More often than not, we hear of many athletes that suffer from the same muscle problem repeatedly during a single season or year after year. The main cause for such injury reoccurrences is that health professionals tend to focus on the injured muscle alone. Typically, the repeatedly injured muscle is a symptom of a bigger problem. For example, a repeated hamstring injury for an athlete that constantly runs at high speeds and stops frequently may not be suffering from a bad hamstring at all, but rather from a problem with the gluteas maximus (glute). It’s very typical of doctors to isolate the problem and not look at the rest of the body or the bigger picture. To further this example, the glute is a major component in running, and if that muscle is not functioning properly during a practice or game, the hamstring muscle has to work harder to compensate for the glute. The stress placed on the hamstring muscle causes it to “blow out”. Following the hamstring injury, the athlete rehabs the hamstring, making the muscle stronger, which causes a muscle imbalance in the body. Still not addressing the glute problem, the hamstring continues to be stressed thus causing a reoccurance in injury which then leads to surgery and more rehab. The point is that reoccurring injuries are a sign of an underlying stress of a bigger problem. And when it comes to professional athletes, these stresses tend to stem from metabolic overtraining syndrome, more simply, overtraining.
Overtraining leads to poor athletic performance, structural injury secondary to muscle imbalance, and metabolic problems leading to fatigue, infection, bone loss, sexual dysfunction, altered mood states and other problems. These signs and symptoms not only affect training and competition, but all aspects of a person’s life.
Metabolic Overtraining Syndrome
Metabolic Overtraining Syndrome (MOS) not only stems from exercising too much physically, but it can also come from mental stress, chemical stress and/or structural stress.
Prevention and balance need to be at the forefront of training in order to have the best chance to not only play on game day, but to play at your individual best.
Balanced bodies = Maximum performance
Overtraining is described as diminished performance resulting from an increase in training volume and/or intensity. Overtraining can also cause:
- increased injuries
- decreased performance
- decrease overall health
- increased chances of disease and dysfunction in retirement.
The 3 Stages of Metabolic Overtraining
The spectrum of overtraining syndrome can be described as having three stages:
- Stage 1 – Functional Overtraining
- Stage 2 – Sympathetic Overtraining
- Stage 3 – Parasympathetic Overtraining
Stage 1: Function Overtraining
Stage 1 is the onset and earliest stage of overtraining where very subtle signs and symptoms can indicate the start of overtraining. Subtle signs may include:
- Minor plateau or slight regression in training performance
- Back, knee, ankle, and foot injuries.
- Mental and emotional stress, including mild or clinical depression and anxiety are not uncommon.
Interestingly, this stage is sometimes accompanied by a sudden or dramatic improvement in competitive performance that may convince the athlete that training is progressing well. This temporary improvement may be due to an abnormal overactive sympathetic nervous system. (This may be followed by a physical injury, marking the start of the second stage of overtraining.)
Aerobic/Anaerobic Imbalances – A common problem in Stage 1 is developing an imbalance between the aerobic and anaerobic systems. An imbalance causes WHAT???
Overreaching – Stage 1 may be synonymous with overreaching or extending beyond one’s boundaries. Overreaching has been shown in studies to boost performance but often results in overtraining.
Adrenal Gland Dysfunction – Adrenal gland (the stress gland) dysfunction is very common in overtraining and usually begins in Stage 1. It typically parallels the start of aerobic deficiency or lack of oxygen. As this stage progresses, athletes begin to experience the following:
- sleeping irregularities
- abnormal hunger or cravings for sweets
- inability to lose extra body fat
- get sleepy after meals, and/or
- crave caffeine.
Nutrition – Stage 1 may result in nutritional problems that include excess consumption of refined carbohydrates at the expense of healthy fats and protein.
When overtraining is not discovered and corrected, the body moves into Stage 2 of overtraining.
Stage 2: Sympathetic (Gas Pedal) Overtraining
Stage 2 is associated with specific nervous system, hormonal and mechanical imbalances causing a variety of signs and symptoms.
As overtraining progresses, the imbalances described in Stage 1 worsen. Specifically, the sympathetic part of the nervous system becomes overactive. This results in an increased resting heart rate often associated with restlessness and being over excited or anxious. An increased heart rate causes WHAT for athletes?
If corrections are not made, athletes can enter the third stage of overtraining.
Stage 3: Parasympathetic Overtraining
Stage 3 is the serious end-stage of overtraining associated with the exhaustion of neurological and hormonal factors, typically with physical, chemical or mental injuries. Stage 3 is usually accompanied by the lack of desire to compete (and sometimes train), depression, significant injury and, most notably, exhaustion. Performance may diminish considerably and many athletes in this state consider themselves “sidelined”. During this stage, the sympathetic nervous system becomes exhausted, and most, if not all, hormone levels are significantly reduced, including cortisol. What’s the importance of cortisol??
Stage 3 also results in abnormally low resting heart rates and low heart-rate recovery from interval training or competition. (Often there is a misinterpretation that a low heart rate is a good sign.) What does low resting heart rates and low heart-rate recover mean for athletes?
Athletes who are in the third stage of overtraining are seriously unwell. Recovery and return to previous optimal levels of performance is a very difficult task.
While total weekly training and intensity are associated with overtraining, RECOVERY is a very important antidote to overtraining.
Overtraining syndrome is an imbalance in a simple equation: Training = Workout + Recovery.
Prevention and correction of the overtraining syndrome begins with assessment, something that should be an ongoing process for every athlete. Observing the subtle signs in their earliest stages are crucial to the PREVENTION of further regression.
In order to overcome overtraining, it must first be properly assessed. This means finding a doctor or a team of doctors who understand and are trained in functional imbalances and practice a patient-centered approach. Typically these are doctors of functional medicine, functional chiropractic neurology and applied kinesiology.
When committed, athletes can often recover rapidly from the overtraining syndrome.
Finding the Right Doctors
Specialty doctors who have been trained in identifying, assessing and eliminating overtraining and the different stress factors are the right types of doctors to address reoccurring injuries. Together, Dr. Kotsanis and Dr. Ozzie believe that the player-centered method is NOT a “one size fits all” approach that should be applied. Every player is unique – both physically and mentally. Our doctors recognize this and are well-practiced in individualizing each patient’s preventative and treatment care.
“It is a FINE LINE between optimal athletic performance and the beginning of athletic decline.”