is prolonged or recurrent—or when the body’s symptoms include system-wide changes—the best course of action is enlisting the help of a team of healthcare and fitness professionals. Here are some key pillars of recovery that they will likely address:
REST
It may be best to stop training entirely for at least a week and cancel upcoming competitions or events in severe cases. Many athletes may see improvements by merely reducing their training by 50 to 80 percent.
This does not mean that light activity (such as walking or household chores) is necessarily off-limits unless a physical illness or injury requires even greater rest (Cleveland Clinic, 2020; Stryker, 2016).
Active recovery workouts are a great way to incorporate rest – and at the same time – facilitate recovery.
SLEEP
Most American adults fall short of the 7 to 9 hours of sleep per night recommended by the National Sleep Foundation. These needs may increase when a person is recovering from overtraining or simply after a challenging workout or series of workouts.
Good sleep hygiene begins with choosing a time to go to sleep and a time to wake up, then sticking to them consistently, even on weekends. To learn how to create habits that will set make it easier to fall and stay asleep, the NSF’s website (NSF, 2020; Lastella et al., 2018).
FUEL
Often, people who are seeking to reduce bodyweight will reduce caloric intake to the point at which there is not enough nutrition available for recovery. For example, the body needs adequate protein intake for muscle protein synthesis (rebuilding muscles at the molecular level) to occur (Sutton, 2022).
Also of interest is the recent increase in the daily recommendation for fluid intake. Today, 11.5 cups per day are recommended for women and 15.5 for men. After exercising for more than an hour, another 12 to 16 ounces per 15 minutes is recommended (Sutton, 2022).
The NASM Nutrition Coach Certification explains things like how to take in enough macronutrients (protein, carbohydrate, fats) and when to time meals and snacks to maximize recovery.
TREAT
If an illness or injury is present, these should be assessed and addressed before return to sport. Depending upon the type of injury, the athlete may need to modify workouts, make adaptations to exercises, or cross-train in other areas until they have healed. Again, a healthcare professional can best guide these areas of recovery.
“Treatments” can also include using tools and strategies that have been proven to aid in recovery, such as water immersion, compression garments, massage, active recovery, and self-myofascial release (e.g., using a foam roller).
RETHINK
Downtime provides an opportunity for exercisers to take a closer look at their training program. Even though OTS is not caused by workouts alone, it can be reduced with evidence-based programming. For example, NASM recommends adopting an integrated training program, which includes “all forms” of exercise (balance, cardio, core, flexibility, plyometrics, resistance, and speed-agility-and-quickness training).
It’s also vital to use a systematic and progressive approach like the NASM OPT model, which begins with the mastery of fundamental movement patterns (essential everyday motions). Together, integrated, systematic, and progressive approaches can help prevent injury and overtraining while maximizing results (Sutton, 2022 ).
IS OVERTRAINING SYNDROME REAL?
Even those overtraining syndrome is a prevalent force in the fitness world, why has OTS sometimes been treated with the same skepticism as UFOs?
- First, there is no test “that” can definitively diagnose overtraining syndrome.
- Second, there’s no consensus on the observable and measurable changes that should be used to identify OTS. In a recent comparison of 22 studies on resistance exercise, the OTS marker that every research team agreed upon was a “sustained decrease in performance” (Grandou et al., 2020).
These two facts have led some experts to suggest renaming it “paradoxical deconditioning syndrome” or “unexplained underperformance syndrome.” Further, many researchers have argued that including the word “overtraining” in the name implies that the root cause always lies in the workout program. However, it is now believed OTS results from an accumulation of factors, many outside of exercise sessions.
This more complex viewpoint is reflected in the NASM textbook’s definition of overtraining as “excessive frequency, volume, or intensity of training, resulting in a reduction of performance, which is also caused by a lack of proper rest and recovery” (Sutton, 2022).
This article will use the term overtraining, which remains the most familiar among the general population. Let’s begin with a look at the spectrum of physiological changes resulting from exercise.
ADAPTATION VS. OVERTRAINING
For an athlete to achieve their exercise goals—whether they are related to appearance, health, strength, performance, or a combination of these—a stimulus or stressor has to be introduced to the body repeatedly over time. This will result in specific adaptations that are related to that stressor.
This response is known as general adaptation syndrome. Once the body can meet the new demands of that stressor, an additional or different stimulus will need to be applied for the athlete to make further progress.
Part of the art and science of fitness programming involves understanding how to select stressors appropriate to the athlete’s goals and progress them safely . (NASM Certified Personal Trainercourse provides essential foundational knowledge in this area, and the course is available to everyone, including fitness enthusiasts who are not pursuing a career in the industry.)
THE THREE STAGES OF GENERAL ADAPTATION SYNDROME
The general adaptation syndrome model includes three stages in which the body reacts to a stressor:
• alarm reaction (the body’s initial response, such as fatigue, joint stiffness, and/or delayed-onset muscle soreness).
• resistance development (the body’s adaptation to the stressor after repeated sessions).
• exhaustion (a distressed state that results from exposure to “prolonged” and/or “intolerable” stressors).
Exhaustion can result in ongoing fatigue that can lead to pain, injury, and (in time) harmful changes to the body’s organ systems and processes. Thus, the ideal exercise approach involves progressive overload, in which the intensity or volume of exercise is increased gradually and systematically to avoid exhaustion and while achieving the desired adaptations.
The phased approach of the NASM Optimum Performance Training™ model is designed to help exercise participants work toward their goals in a systematic, safe way. It is based on a multistage, multiphase approach that assesses athletes’ current state and works from there to build strength, balance, integrated movement, flexibility, and other improvements.
Rick Richey, MS, NASM-CPT, and Master Instructor provides an overview in The NASM-CPT Podcast: Introducing the OPT Model, available as an audio file and a written transcript.
OVERTRAINING VS. OVERREACHING
Many fitness enthusiasts will exercise to excess now and then—for example, when engaging in a competitive event or returning to sport after an extended break. But when overzealous workouts lead to fatigue and a decrease in performance that lasts for a few weeks, it is referred to as overreaching.
When followed by enough recovery, this can improve performance, as the body will “super-compensate” after the rest period; this is known as functional overreaching. Nonfunctional overreaching happens when the body does not enjoy the rest and recovery necessary to repair and regenerate before the next workout.
While overtraining and overreaching sound similar, NASM 2022 notes that “the subtle difference has to do with the amount of time for performance restoration, not the type or duration of training stress .”
• Functional overreaching results in underperformance for a few days, followed by a full recovery.
• Nonfunctional overreaching results in underperformance that lasts up to three weeks and is followed by a full recovery.
• Overtraining syndrome is characterized by two months or more of underperformance. Recovery from OTS can take months or even years.
Sometimes, damage caused by OTS can be so severe that the athlete may not be able to return to that sport (Cadegiani et al., 2020).
Fortunately, by learning to identify overtraining symptoms early, athletes can stop their slide down this slippery slope rather than downplaying or pushing through them.