Overtraining syndrome (OTS) is an entity which is poorly understood in sports medicine.
Overtraining syndrome (OTS) is an entity which is poorly understood in sports medicine. Prior studies have shown varying degrees of this disease prevalence but it is classified as rare. Additionally, the pathophysiology is poorly understood; however, there are many hypotheses as to why these issues occur in athletes.
These include the most widely accepted cytokine hypothesis as well as the less accepted glycogen, central fatigue, glutamine, oxidative stress, autonomic nervous system, and Hypothalamic/Hypopituitary (HPA/HPG) axis hypothesis (Kreher and Schwartz). Low muscle glycogen can most certainly impair athletic performance by decreasing the amount of amino acids synthesized by the body and has been shown to have a deleterious effect on central neurotransmitters. The central fatigue hypothesis centers around the neurotransmitter serotonin.
Unfortunately, ew studies have evaluated the levels of serotonin in association with exercise. After ruling out other causes, history requires the following for diagnosis: worsened performance for at least two months even in the setting of appropriate rest, mood disturbance, and no other organic or psychological cause that could cause said symptoms. History should also look at possible triggers which can range from environmental exposures such as extreme heat or altitude, burnout with sport training, life stress, or insomnia among other possibilities.
Nutritional history is also an important part of the evaluation. In past years, studies have been done on ways to further evaluate this disease by evaluating biochemical and immunologic markers. This has been shown to be effective in the literature.
One study showed a decrease in “burnout” in college swimmers from 10% to 0% when implementing questionnaires on the mood of the athlete and altering training schedules based on survey results. Along with training monitoring, preemptive questioning of athletes with decreased performance could be done to evaluate the myriad of factors involved in this disease state. Identification of the athlete with functional overreaching or early stage nonfunctional overreaching is key to make changes to prevent full blown overtraining syndrome.
If you are experiencing symptoms that may be related to a overtraining syndrome (ots), it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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