When Training Becomes a Risk: The Hidden Pain of Overtraining

The fine line between strength and exhaustion

Introduction

Overtraining Syndrome (OTS) is a complex physiological and psychological disorder that arises from the body being exposed to prolonged periods of intense or repetitive training without sufficient time for recovery. This syndrome negatively affects physical performance, general health, and the psychological state of athletes. It represents a significant challenge in sports medicine due to the difficulty of diagnosis and the absence of standardized criteria for its measurement.

What is Overtraining Syndrome (OTS)?

It is a condition that occurs from excessive or high-intensity exercise for a long duration, so much so that it begins to harm the body. This condition often affects athletes, especially those who train for competitive purposes. It is important to give the body enough time to rest and recover after any intense physical activity, especially when trying to push the limits to improve performance in a specific sport or activity. Overtraining Syndrome causes physical symptoms and can also affect mental and emotional health. Therefore, you should consult a healthcare provider if symptoms such as pain, fatigue, and a sudden drop in performance appear. There are two main classifications for overtraining conditions:

• Overreaching

• Overtraining

What Is the Difference Between Overreaching and Overtraining?

Overreaching is characterized by a feeling of muscle soreness that is more than usual and occurs when there is not enough recovery time between workouts. It often happens after several consecutive days of intense training and leads to a feeling of general fatigue, but its effects can be easily reversed with rest. Overtraining occurs when an athlete ignores the signs of overreaching and continues to train. Some athletes believe that poor or decreased performance is an indicator of the need for more intense training, which pushes them to continue pushing themselves, and this leads to a greater deterioration in their physical condition.

Types of Overtraining Syndrome

Overtraining Syndrome is divided into three stages based on where it affects the body and the type of symptoms you experience:

• The First Stage of Overtraining Syndrome (Functional Overtraining): The first stage of OTS causes mild symptoms that may be difficult to notice or distinguish from the usual aches and pains after training. In this stage, your body sends warning signals that it is not recovering properly between activity sessions.

• The Second Stage of Overtraining Syndrome (Sympathetic Overtraining Syndrome): The second stage of OTS causes symptoms that affect the sympathetic nervous system, which is the part of your nervous system responsible for controlling your body's stress response, i.e., the "fight or flight" response. Some healthcare providers refer to the second stage of OTS as Basedow’s overtraining syndrome.

• The Third Stage of Overtraining Syndrome (Parasympathetic Overtraining Syndrome): The third stage of OTS causes symptoms in the parasympathetic nervous system, which is responsible for relaxing your body's systems. The third stage is usually the most severe and takes longer to recover from. Some healthcare providers refer to it as Addison’s overtraining syndrome.

Source: Overtraining Syndrome: Symptoms, Causes & Treatment Options

Prevalence of Overtraining Syndrome

Overtraining Syndrome is often seen in endurance sports such as swimming, cycling, and running, among others, but accurate data on the actual prevalence and incidence of OTS is not available. Estimates indicate that its prevalence at any given moment is up to about 10% in elite athletes in collegiate endurance sports (in a range of 7-21%). The incidence of Overtraining Syndrome in elite runners is close to 60%, and even among non-elite competitive runners, about one-third of them may experience OTS at some point in their athletic lives. Outside of running, the incidence rate is estimated to be around 30–40% among high-level athletes across various sports.

Source: Overtraining Syndrome - Physiopedia

Signs and Symptoms of Overtraining Syndrome

• Not eating enough food: Weightlifters who maintain an intense training schedule may also reduce their calorie intake. This can negatively affect health and performance. If your body is constantly relying on energy reserves, you may develop nutrient deficiencies such as anemia. More serious conditions can arise that affect the cardiovascular, digestive, and endocrine systems. Complications may also appear in the nervous and reproductive systems, including amenorrhea or irregular menstruation.

• Muscle pain, stress, and injuries: Pushing yourself beyond your limits during a high-intensity interval training (HIIT) workout can lead to muscle strain and soreness. Over-stressing the body can cause injuries and microscopic muscle tears (Microtears).

• Overuse injuries: Repetitive running may cause injuries such as shin splints, stress fractures, and plantar fasciitis. Overuse injuries also include joint strain, fractures, and soft tissue injuries. High-impact exercises such as running put stress and wear and tear on the body. If you have an injury, you must stop all forms of training to allow it to heal.

• Fatigue: It is normal to feel tired after exercise, but the fatigue associated with overtraining occurs when the body does not fully recover after exertion repeatedly. You may feel extremely exhausted, especially during or immediately after a workout. Fatigue can also appear when you do not get enough fuel before training, which forces the body to use its stores of carbohydrates, protein, and fat for energy production.

• Decreased appetite and weight loss: Exercise usually stimulates a healthy appetite, but overtraining may cause hormonal imbalances that affect the feeling of hunger or fullness. Overtraining Syndrome may cause fatigue, decreased appetite, and weight loss.

• Irritability and nervousness: Overtraining can affect stress hormone levels, which may cause depression, mental fog, and mood swings. You may also suffer from insomnia, poor concentration, or a loss of enthusiasm.

• Persistent muscle injuries or pain: Prolonged muscle pain and injuries that do not heal may be signs of overtraining. You may suffer from chronic or recurring injuries that last for long periods. Rest between workout sessions is essential for recovery, and it is difficult for the body to heal when exposed to excessive stress.

• Decreased performance: Overtraining may cause performance to stagnate or decrease instead of improving. You may notice a decrease in strength, agility, and endurance, which makes it difficult to reach your training goals. It can also slow down reaction time and running speed.

• Feeling that workouts have become harder: If you are suffering from OTS, you may feel that workouts are more difficult and require more effort to complete, even if your body is working at the usual rate. You may have a higher heart rate during exercise as well as a higher heart rate at rest, and it may take your heart longer to return to its resting rate after finishing the workout.

• Sleep disturbance: When stress hormones are imbalanced, you may find it difficult to relax and get rid of stress when you sleep, and this reduces the vital time your body needs to rest, repair, and regenerate while sleeping. Lack of quality sleep can also lead to chronic fatigue and mood swings.

• Decreased immunity or illness: In addition to feeling fatigued, you may notice that you get sick more often. You may also become susceptible to infections, minor illnesses, and upper respiratory tract infections (URTIs).

• Weight gain: Overtraining without taking sufficient rest periods can lead to decreased testosterone levels and increased cortisol levels (the stress hormone). These hormonal changes are often associated with muscle mass loss, weight gain, and fat accumulation in the abdominal area.

• Loss of motivation: You may find it difficult to stay motivated to exercise, either due to mental or physical exhaustion, or feeling that you are not achieving your goals or a loss of enjoyment. In all cases, it is important to make positive changes to regain motivation.

Source: Signs of Overtraining: 13 Tip-Offs and What to Do

Causes of Overtraining Syndrome

Overtraining Syndrome (OTS) is usually caused by an excessive training volume and intensity without providing enough time for recovery. Other contributing factors may include:

• Malnutrition.

• Poor sleep quality.

• Psychological stress.

• Lack of periodic planning in training programs.

Treatment and Recovery Time for Overtraining Syndrome

There are several treatment methods and home remedies that can help with recovery, but rest remains the most important factor from all activities. Massage: You can get a professional massage session that targets the affected muscles, and it is preferable to choose deep tissue massage or sports massage to avoid injuries and relieve muscle tension. If a professional massage session is not available, you can perform a self-massage using essential oils or muscle balm. Hot and cold therapy: This is also an available option. You can use a heating pad, a sauna, or a warm bath to soothe sore muscles. A cold bath or ice packs can also help reduce pain and swelling. Recovery time: Recovery time varies from person to person. If you take a complete break from physical activity, you may notice an improvement within two weeks. However, full recovery may take up to 3 months. During this period, you can do light exercises to stay active, but you must listen to your body at this important stage. If you return to training and start suffering from the symptoms of overtraining again, you should return to rest immediately.

Source: Signs of Overtraining: 13 Tip-Offs and What to Do

Examinations and Diagnosis of Overtraining Syndrome

There is no single decisive medical test to diagnose Overtraining Syndrome. Instead, it relies on a combination of steps, including:

• Medical history: Reviewing training volume, intensity, recent changes in exercise habits, nutrition, and sleep patterns.

• Symptom evaluation: Examining physical symptoms (such as fatigue, muscle pain, and recurring injuries) and psychological symptoms (such as mood swings, irritability, and loss of motivation).

• Physical examination: Checking for tenderness or pain in the muscles, muscle weakness, or signs of injury.

• Excluding other conditions: Excluding diseases that may resemble the symptoms of the syndrome, such as infections, anemia, thyroid disorders, or depression.

• Performance tests: Comparing current athletic performance with past data to detect a decrease in strength, endurance, or reaction time.

• Laboratory tests: May include measuring hormone levels (such as cortisol, testosterone), immune markers, and inflammatory markers, knowing that they are not decisive.

Conclusion

Overtraining Syndrome is not just a transient state of physical exhaustion; rather, it is a complex imbalance that affects the body and mind together and results from ignoring the warning signals the body sends. Its danger lies in its ability to weaken athletic performance in the long run and to negatively affect mental and physical health if not diagnosed and treated correctly and in a timely manner. Therefore, early awareness and adopting training strategies based on progression, systematic recovery periods, and providing integrated nutritional and psychological support are the cornerstone of prevention and treatment. True athletic success is not measured only by the amount of effort exerted but also by the intelligence of dealing with the body's limits and respecting its need for rest and regeneration to ensure the continuity of performance and maintain health in the long run.

Key Terms

• التهاب الجهاز التنفسي العلوي: Upper Respiratory Tract Infections (URTIs)

• التمزقات العضلية الدقيقة: Microtears

• التهاب الساقين: Shin Splints

• متلازمة بازيدو: Basedow’s Disease

• الجهاز العصبي اللاودي: Parasympathetic Nervous System (PNS)

• الجهاز العصبي الودي: Sympathetic Nervous System (SNS)