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First published online January 31, 2012

Overtraining Syndrome: A Practical Guide

Jeffrey B. Kreher, MD [email protected] and Jennifer B. Schwartz, MDView all authors and affiliations
Volume 4, Issue 2
https://doi.org/10.1177/1941738111434406

Abstract

Context: Fatigue and underperformance are common in athletes. Understanding overtraining syndrome (OTS) is helpful in the evaluation, management, and education of athletes.
Evidence Acquisition: Relevant articles in English were searched with OVID (1948-2011) and PubMed using the following keywords: overtraining syndrome, overtraining, overreaching, unexplained underperformance, staleness, pathophysiology, management, treatment, evaluation. Bibliographies were reviewed for additional resources.
Results: OTS appears to be a maladapted response to excessive exercise without adequate rest, resulting in perturbations of multiple body systems (neurologic, endocrinologic, immunologic) coupled with mood changes. Many hypotheses of OTS pathogenesis are reviewed, and a clinical approach to athletes with possible OTS (including history, testing, and prevention) is presented.
Conclusions: OTS remains a clinical diagnosis with arbitrary definitions per the European College of Sports Science’s position statement. History and, in most situations, limited serologies are helpful. However, much remains to be learned given that most past research has been on athletes with overreaching rather than OTS.

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Published In

Volume 4, Issue 2
Pages: 128 - 138
Article first published online: January 31, 2012
Issue published: March/April 2012

Keywords

  1. overtraining syndrome
  2. overtraining
  3. overreaching
  4. unexplained underperformance
  5. staleness
  6. pathophysiology
  7. management
  8. treatment
  9. evaluation

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© 2012 American Orthopaedic Society for Sports Medicine.
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History

Published online: January 31, 2012
Issue published: March/April 2012
PubMed: 23016079

Authors

Affiliations

Jeffrey B. Kreher, MD*
Department of Orthopaedic Surgery–Pediatric Orthopaedics, Massachusetts General Hospital for Children, Boston, Massachusetts
[email protected]
View all articles by this author
Jennifer B. Schwartz, MD
Department of Family Medicine, Tufts University Family Medicine Residency at Cambridge Health Alliance, Malden, Massachusetts
View all articles by this author

Notes

*
Jeffrey B. Kreher, MD, Department of Orthopaedic Surgery–Pediatric Orthopaedics, Massachusetts General Hospital for Children, Yawkey Center for Outpatient Care, Suite 3400, 55 Fruit Street, Boston, MA 02114 (e-mail: [email protected]).

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