Overtraining
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Overtraining occurs when a person exceeds their body's ability to recover from strenuous
exercise Exercise is a body activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons, to aid growth and improve strength, develop muscles and the cardiovascular system, hone athletic ...
. Overtraining can be described as a point where a person may have a decrease in performance and plateauing as a result of failure to consistently perform at a certain level or training load; a load which exceeds their recovery capacity. People who are overtrained cease making progress, and can even begin to lose
strength Strength may refer to: Physical strength *Physical strength, as in people or animals * Hysterical strength, extreme strength occurring when people are in life-and-death situations *Superhuman strength, great physical strength far above human c ...
and fitness. Overtraining is also known as chronic fatigue, burnout and overstress in athletes. It is suggested that there are different variations of overtraining, firstly monotonous program over training suggest that repetition of the same movement such as certain weight lifting and baseball batting can cause performance plateau due to an adaption of the central nervous system which results from a lack of stimulation. A second example of overtraining is described as chronic overwork type training where the subject may be training with too high intensity or high volume and not allowing sufficient recovery time for the body. Up to 10% of elite endurance athletes and 10% of American college swimmers are affected by overtraining syndrome (unexplained underperformance for approximately 2 weeks even after having adequate resting time).


Signs and symptoms

Listed below are some of the common effects and cited signs of overtraining. Overtraining may be accompanied by one or more concomitant symptoms: * Persistent muscle
soreness Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
* Persistent
fatigue Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve ...
, different from just being tired from a hard training session, occurs when fatigue continues even after adequate rest. * Elevated resting
heart rate Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excr ...
, a persistently high heart rate after adequate rest such as in the morning after sleep, can be an indicator of overtraining. * Reduced
heart rate variability Heart rate variability (HRV) is the physiological phenomenon of variation in the time interval between heartbeats. It is measured by the variation in the beat-to-beat interval. Other terms used include: "cycle length variability", "R–R variabi ...
* Increased susceptibility to
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
s * Increased incidence of
injuries An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or ...
*
Irritability Irritability (also called as crankiness) is the excitatory ability that living organisms have to respond to changes in their environment. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessi ...
* Depression *
Mental breakdown A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
* Burnout It is important to note the difference between overtraining and over-reaching; over-reaching is when an athlete is undergoing hard training but with adequate recovery, overtraining however, is when an athlete is undergoing hard training without the adequate recovery. With over-reaching, the consequential drop in performance can be resolved in a few days or weeks.


Performance

* Early onset of fatigue * Decreased
aerobic capacity VO2 max (also maximal oxygen consumption, maximal oxygen uptake or maximal aerobic capacity) is the maximum rate of oxygen consumption attainable during physical exertion. The name is derived from three abbreviations: "V̇" for volume (the dot ap ...
(VO2 max) * Poor physical performance * Inability to complete workouts * Delayed recovery Overtraining can affect the athlete's athletic ability and other areas of life, such as performance in studies or the work force. An overtrained athlete who is suffering from physical and or psychological symptoms could also have trouble socialising with friends and family, studying for an exam or preparing for work.


Cause

Like pharmacological drugs, physical exercise may be chemically
addictive Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use oft ...
. Addiction can be defined as the frequent engaging in the behavior to a greater extent or for a longer time period than intended. It is theorized that this addiction is due to natural
endorphin Endorphins (contracted from endogenous morphine) are chemical signals in the brain that block the perception of pain and increase feelings of wellbeing. They are produced and stored in an area of the brain known as the pituitary gland. Hist ...
s and
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic compound, organic chemical of the catecholamine and phenethylamine families. Dopamine const ...
generated and regulated by the exercise. Whether strictly due to this chemical by-product or not, some people can be said to become addicted to or fixated on psychological/physical effects of physical exercise and fitness. This may lead to over exercise, resulting in the "overtraining" syndrome.


Mechanism

A number of possible mechanisms for overtraining have been proposed. One stipulates that
microtrauma Microtrauma is any of many possible small injuries to the body. Microtrauma can include the microtearing of muscle fibres, the sheath around the muscle and the connective tissue. It can also include stress to the tendons, and to the bones (see ...
to the
muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
s are created faster than the body can heal them. Another proposes that
amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...
s are used up faster than they are supplied in the diet, a condition sometimes referred to as "
protein deficiency Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, respon ...
". Finally, systemic inflammation has been considered as a mechanism in which the release of
cytokine Cytokines are a broad and loose category of small proteins (~5–25 kDa) important in cell signaling. Cytokines are peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrin ...
s activates an excessive immune response.


Treatment

The most effective way to treat the effects of overtraining is to allow the body enough time to recover: * Taking a break from training to allow time for recovery. * Reducing volume and/or intensity of training. * Suitable
periodization In historiography, periodization is the process or study of categorizing the past into discrete, quantified, and named blocks of time for the purpose of study or analysis.Adam Rabinowitz. It's about time: historical periodization and Linked Ancie ...
of training. * Splitting the training program so that different sets of muscles are worked on different days. * Increase
sleep Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a de ...
time. * Deep-tissue or sports
massage Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet or a device. The purpose of massage is generally for the treatment of body stress or pain. In Eu ...
of the affected muscles. * Self-massage or rub down of the affected muscles. * Short sprints with long resting time once the athlete is able to continue with light training.


Diet

Adapting nutritional intake can help to prevent and treat overtraining. Athletes in different fields will emphasize different proportional nutrition factors on the diet mainly including proteins, carbohydrates and fats. The diet includes a calorie intake that at least matches expenditure, ideally forming a suitable
macronutrient A nutrient is a substance used by an organism to survive, grow, and reproduce. The requirement for dietary nutrient intake applies to animals, plants, fungi, and protists. Nutrients can be incorporated into cells for metabolic purposes or excre ...
ratio. During the recovery process, extra calories from diets may help the body speed the recovery. Finally, addressing
vitamin A vitamin is an organic molecule (or a set of molecules closely related chemically, i.e. vitamers) that is an Nutrient#Essential nutrients, essential micronutrient that an organism needs in small quantities for the proper functioning of its ...
deficiencies with improved diet and/or
nutritional supplements A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...
has been proposed as a way to speed up recovery.


Rhabdomyolysis

Exertional rhabdomyolysis Exertional rhabdomyolysis (ER) is the breakdown of muscle from extreme physical exertion. It is one of many types of rhabdomyolysis that can occur, and because of this, the exact prevalence and incidence are unclear. Cause ER is more likely to oc ...
is an extreme and potentially deadly form of overtraining that leads to a breakdown of skeletal muscle which makes its way into the blood. Many molecules such as potassium,
creatine kinase Creatine kinase (CK), also known as creatine phosphokinase (CPK) or phosphocreatine kinase, is an enzyme () expressed by various tissues and cell types. CK catalyses the conversion of creatine and uses adenosine triphosphate (ATP) to create phosp ...
, phosphate, and myoglobin are released into circulation.
Myoglobin Myoglobin (symbol Mb or MB) is an iron- and oxygen-binding protein found in the cardiac and skeletal muscle tissue of vertebrates in general and in almost all mammals. Myoglobin is distantly related to hemoglobin. Compared to hemoglobin, myoglobi ...
is the protein that causes the lethal reaction in the body. Early detection of the syndrome is essential in full recovery. A serious late complication of rhabdomyolysis which occurs in 15% of the population is
acute kidney injury Acute kidney injury (AKI), previously called acute renal failure (ARF), is a sudden decrease in kidney function that develops within 7 days, as shown by an increase in serum creatinine or a decrease in urine output, or both. Causes of AKI are cla ...
, and in some cases it can lead to death.


Clinical presentation

* Muscle pain * Tenderness * Swelling * Weakness * Bruising * Tea colored urine * Fever *
Malaise As a medical term, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. The word has existed in French since at least the 12th century. The term is often used ...
* Nausea * Emesis * Confusion * Agitation * Delirium *
Anuria Anuria is nonpassage of urine, in practice is defined as passage of less than 100Harrison's Principles of Internal Medicine, 19E PAGE 292 milliliters of urine in a day. Anuria is often caused by failure in the function of kidneys. It may also occu ...


CrossFit and rhabdomyolysis

As
CrossFit CrossFit is a branded fitness regimen that involves constantly varied functional movements performed at high intensity. The method was developed by Greg Glassman, who founded CrossFit with Lauren Jenai in 2000, with CrossFit its registered trad ...
has become more and more prevalent and popular, this has led to speculation that spikes in rhabdomyolysis cases are related to CrossFit. According to a study performed in the '' Journal of Strength and Conditioning Research'', unless performed incorrectly and in harmful environments, CrossFit presents no serious physical threat to the human body, and research into whether rhabdomyolysis cases and CrossFit are correlated is inconclusive.


Prevention

Passive recovery, instead of active recovery, is a form of rest that is recommended to be performed by athletes in between rigorous, intermittent exercise. With active recovery, time to exhaustion is much shorter because the muscles are deoxygenated at a much quicker rate than with passive recovery. Thus, if avoiding overtraining means preventing exhaustion, passive recovery or "static rest" is safest. If active recovery is performed during intense exercise, an athlete may find themselves in a state of being overtrained. The gradual variation of intensity and volume of training is also an effective way to prevent overtraining.


References

{{reflist Exercise physiology Weight training