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Overtraining Syndrome

Why Training too Hard, too Long, Doesn't Work

Christopher J. Hawley, MD; Robert B. Schoene, MD

Practice Essentials Series Editors:
Kimberly G. Harmon, MD; Aaron Rubin, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 31 - NO. 6 - JUNE 2003


You've been feeling exhausted, achy, edgy, and burned out. Worse yet, your personal relationships are suffering and you're stressed over so many demands on your time. On top of that, your athletic performance has "hit the wall," and you just can't seem to do any better. What's wrong?

You may have an easily explained problem, such as an infection sapping your strength, or you may be training too hard. Constant muscle soreness, difficulty sleeping, or frequent colds may be your body's way of telling you to take it easy for a while. If you keep pushing, you may develop overtraining syndrome.

Q. What is overtraining syndrome?

A. Too much physical training and too little rest and recovery after hard workouts cause a great deal of stress on muscles, joints, and bones. If you are further stressed by worries about money, fear of failure, or conflicts with friends, teachers, or teammates, your body may reach a point where it can no longer repair the damage.

Q. But isn't fatigue normal after a hard training session?

A. Tiredness and some decrease in athletic ability are expected after a series of difficult workouts. You feel better after a few days of rest or lighter training, and your performance improves. If you always feel sore and tired and your performance suffers, it might be overtraining syndrome.

Q. How can I tell if I have overtraining syndrome or something else?

A. Talk to your team doctor or your personal physician. The symptoms are similar to many other medical problems (table 1), so your doctor will need to examine you to rule out other causes. He or she may recommend that you adjust your schedule to see if 2 weeks of lighter training and more rest will help.

TABLE 1. Common Symptoms of Overtraining

Workout Symptoms
Usual workouts feel more difficult
Early fatigue during workouts
Faster heart rate with less effort
Decreased strength
Decreased coordination
Physical challenges seem too hard
Decreased performance on strength,
   speed, or endurance testing
Physical Symptoms
Persistent fatigue
Ongoing muscle soreness
Loss of appetite
Increased aches and pains
Increase in overuse injuries
Frequent colds or infections
Nonphysical Symptoms
Difficulty sleeping
Feelings of irritation or anger
Feelings of depression
Lack of motivation
Fear of competition
Difficulty concentrating
Increased sensitivity to
   emotional stress

Q. How is overtraining treated?

A. Overtraining is treated like other injuries, such as a broken bone, and is a serious condition. A period of complete rest is often recommended. The longer you were overtraining, the longer you will need to rest. You may be able to do some light cross-training during the 6- to 12-week recovery period. You can use the time to work on other sources of stress, such as grades or personal relationships. Eating well will give your body fuel for healing, and you might enjoy massage or whirlpool baths.

Q. Can overtraining be prevented?

A. Yes. The key is to include rest and recovery time in your training schedule. A heavy week of training should be balanced with some light training or a day off. Heavy weeks and months of training should include time for recovery so that you are well rested before important competitions. Keeping a training log (figure 1) is an easy way to track your progress and watch for symptoms of overtraining. Let your coach and team doctor know early in the process if you have symptoms of overtraining. Prevention is the best cure.

Remember: This information is not intended as a substitute for medical treatment. If you have medical concerns, consult a physician.

Dr Hawley is a staff and team physician in the Sports Medicine Clinic of the University Health Services at the University of Texas in Austin. Dr Schoene is a professor of medicine in the division of pulmonary and critical care and director of clinical exercise testing at the University of Washington Medical Center in Seattle.


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