Top 5 tips if you think you might have 'Overtraining Syndrome'

I recently had a patient come to me with a complaint of progressive fatigue, inability to complete training runs and an overall sense of malaise/"the blahs". He was told by his training buddies that he had 'overtraining syndrome', the new popular endurance sports "disease". I told him he did not. Why?

Overtraining syndrome has become a very popular diagnosis, even trendy if you will, in the past few years. With the explosion of endurance athletic events, particularly in the field of ultrarunning, has come an equal explosion in the number of athletes, who are, well...tired. Not just a little tired, like "I don't want to do today's hard workout", but really tired, like I don't want do any workout, EVER. However, by definition this is a diagnosis of exclusion, meaning other critical causes of fatigue MUST first be ruled out in order to even contemplate this as a possibility. For example, hypothyroidism (low thyroid) and iron deficiency (low iron) are both common, very treatable causes of prolonged fatigue in endurance athlete. As the main treatment or cure for overtraining syndrome is REST for weeks or months, it would be unfortunate to take weeks or months off of your training only to feel the exact same and then discover that you had a treatable cause after all. So, 5 ideas to try if you are feeling 'blah' with your exercise and suspect you might have overdone it.

1. See a doctor.

Rule out the obvious and treatable causes of fatigue. Seek out a practitioner skilled in sports medicine, or you may be met with an unsympathetic physician who can't contemplate why you want to exercise for 10+ hours a week anyways and thinks you should be tired because you are exercising so much.

2. Gather data.

This is where some sort of training log can be helpful to track your fitness and progress. Are you really slowing down? Have you increased your volume of training in the past few weeks or months? You know your body better than anyone, and looking through your own collective data can be useful.

3. Consider heart rate training.

Increasingly popular is low aerobic intensity training, popularized recently by the Maffetone Method. (http://philmaffetone.com/what-is-the-maffetone-method/). Dropping your training down to a level where you are still gaining aerobic fitness but are not excessively stressing your autonomic nervous system through high-intensity, anaerobic exercise, can be a way to restore some energy. In addition, tracking heart rate can provide good data. If you have a favorite running route, and you usually run it at a heart rate of 130 @ an average 9 minute pace, and your same route at the same heart rate is getting progressively slower (10 min pace, 11 min pace...), if your training has remained consistent you may have a problem that needs to be addressed.

4. Get enough sleep.

This is critical to any fatigue issue, and really to any athlete putting in long hours and hard workouts. Recovery is essential. 8-9 hours of quality sleep. Yes, this can be challenging with everyone's busy lives. But if you are worn out and not sleeping enough, you are taking a problem and making it worse.

5. Back your training down for a bit or mix it up.

Easier said than done for those of us that crave that endurance endorphin high. But a few weeks or even months rest is better than years, yes YEARS of fatigue and poor performance, as has occurred in some high-profile endurance athletes (see below). You want to be healthy and fit and able to exercise long FOR LIFE. You want to be the 70 or 80 year old kicking butt and inspiring other athletes. Some recent good articles and resources: http://www.irunfar.com/2013/09/overtraining-syndrome-part-one.html (a 3-part series) http://www.outsideonline.com/1986361/running-empty Keep moving!