dr. randy wilber overtraining causes recognition prevention

OVERTRAINING: Causes - Recognition - Prevention

USA Track & Field / VS Athletics Super Clinic US Olympic Trials Eugene, OR June 26, 2012

Randall L. Wilber, Ph.D., FACSM Olympic Athlete Performance Laboratory United States Olympic Committee Colorado Springs, CO

Thank you Dank u wel

Merci beaucoup Kiitoksia

Danke schön Efcharisto

Grazie Gracias

Obrigado Cheers

CC & TRACK COACH (1976-1993) • Titusville High School (Florida) • University of Wisconsin-Eau Claire • Florida State University

Randall L. Wilber, PhD, FACSM US Olympic Committee

EXERCISE PHYSIOLOGIST (1993-present) • US Olympic Committee • Salt Lake City 2002 • Athens 2004 • Torino 2006 • Beijing 2008 • Vancouver 2010 • London 2012

US Olympic Training Center Colorado Springs OVERTRAINING:

Causes – Recognition - Prevention

� Introduction

� Recognition and Prevention

� Summary

28% of US athletes who competed in the 1996 Atlanta Olympics reported that they had overtrained for the Games . . . and that this overtraining had a negative impact on their performance. These US Olympians also identified the need to taper, rest, travel less, and stay healthy as changes they would make if they could prepare again for the Olympics.

Overtraining

2012 TRIALS SUPERCLINIC Dr. Randy Wilber

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OVERREACHING � Short term (days) � Reversible with recovery � Positive training adaptation

- necessary to improve performance especially at elite level.

Overreaching vs Overtraining

OVERREACHING � Short term (days) � Reversible with recovery � Positive training adaptation

- necessary to improve performance especially at elite level.

OVERTRAINING � Long term (weeks, months) � Irreversible with recovery � Negative training adaptation

- performance suffers chronically - competitive season is over.

Overreaching vs Overtraining Overreaching vs Overtraining


Figure 1 from Armstrong review

Adapted from: Armstrong, LE, and JL VanHeest. The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Medicine, 32: 185-209, 2002.


Figure 1 from Armstrong review

Adapted from: Armstrong, LE, and JL VanHeest. The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Medicine, 32: 185-209, 2002.



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Overtraining

“More performances are spoiled by slight overtraining than by slight lack of fitness.”

“An athlete who is 90% conditioned for an event will do better than an athlete who is

0.5% overtrained.” Bobby McGee

Josiah Thugwane Gold Medalist

Marathon 1996 Atlanta

OVERTRAINING:


� Introduction


� Summary

TRAINING

Volume Intensity Recovery Technique

Competition

LIFESTYLE

Sleep Daily schedule

Nutrition Housing conditions

Leisure activities

HEALTH

Cold Fever

GI infection Menstrual

dysfunction

ENVIRONMENT

Family Roommates Teammates

Coach Job/School

RECOVERY

Prevention of Overtraining

Strategy 1 Recognize OT Risk Factors

Prevention of Overtraining 1. Recognize OT Risk Factors

ATHLETE

� Perfectionist / Obsessive-Compulsive personality � Excessive level of motivation � “More is better” training approach . . . based on bad or good performance � Resistant to taking time off . . . during injury/illness or non-injury/illness � Sport specialization at an early age � Eating disorders or disordered eating � Competition schedule designed to chase “points” or “money” � External stressors . . . home, school/job, relationships, financial


� Ultra-sport (e.g., Ironman events, multi-day cycling events) � Multi-sport (e.g., triathlon, pentathlon) � Endurance-sport (e.g., marathon) � Sport that allows for little or no individualization of training load � Meat grinder” sports (e.g., DR in Kenya; soccer in Brazil; gymnastics in China)

SPORT


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TRAINING 1

� Overloading adolescent athletes during growth spurts � Transition from junior/developmental level to senior level . . . and accompanying increase in training load � Lack of scientifically-based periodization leading to stress-recovery imbalances and OT � “Knee jerk” response to under-performance leading to excessive increase in training load


� Training individually with minimal or no “face-to-face” coaching and objective monitoring � Training with significantly more skilled/fit athletes � Poor monitoring of “recovery” workouts � Olympic / World Championship season � Lack of scientifically-based taper � Coaching directed by a former successful elite athlete � Change in training environment . . . heat + humidity, altitude

TRAINING 2


www.humankinetics.com

Strategy 2 Scientifically Sound Training Program: PERIODIZATION

Prevention of Overtraining 2. Scientifically Sound Training Program: PERIODIZATION

Prevention of Overtraining 2. Scientifically Sound Training Program: PERIODIZATION


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Strategy 3 Scientifically Sound Training Program: TAPERING

Inigo Mujika, PhD

The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: VOLUME: FREQUENCY:

Prevention of Overtraining 3. Scientifically Sound Training Program: TAPERING

Inigo Mujika, PhD

The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: The maintenance/increase of training intensity is necessary to avoid detraining, provided that reductions in other training variables allow for sufficient recovery to optimize performance. VOLUME: FREQUENCY:


Inigo Mujika, PhD

The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: The maintenance/increase of training intensity is necessary to avoid detraining, provided that reductions in other training variables allow for sufficient recovery to optimize performance. VOLUME. Training volume is decreased by 40-60% to induce positive physiological, psychological and performance responses. FREQUENCY:


-3%

Adapted from: Shepley et al. Physiological effects of tapering in highly trained athletes. Journal of Applied Physiology, 72: 706-711, 1992. * P < 0.05

Rest


-3% +6%


LOW Intensity HIGH Volume Rest



5

0

50

100

150

200

250

300

350PRE TaperPOST Taper

-3% +6%

+22%

*


LOW Intensity HIGH Volume

HIGH Intensity LOW Volume Rest


Inigo Mujika, PhD

The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: The maintenance/increase of training intensity is necessary to avoid detraining, provided that reductions in other training variables allow for sufficient recovery to optimize performance. VOLUME: Training volume is decreased by 40-60% to induce positive physiological, psychological and performance responses in highly trained athletes. FREQUENCY: The maintenance of training frequency seems to be necessary to avoid detraining in highly trained athletes.


The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: “Work ‘em hard” VOLUME: FREQUENCY:


The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: “Work ‘em hard” VOLUME: “Send ‘em home early” FREQUENCY:


The aim of the taper should be to minimize accumulated fatigue and enhance training adaptations during the taper period. INTENSITY: “Work ‘em hard” VOLUME: “Send ‘em home early” FREQUENCY: “Practice/train every day as scheduled”


Trai

ning

Loa

d (%

)


Adapted from: Mujika, I and S Padilla. Scientific bases for precompetition tapering strategies. Medicine and Science in Sports and Exercise, 35: 1182-1187, 2003.


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Trai

ning

Loa

d (%

)



Trai

ning

Loa

d (%

)



Hormones � Cortisol (catabolic) ↑ Testosterone (anabolic)




Enzymes � CK

↑ Oxidative enzymes ↑ Myofibrillar ATPase



Enzymes � CK


Skeletal Muscle ↑ Fiber size ↑ Fiber power



Enzymes � CK


Substrates � Liver & Muscle glycogen

Skeletal Muscle ↑ Fiber size ↑ Fiber power


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Inigo Mujika, PhD



Strategy 4 Detailed Monitoring of Training Response

Prevention of Overtraining 4. Detailed Monitoring of Training Response

Laurent et al. J Strength Cond Res 25(3): 620-628, 2011

Prevention of Overtraining 4. Detailed Monitoring of Training Response: PRS SURVEY

Prevention of Overtraining 4. Detailed Monitoring of Training Response: RESTQ


Prevention of Overtraining 4. Detailed Monitoring of Training Response: OVERNIGHT HR


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Monitor dehydration � Total body weight (decrements should not > 1%) � Urine color � Urine specific gravity (< 1.020)

Prevention of Overtraining 4. Detailed Monitoring of Training Response: DEHYDRATION

Strategy 5 Biochemical and Biological Markers

Blood Chemistry Protocol

Blood Draw Protocol � Early AM: 0600-0800 � Fasted: no food or drink (except H2O) from previous evening’s dinner until after blood draw. � Position: upright seated or reclined . . . but keep it consistent! � Urine sample: provide sample cups the day before . . . athlete produces waking mid-stream sample for USG.

Blood Chemistry

Cost

Nissan Pathfinder

$50 – 75 1-1.5 day turnaround for 100% results

Cadillac Escalade

$250 – $1000 4-7 day turnaround for 100% results

Blood Chemistry

Iron Status

WHY To prevent Fe-deficiency or Fe-depletion leading to anemia. WHAT Ferritin Serum iron Total iron binding capacity (TIBC) Saturation percent Complete blood count (CBC) Vitamin B6 Vitamin B12 Folate PRIORITY

Blood Chemistry

Iron Status


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Cytochrome-c Oxidase

Blood Chemistry

Iron Status

Ferritin Red Bone Marrow Total Iron Binding Capacity (TIBC)

RBCs

Blood Chemistry

Iron Status

PREDISPOSING FACTORS for ANEMIA: � Dietary regimen

� chronic undereating (<2,000 kcal/day) � vegetarian � high CHO + low PRO diet (minimal red meat) � heavy focus on “sports foods” (bars, gels, powders) � lack of Fe-fortified breakfast cereals

� � � � �

Blood Chemistry

Iron Status



� Menstrual flow � � � �

Blood Chemistry

Iron Status



� Menstrual flow � Training-induced hemolysis (“crushing” of RBCs) � � �

Blood Chemistry

Iron Status



� Menstrual flow � Training-induced hemolysis (“crushing” of RBCs) � Sweat Fe loss � �

Blood Chemistry

Iron Status


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� Menstrual flow � Training-induced hemolysis (“crushing” of RBCs) � Sweat Fe loss � Aesthetic sports (gymnastics, figure skating) � Endurance sports (triathlon, distance running)

Blood Chemistry

Iron Status

Stage 1 Iron depletion Stage 2 Iron deficient non-anemia Stage 3 Iron deficient anemia

Blood Chemistry

3 Stages of Anemia

Blood Chemistry

Stage 1: Iron-depletion

Triathlete Female 23 yr

Blood Chemistry

Stage 2: Iron-deficient non-anemia

Triathlete Female 18 yr

If serum Ferritin low: � Attention to “heme Fe” in diet. � Moderate Fe supplementation

� 27 mg ferrous bisglycinate chelate

� 60 mg Vitamin C � 60 ug Vitamin B-12 � 200 ug Folate � taken daily

Blood Chemistry

Iron Status

If serum Ferritin normal: � Attention to “heme Fe” in diet. � Multivitamin

Blood Chemistry

Iron Status


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Blood Chemistry

Stage 3: Iron-deficient anemia

VB Player Female 24 yr

Blood Chemistry

Interpretation of Results using Athlete-Specific Range (ASR)

Blood Chemistry

Interpretation of Results using Athlete-Specific Range (ASR)

Prevention of Overtraining 4. Detailed Monitoring of Training Response: SALIMETRICS

iPro® Salimetrics

Strategy 6 Training Guidelines during Illness

YES � Symptoms of a common cold

with NO systemic involvement. � Submaximal exercise (sub HLa

TH) is not contraindicated. � Short duration maximal exercise

is not contraindicated.

Should I train when sick?

Prevention of Overtraining 6. Training Guidelines during Illness


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NO � Symptoms of systemic

involvement (fever, extreme fatigue, muscle aches, swollen lymph glands, etc.)

� Submaximal and maximal exercise are contraindicated.

� Allow 2-4 weeks of recovery before resumption of training.

Should I train when sick?

Prevention of Overtraining 6. Training Guidelines during Illness

Strategy 7 Recovery Techniques: PASSIVE REST !

0

5

10

15

20hGHCortisol

Noon 8:00 am 4:00 am Midnight 8:00 pm 4:00 pm

Hor

mon

e co

ncen

tratio

n (u

g/dl

)

Prevention of Overtraining 7. Recovery Techniques: PASSIVE REST !

Discover lifestyle factors that impact your sleep quality Prevention of Overtraining

7. Recovery Techniques: SLEEP QUALITY Strategy 8 Recovery Techniques: HYDRATION & NUTRITION

Prevention of Overtraining 8. Post-Workout Recovery: HYDRATION & NUTRITION

WATER

1 2

3 4


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WATER

1

ELECTROLYTES

2 2

3 4


Gabrielle Andersen-Scheiss (SWI)


WATER

1

ELECTROLYTES

2

GLUCOSE

3 4


GLUCOSE During WO


GLUCOSE


After WO


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WATER

1

ELECTROLYTES

2

GLUCOSE

3 4



WATER

1

ELECTROLYTES

2

GLUCOSE

3 4

PROTEIN




WATER

1

ELECTROLYTES

2

GLUCOSE

3 4

PROTEIN



15

CHO/PRO = 4/1


30-45 min

1 x 8-10 oz. cup


Hour 1 30-45 min Hour 2 Hour 3

1 x 8-10 oz. cup 1-3 x 8-10 oz. cup


GLUCOSE


After WO

Strategy 9 Recovery Techniques: THERAPIES / MODALITIES

US Olympic Training Center: Colorado Springs Recovery Center 1860 m / 6200 ft


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Prevention of Overtraining 9. Recovery Techniques: THERAPIES/MODALITIES


Arterio-venous anastomoses (AVAs)

Radiator cooling system


Arterio-venous anastomoses (AVAs)





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Dan Huling Berlin 2009 3,000 m SC

8:13.69 PR (2010)

Prevention of Overtraining 9. Recovery Techniques: THERAPIES/MODALITIES OVERTRAINING:


� Introduction


� Summary

1. OT is very common among high performance athletes due to the heavy training loads required to be successful.

SUMMARY


2. It is often difficult for coaches to distinguish between “overtraining” and

“overreaching” in their athletes.

SUMMARY




3. Because OT appears to be due to a complex combination of physiological, immunological and psychological factors, there is no single marker that serves to quickly and clearly identify OT in athletes.

SUMMARY


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4. Based on our current knowledge, recommendations to prevent OT include: � recognition of OT risk factors � a scientifically based training program that includes strategically placed

recovery phases � detailed monitoring of the training response � nutritional intervention � periodic blood testing, with focus on Fe status � recovery techniques, with emphasis on Passive Rest.

SUMMARY





4. Based on our current knowledge, recommendations to prevent OT include: � recognition of OT risk factors � a scientifically based training program that includes strategically placed

recovery phases � detailed monitoring of the training response � nutritional intervention � periodic blood testing, with focus on Fe status � recovery techniques, with emphasis on Passive Rest.

5. OT continues to be a major challenge facing athletes and thus is an area that warrants continued research.

SUMMARY

Thank you for your attention!

Jenny Barringer Simpson 2011 World Champion 1500 m Oviedo (FL) HS 2002-2005


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dr. randy wilber overtraining causes recognition prevention

Documents

minimize accumulated

overtrainingoverreaching

work em hard

blood chemistryiron

highly trained

induce positive

enhance training

precompetition