Overtraining/UUPS

Learning outcomes

• How to define overtraining and UUPS and the various sub terms.

• Understand how overtraining manifests and what the symptoms (physiological and biochemical) are.

• Other factors that may indicate an athlete is overtrained e.g.overuse injuries and psychology.

IntroductionIn order for athletes to perform optimally they must be trained correctly. Athletes who are under training may not reach their full potential. On the other hand athletes who train too often or too intensely may In fact hinder their performance.

It is important for a coach to find the balance in training and this can be different for each person.

When an athlete trains their main aim is to adapt to the training stimulus resulting in them adapting and becoming faster, stronger etc.

(Beatthebeeptest.com, 2015)

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Also need to consider that psychological pressures of being a competitive athlete may add to the stress of training and therefore increase the likelihood of overtraining occurring (Kreider, Fry and O'Toole, 1998).

Many athletes try and improve their decrease in performance by training even harder, this further causes them to slip into an over trained state (Derman et al., 1997).

Terms, definitions and prevalence

Overtraining syndrome (OTS) has been described using many terms throughout the literature: overworking, stale-ness, burnout, athletes chronic fatigue.. to name a few.

Overreaching is a lesser form of overtraining sydrome (OTS) and is the stage an athlete finds themselves in prior to becoming fully overtrained.

Overreaching is defined as: An accumulation of training and non-training stress resulting in short-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of overtraining in which restoration of performance capacity may take several days to several weeks. (Kreider, Fry and O'Toole, 1998)

Overtraining syndrome is defined as: An accumulation of training and non-training stress resulting in short-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of overtraining in which restoration of performance capacity may take several weeks or months. (Kreider, Fry and O'Toole, 1998)

Overreaching can be broken down into two types:

• Functional overreaching is basically short term overtraining, if an athlete gets the required rest then they will recover and super compensate.

• Non-functional overreaching is a more advanced version of overreaching, it will occur if a player or athlete who is currently functionaly overreaching continues to push themselves without the adequate rest. This form of overreaching acts as a type of bridge into overtraining syndrome (Meeusen et al., 2013).

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Re-defining as UUPS

More recently overtraining syndrome has been redefined as UUPS – also know as unexplained under performance syndrome.

UUPS is persistent unexplained performance deficit which is both agreed upon by player/athlete and coach despite two weeks of relevant rest

Although one of the more popular definitions of overtraining, this definition hasn’t grown much in use outside the UK.

Diagnosis

Diagnosis

Although there has been an increase in knowledge and literature regarding overtraining syndrome (OTS) there has still yet to be an easy way of diagnosing OTS early on or before it has manifested.

OTS is characterised by a *sports specific* decrease in performance coupled with disturbances in mood state. This underperformance persists despite a recovery period of weeks to months.

(Meeusen et al., 2013)

OTS can only be diagnosed once all other factors affecting performance and mood state have been ruled out.

Early recognition of OTS is basically impossible as the only certain sign is a decrease in performance, which is already to late. However it is important to recognise when an athlete or player beings to slip into an overreached or overtrained state, so that training and rest can be changed accordingly

OTS can only be diagnosed if there are no signs of organic disease: endocrinological disorders (thyroid or adrenal gland, diabetes), iron deficiency with anaemia, or infectious diseases (including myo-carditis, hepatitis, glandular fever)

(Meeusen et al., 2013)

Symptoms of OTS

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Common symptomsFirst sign is a change in the circulatory system, an increased morning (resting) heart rate has been found to be linked with overtraining. More specifically an increase of more than 5 beats a minute.

Changes in blood pressure, particularly increased resting blood pressure may also indicate an overtrained state.

As coaches, you should keep up to date records of athletes/players resting heart rates and blood pressures. These can then be cross checked to see if any changes have taken place. (Stone et al., 1991)

A second sign of overtraining is unexplained weight loss. Elite athletes already have a low body fat percentage therefore a further decrease in weight (5 pounds or more) or decrease in bodyfat %, without reason, can indicate overtraining (Stone et al., 1991)

Once again as a coach you can keep track of weight over time and therefore are more likely to spot any changes quickly. Pre and post exercise weight is important to record.

Sleep disturbance is another symptom of overtraining, sleep is extremely important in recovery.

Changes in normal sleeping pattern and sleep time may indicate overtraining and will further contribute to fatigue and performance decline. (Kreider, Fry and O'Toole, 1998).

A psychological sign of an overtrained state can be changes In an athletes mood and especially their feeling toward their chosen sport. Athletes/players may have an inability to be well prepared prior to competition. E.g. they may lack motivation in training or feel extremely nervous before a big game or competition.

Biochemical markers

A lot of research has now been conducted into the biochemical signs of overtraining. Blood levels of certain hormones have been used to try and determine if overtraining syndrome is present.

As a coach you have the responsibility to recommend your athletes get blood tests taken by a sports practioner – the following biochemical markers have been linked to an overtrained state:

CortisolIn an overtrained athlete , an overreactive pituitary gland is mainly responsible for the physiological responses to overtraining. Stimulus of the hypothalamus causes the pituitary gland to secrete greater amounts of adre-nocorticotropic hormone.

This causes the adrenal cortex to release cortisol which aids the body in adapting to stress.

Study by Barron et al found that cortisol levels were significantly higher in athletes that had overtrained compared to the same athletes following 4 weeks rest. (BARRON et al., 1985)

(Organsofthebody.com, 2015)

Creatine Kinase (CK)CK is an enzyme located within tissue in the body, mainly muscles. CK level rises following injury or muscle damage e.g. after heavy training. CK level can show the extent to which muscles are over-exerted (Siegel, 1983).

CK has been shown to rise in athletes who are overtrained and is used as a marker of overtraining (HARTMANN and MESTER, 2000).

However can’t be used solely as an indicator of overtraining , must be present along with other symptoms and unexplained performance decrease. (Urhausen et al., 1998a)

https://www.youtube.com/watch?v=xbsK6Pd8M2s

Premier League Physiotherapist Neal Reynolds explains some common signs of overtraining such as overuse injuries.

Overtraining and injuries

The musculoskeletal system responds to overtraining also. This is usually in the form of overuse injuries.

The three most common overuse injuries associated with overtraining are: posterior tibialis syndrome , lower limb stress fractures and tendinitis conditions in the lower extremities (Sheehan, 1977). These injuries should therefore be paid close attention and training and other markers previously talked about should be looked into.

Psychological symptoms

• On a final note, overtraining also causes psychological symptoms as well. These are usually harder to spot, so having a good relationship with your players and athletes is paramount.