Skip to main content
Intended for healthcare professionals
Restricted access
Research article
First published online January 31, 2012

Overtraining Syndrome: A Practical Guide

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.

Get full access to this article

View all access and purchase options for this article.

References

1. Angeli A, Minetto M, Dovio A, et al. The overtraining syndrome in athletes: a stress-related disorder. J Endocrinol Invest. 2004;27:603-612.
2. Armstrong LE, VanHeest JL. The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Med. 2002;32:185-209.
3. Budgett R. Fatigue and underperformance in athletes: the overtraining syndrome. Br J Sports Med. 1998;32:107-110.
4. Budgett R, Hiscock N, Arida R, et al. The effects of the 5-HT2C agonist m-chlorphenylpiperazine on elite athletes with unexplained underperformance syndrome (overtraining). Br J Sports Med. 2010;44:280-283.
5. Budgett R, Newsholme E, Lehmann M, et al. Redefining the overtraining syndrome as the unexplained underperformance syndrome. Br J Sports Med. 2000;34:67-68.
6. Castell LM, Poortmans JR, Leclercq R, et al. Some aspects of the acute phase response after a marathon race, and the effects of glutamine supplementation. Eur J Appl Physiol. 1997;75:47-53.
7. Costill DL, Flynn MG, Kirwan JP, et al. Effects of repeated days of intensified training on muscle glycogen and swimming performance. Med Sci Sports Exerc. 1988;20:249-254.
8. Edwards KM, Burns VE, Ring C, Carroll D. Individual differences in the interleukin-6 response to maximal and submaximal exercise takes. J Sports Sci. 2006;24(8):855-862.
9. Fry RW, Grove JR, Morton AR, et al. Psychological and immunological correlates of acute overtraining. Br J Sports Med. 1994;28(4):241-246.
10. Fry RW, Morton AR, Keast D. Overtraining in athletes: an update. Sports Med. 1991;12(1):32-65.
11. Gabriel H, Kindermann W. The acute immune response to exercise: what does it mean? Int J Sports Med. 1997;18(1)(suppl):S28-S45.
12. Gouarne C, Groussard C, Gratas-Delamarche A, et al. Overnight urinary cortisol and cortisone add new insights into adaptation to training. Med Sci Sports Exerc. 2005;37:1157-1167.
13. Gustafsson H, Holmberg H, Hassmen P. An elite endurance athlete’s recovery from underperformance aided by a multidisciplinary sport science support team. Eur J Sport Sci. 2008;8(5):267-276.
14. Halson SL, Jeukendrup AE. Does overtraining exist? An analysis of overreaching and overtraining research. Sports Med. 2004;34(14):967-981.
15. Halson SL, Lancaster GI, Jeukendrup AE, et al. Immunological responses to overreaching in cyclists. Med Sci Sports Exerc. 2003;35(5):854-861.
16. Hiscock N, Pedersen BK. Exercise-induced immunosuppresion: plasma glutamine is not the link. J Appl Physiol. 2002;93:813-822.
17. Hohl R, Ferraresso RL, DeOliveira RB, et al. Development and characterization of an overtraining animal model. Med Sci Sports Exerc. 2009;41(5):1155-1163.
18. Hooper S, MacKinnon LT, Hanrahan S. Mood states as an indication of staleness and recovery. Int J Sport Psychol. 1997;28:1-12.
19. Hynynen A, Uusitalo A, Konttinen N, et al. Heart rate variability during night sleep and after awakening in overtrained athletes. Med Sci Sports Exerc. 2006;38(2):313-317.
20. Kentta G, Hassmen P. Overtraining and recovery: a conceptual model. Sports Med. 1998;26(1):1-16.
21. Koutedakis Y, Sharp NC. Seasonal variations of injury and overtraining in elite athletes. Clin J Sport Med. 1998;8(1):18-21.
22. Lehmann M, Foster C, Keul J. Overtraining in endurance athletes: a brief review. Med Sci Sports Exerc. 1993;25(7):854-862.
23. Mackinnon LT. Chronic exercise training effects on immune function. Med Sci Sports Exerc. 2000;32(7)(suppl):S369-S376.
24. Mackinnon LT, Hooper SL. Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining. Int J Sports Med. 1994;15(3)(suppl):S179-S183.
25. Mackinnon LT, Hooper SL. Plasma glutamine and upper respiratory tract infection during intensified training in swimmers. Med Sci Sports Exerc. 1996;28(3):285-290.
26. Margonis K, Fatouros IG, Jamurtas AZ, et al. Oxidative stress biomarkers responses to physical overtraining: implications for diagnosis. Free Radic Biol Med. 2007;43(6):901-910.
27. Matos NF, Winsley RJ, Williams CA. Prevalence of non-functional overreaching/overtraining in young English athletes. Med Sci Sports Exerc. 2011;43(7):1287-1294.
28. Meehan HL, Bull SJ, Wood DM, et al. The overtraining syndrome: a multicontextual assessment. Sports Psychol. 2004;18:154-171.
29. Meeusen R, Duclos M, Gleeson M, et al. The overtraining syndrome: facts and fiction. Eur J Sport Sci. 2006;6(4):263.
30. Meeusen R, Duclos M, Gleeson M, et al. Prevention, diagnosis and treatment of the overtraining syndrome: ECSS Position Statement Task Force. Eur J Sport Sci. 2006;6(1):1-14.
31. Meeusen R, Nederhof E, Buyse L, et al. Diagnosing overtraining in athletes using the two-bout exercise protocol. Br J Sports Med. 2010;44:642-648.
32. Meeusen R, Piacentini MF, Busschaert B, et al. Hormonal response in athletes: the use of a two bout exercise protocol to detect subtle differences in (over)training status. Eur J Appl Physiol. 2004;91:140-146.
33. Morgan WP, Brown Dr, Raglin JS, et al. Psychological monitoring of overtraining and staleness. Br J Sports Med. 1987;21:107-114.
34. Morgan WP, Costill DL, Flynn MG, et al. Mood disturbance following increased training in swimmers. Med Sci Sports Exerc. 1988;20(4):408-414.
35. Morgan WP, O’Connor P, Sparling P, et al. Psychological characterizations of the elite female distance runner. Int J Sports Med. 1987;8:124-131.
36. Nederhof E, Lemmeink K, Visscher C, et al. Psychomotor speed, possibly a new marker for overtraining syndrome. Sports Med. 2006;36:817-828.
37. O’Connor PJ, Morgan WP, Raglin JS, et al. Mood state and salivary cortisol levels following overtraining in female swimmers. Psychoneuroendocrinology. 1989;14(4):303-310.
38. Pearce PZ. A practical approach to the overtraining syndrome. Curr Sports Med Rep. 2002;1:179-183.
39. Petibois C, Cazoral G, Deleris G. FT-IR spectroscopy utilization to sportsmen fatigability evaluation and control. Med Sci Sports Exerc. 2000;32(10):1803-1808.
40. Petibois C, Cazoral G, Poortmans JR, et al. Biochemical aspects of overtraining in endurance sports: the metabolism alteration process syndrome. Sports Med. 2003;33:83-94.
41. Pichot V, Roche F, Gaspoz FE. Relation between heart rate variability and training load in middle-distance runners. Med Sci Sports Exerc. 2000;32:1729-1736.
42. Raglin J, Sawamura S, Alexiou S, et al. Training practice and staleness in 13-18-year-old swimmers: a cross-cultural study. Pediatr Exerc Sci. 2000;12:61-70.
43. Reid VL, Gleeson M, Williams N, et al. Clinical investigation of athletes with persistent fatigue and/or recurrent infections. Br J Sports Med. 2004;38:42-45.
44. Robson PJ. Elucidating the unexplained underperformance syndrome in endurance athletes: the interleukin-6 hypothesis. Sports Med. 2003;33:771-781.
45. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med Sci Sports Exerc. 2000;32:317-331.
46. Smith LL. Overtraining, excessive exercise, and altered immunity: is this a T helper-1 versus T helper-2 lymphocyte response? Sports Med. 2003;33(5):347-364.
47. Snyder AC, Kuipers H, Cheng B, et al. Overtraining following intensified training with normal muscle glycogen. Med Sci Sports Exerc. 1995;27(7):1063-1070.
48. Tanskanen M, Atalay M, Uusitalo A. Altered oxidative stress in overtrained athletes. J Sports Sci. 2010;28(3):309-317.
49. Tenenbaum G, Jones CM, Kitsantas A, et al. Failure adaptation: psychological conceptualization of the stress response process in sport. Int J Sport Psychol. 2003;34:1-26.
50. Tiidus PM. Radical species in inflammation and overtraining. Can J Physiol Pharmacol. 1998;76:533-538.
51. Urhausen A, Kindermann W. Diagnosis of overtraining: what tools do we have? Sports Med. 2002:32;95-102.
52. Varelet-Marie E, Mercier J, Brun J. Is plasma viscosity a predictor of overtraining in athletes? Clin Hemorheol Microcirc. 2006;35:329-332.
53. Walsh NP, Blannin AK, Robson PJ, Gleeson M. Glutamine, exercise and immune function. Sports Med. 1998;28(3):177-191.

Cite article

Cite article

Cite article

OR

Download to reference manager

If you have citation software installed, you can download article citation data to the citation manager of your choice

Share options

Share

Share this article

Share with email
EMAIL ARTICLE LINK
Share on social media

Share access to this article

Sharing links are not relevant where the article is open access and not available if you do not have a subscription.

For more information view the SAGE Journals article sharing page.

Information, rights and permissions

Information

Published In

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

Rights and permissions

© 2012 American Orthopaedic Society for Sports Medicine.
Request permissions for this article.

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
Jennifer B. Schwartz, MD
Department of Family Medicine, Tufts University Family Medicine Residency at Cambridge Health Alliance, Malden, Massachusetts

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]).

Metrics and citations

Metrics

Journals metrics

This article was published in Sports Health: A Multidisciplinary Approach.

VIEW ALL JOURNAL METRICS

Article usage*

Total views and downloads: 7323

*Article usage tracking started in December 2016

Altmetric

See the impact this article is making through the number of times it’s been read, and the Altmetric Score.
Learn more about the Altmetric Scores


Articles citing this one

Web of Science: 0

Crossref: 167

  1. Cardiopulmonary exercise for management of cardiovascular toxicity
    Go to citation Crossref Google Scholar
  2. Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in Adolesc...
    Go to citation Crossref Google Scholar
  3. Treatment Considerations for Compulsive Exercise in High-Performance A...
    Go to citation Crossref Google Scholar
  4. External and Internal Load Variables Encountered During Training and G...
    Go to citation Crossref Google Scholar
  5. Recommendations for Advancing the Resistance Exercise Overtraining Res...
    Go to citation Crossref Google Scholar
  6. Dietary and hydration patterns as indicators of overtraining in elite ...
    Go to citation Crossref Google Scholar
  7. Impact of 12 weeks of basic military training on testosterone and cort...
    Go to citation Crossref Google Scholar
  8. Multiomics Analysis Reveals Aberrant Metabolism and Immunity Linked Gu...
    Go to citation Crossref Google Scholar
  9. Association between Self-reported Overtraining Syndrome and Symptoms ...
    Go to citation Crossref Google Scholar
  10. Is self-regulation key in reducing running-related injuries and chroni...
    Go to citation Crossref Google Scholar
  11. Diagnosing Overtraining Syndrome: A Scoping Review
    Go to citation Crossref Google ScholarPub Med
  12. Subjective and objective variables of overtraining syndrome in female ...
    Go to citation Crossref Google Scholar
  13. Intrafasciomembranal Fluid Pressure: A Novel Approach to the Etiology ...
    Go to citation Crossref Google Scholar
  14. Treating mental stress in elite footballers using a stigma-free psycho...
    Go to citation Crossref Google Scholar
  15. Why do we climb mountains? An exploration of features of behavioural a...
    Go to citation Crossref Google Scholar
  16. Mindfulness for the Moment: Adapting Interventions for the Period of t...
    Go to citation Crossref Google Scholar
  17. Comparing the Current Training Running Demands of Elite Camogie Player...
    Go to citation Crossref Google Scholar
  18. An Analysis Method of Exercise Load in Physical Training Based on Radi...
    Go to citation Crossref Google Scholar
  19. Considerations for Sex-Cognizant Research in Exercise Biology and Medi...
    Go to citation Crossref Google Scholar
  20. The demands of training and match-play on elite and highly trained jun...
    Go to citation Crossref Google Scholar
  21. “I Want to Create So Much Stimulus That Adaptation Goes Through the Ro...
    Go to citation Crossref Google Scholar
  22. Effects of exercise on reducing diabetes risk in Korean women accordin...
    Go to citation Crossref Google Scholar
  23. Ergogenic potential of foods for performance and recovery: a new alter...
    Go to citation Crossref Google Scholar
  24. Impact of military training stress on hormone response and recovery
    Go to citation Crossref Google Scholar
  25. An Evidence-Informed Framework to Promote Mental Wellbeing in Elite Sp...
    Go to citation Crossref Google Scholar
  26. Adrenal, Gonadal and Peripherally Steroid Changes in Response to Extre...
    Go to citation Crossref Google Scholar
  27. Laktatveränderungen während der Mobilisation internistischer Intensivp...
    Go to citation Crossref Google Scholar
  28. Acceptance Mindfulness-Trait as a Protective Factor for Post-Natal Dep...
    Go to citation Crossref Google Scholar
  29. Life Habits and Mental Health: Behavioural Addiction, Health Benefits ...
    Go to citation Crossref Google Scholar
  30. Linking psychological risk profiles to running-related injuries and ch...
    Go to citation Crossref Google Scholar
  31. Surface Electromyography: A New Indicator of Fatigue Level
    Go to citation Crossref Google Scholar
  32. Medical Problems of the Athlete
    Go to citation Crossref Google Scholar
  33. Training load, stress, recovery, mood, and motivation of athletes with...
    Go to citation Crossref Google Scholar
  34. Overtraining Syndrome
    Go to citation Crossref Google Scholar
  35. The Intricate Web of Fatigue in Women
    Go to citation Crossref Google Scholar
  36. Symptomatic second-degree atrioventricular block in a recreational ath...
    Go to citation Crossref Google Scholar
  37. Circulating cell free DNA response to exhaustive exercise in average t...
    Go to citation Crossref Google Scholar
  38. The effects of sleep on firefighter occupational performance and healt...
    Go to citation Crossref Google Scholar
  39. Predictive factors of cardiovascular changes depending on the type and...
    Go to citation Crossref Google Scholar
  40. Cardiopulmonary Exercise Test Parameters in Athletic Population: A Rev...
    Go to citation Crossref Google Scholar
  41. Treadmill training based on the overload principle promotes locomotor ...
    Go to citation Crossref Google Scholar
  42. Chronic Aerobic Training at Different Volumes in the Modulation of Mac...
    Go to citation Crossref Google Scholar
  43. An Ergogenic Medical Education: Building Curricula to Optimize Perform...
    Go to citation Crossref Google Scholar
  44. The experiences of social workers in NCAA Division I athletic departme...
    Go to citation Crossref Google Scholar
  45. Con: The Length of Adult Cardiothoracic Anesthesiology Fellowship Trai...
    Go to citation Crossref Google Scholar
  46. Novel Markers of Recovery From Overtraining Syndrome: The EROS-LONGITU...
    Go to citation Crossref Google Scholar
  47. Thoracic Spinal Manipulation Effect on Neuroendocrine Response in Peop...
    Go to citation Crossref Google Scholar
  48. Psychological Context of Overtraining Syndrome in Elite Athletes in Ad...
    Go to citation Crossref Google Scholar
  49. Exploring the Relationship Between Mental Well-Being, Exercise Routine...
    Go to citation Crossref Google Scholar
  50. Troubleshooting a Nonresponder: Guidance for the Strength and Conditio...
    Go to citation Crossref Google Scholar
  51. Physiological and Psychological Effects of Treadmill Overtraining Impl...
    Go to citation Crossref Google Scholar
  52. Coenzyme Q10: Clinical Applications beyond Cardiovascular Diseases
    Go to citation Crossref Google Scholar
  53. Sleep Characteristics of Highly Trained Wheelchair Rugby Athletes With...
    Go to citation Crossref Google Scholar
  54. Effects of dietary supplementation in sport and exercise: a review of ...
    Go to citation Crossref Google Scholar
  55. Disturbances in Brain Physiology Due to Season Play: A Multi-Sport Stu...
    Go to citation Crossref Google Scholar
  56. Conceptualising a systems thinking perspective in sport studies
    Go to citation Crossref Google Scholar
  57. Upper-Body Resistance Training Following Soccer Match Play: Compatible...
    Go to citation Crossref Google Scholar
  58. Exercise Recovery Practices of Wheelchair Court Sports Athletes
    Go to citation Crossref Google Scholar
  59. Chest Pain and Dyspnea
    Go to citation Crossref Google Scholar
  60. Exercise physiology
    Go to citation Crossref Google Scholar
  61. Astaxanthin for improved muscle function and enhanced physical perform...
    Go to citation Crossref Google Scholar
  62. Brain-Derived Neurotrophic Factor and Psychophysiological Response in ...
    Go to citation Crossref Google Scholar
  63. Plasma oxidative stress (hydrogen peroxide/trolox) responses during a ...
    Go to citation Crossref Google Scholar
  64. Intramuscular mechanisms of overtraining
    Go to citation Crossref Google Scholar
  65. REDUCCIÓN DE MASA LIBRE DE GRASA EN NADADORES DESPUÉS DE UN PERIODO DE...
    Go to citation Crossref Google Scholar
  66. Exercise Time and Intensity: How Much Is Too Much?
    Go to citation Crossref Google Scholar
  67. Guidelines for Physical Activity—A Cross-Sectional Study to Assess The...
    Go to citation Crossref Google Scholar
  68. Pathophysiological Mechanisms by which Heat Stress Potentially Induces...
    Go to citation Crossref Google Scholar
  69. Diagnosis of Overtraining Syndrome: Results of the Endocrine and Metab...
    Go to citation Crossref Google Scholar
  70. Athlete Burnout
    Go to citation Crossref Google Scholar
  71. Immunological assessment of adaptive reserves of the body
    Go to citation Crossref Google Scholar
  72. Hypogonadism in Exercising Males: Dysfunction or Adaptive-Regulatory A...
    Go to citation Crossref Google Scholar
  73. Effect of 8-week n-3 fatty-acid supplementation on oxidative stress an...
    Go to citation Crossref Google Scholar
  74. Medical Problems of the Athlete
    Go to citation Crossref Google Scholar
  75. Oxygen Uptake and Anaerobic Performances
    Go to citation Crossref Google Scholar
  76. Introduction, Historical Perspective, and Basic Concepts on Overtraini...
    Go to citation Crossref Google Scholar
  77. Novel Insights in Overtraining Syndrome: Summary and Conclusions
    Go to citation Crossref Google Scholar
  78. Classical Understanding of Overtraining Syndrome
    Go to citation Crossref Google Scholar
  79. Recovery from Overtraining Syndrome: Learnings from the EROS-Longitudi...
    Go to citation Crossref Google Scholar
  80. Sport, Krankheit und Verletzungen
    Go to citation Crossref Google Scholar
  81. Monitoring Heart Rate Variability As A Biomarker Of Fatigue In Young A...
    Go to citation Crossref Google Scholar
  82. Is Overload an Issue in Young Basketball Players?
    Go to citation Crossref Google Scholar
  83. Índice de pie plano y zonas de mayor prevalencia de alteraciones múscu...
    Go to citation Crossref Google Scholar
  84. Multiaspective diagnostics of training loads as well as biomechanical ...
    Go to citation Crossref Google Scholar
  85. Inter-correlations Among Clinical, Metabolic, and Biochemical Paramete...
    Go to citation Crossref Google Scholar
  86. Oxidative stress in exercise training: the involvement of inflammation...
    Go to citation Crossref Google Scholar
  87. Novel causes and consequences of overtraining syndrome: the EROS-DISRU...
    Go to citation Crossref Google Scholar
  88. The “Journal of Functional Morphology and Kinesiology” Journal Club Se...
    Go to citation Crossref Google Scholar
  89. Perceptual Clinical Features in Exercise-Induced Laryngeal Obstruction...
    Go to citation Crossref Google Scholar
  90. A New Food-grade Coenzyme Q10 Formulation Improves Bioavailability: Si...
    Go to citation Crossref Google Scholar
  91. Biomarker Response to a Competitive Season in Division I Female Soccer...
    Go to citation Crossref Google Scholar
  92. Effects of glutamine and alanine supplementation on muscle fatigue par...
    Go to citation Crossref Google Scholar
  93. Basal Hormones and Biochemical Markers as Predictors of Overtraining S...
    Go to citation Crossref Google Scholar
  94. Optimising Team Sport Training Plans With Grammatical Evolution
    Go to citation Crossref Google Scholar
  95. Ketone ester supplementation blunts overreaching symptoms during endur...
    Go to citation Crossref Google Scholar
  96. Psychotherapy for mental health symptoms and disorders in elite athlet...
    Go to citation Crossref Google Scholar
  97. Mental health in elite athletes: International Olympic Committee conse...
    Go to citation Crossref Google Scholar
  98. Novel insights of overtraining syndrome discovered from the EROS study
    Go to citation Crossref Google Scholar
  99. Martial Arts “Kendo” and the Motivation Network During Attention Proce...
    Go to citation Crossref Google Scholar
  100. Breaking a taboo: why the International Olympic Committee convened exp...
    Go to citation Crossref Google Scholar
  101. A Brief Review of Salivary Biomarkers as Stress Indicators in Sport an...
    Go to citation Crossref Google Scholar
  102. Overtraining Syndrome one more piece of the Central Sensitivity Syndro...
    Go to citation Crossref Google Scholar
  103. The acute effect of training fire exercises on fire service instructor...
    Go to citation Crossref Google Scholar
  104. Muscle Injuries
    Go to citation Crossref Google Scholar
  105. Identifying the Incidence of Exercise Dependence Attitudes, Levels of ...
    Go to citation Crossref Google Scholar
  106. Tiredness, Fatigue, and Exhaustion as Perceived by Recreational Marath...
    Go to citation Crossref Google ScholarPub Med
  107. DIAGNOSIS OF OVERTRAINING SYNDROME
    Go to citation Crossref Google Scholar
  108. Questionnaire method in the diagnosis of fatigue of 14 and 16 years ol...
    Go to citation Crossref Google Scholar
  109. Overtraining elevates serum protease level, increases renal p16INK4α g...
    Go to citation Crossref Google Scholar
  110. Exercising the hepatobiliary-gut axis. The impact of physical activity...
    Go to citation Crossref Google Scholar
  111. Intensified training increases salivary free light chains in trained c...
    Go to citation Crossref Google Scholar
  112. Principles of Physical Activity Promotion Among Older People
    Go to citation Crossref Google Scholar
  113. Common peripheral nerve injuries in sport: diagnosis and management
    Go to citation Crossref Google Scholar
  114. Methane Medicine: A Rising Star Gas with Powerful Anti-Inflammation, A...
    Go to citation Crossref Google Scholar
  115. Monitoring training load in beach volleyball players: a case study wit...
    Go to citation Crossref Google Scholar
  116. Effect of fatigue and gender on kinematics and ground reaction forces ...
    Go to citation Crossref Google Scholar
  117. Identifying the predisposing factors, signs and symptoms of overreachi...
    Go to citation Crossref Google Scholar
  118. Effects of supplementation with L-glutamine and L-alanine in the body ...
    Go to citation Crossref Google Scholar
  119. Exercise-dependent regulation of the tumour microenvironment
    Go to citation Crossref Google Scholar
  120. Muscle Hypertrophy: A Narrative Review on Training Principles for Incr...
    Go to citation Crossref Google Scholar
  121. Prevalence of non-functional overreaching in elite male and female you...
    Go to citation Crossref Google Scholar
  122. The Lower Extremity Athlete: Postrehabilitation Performance and Injury...
    Go to citation Crossref Google Scholar
  123. Neuroendocrine Response Following a Thoracic Spinal Manipulation in He...
    Go to citation Crossref Google Scholar
  124. Reductions in training load and dietary carbohydrates help restore hea...
    Go to citation Crossref Google Scholar
  125. Interactive Effect of Corticosterone and Lactate on Regulation of Test...
    Go to citation Crossref Google Scholar
  126. Interepisode Sleep Bruxism Intervals and Myofascial Face Pain
    Go to citation Crossref Google Scholar
  127. Features selection for Bayes classification of prolonged fatigue on re...
    Go to citation Crossref Google Scholar
  128. Profiles of mood states, depression, sleep quality, sleepiness, and an...
    Go to citation Crossref Google Scholar
  129. Effects of creatine supplementation on cardiac autonomic functions in ...
    Go to citation Crossref Google Scholar
  130. Psychological tools used for monitoring training responses of athletes
    Go to citation Crossref Google Scholar
  131. Exercise Therapy for Physical Therapist
    Go to citation Crossref Google Scholar
  132. Changes in Salivary Hormones Concentration during the Preparation and ...
    Go to citation Crossref Google Scholar
  133. Stress and Alterations in Bones: An Interdisciplinary Perspective
    Go to citation Crossref Google Scholar
  134. Bench-to-Bedside Approaches for Personalized Exercise Therapy in Cance...
    Go to citation Crossref Google Scholar
  135. Resting Heart Rate Variability Among Professional Baseball Starting Pi...
    Go to citation Crossref Google Scholar
  136. Athletes: Fit but Unhealthy?
    Go to citation Crossref Google Scholar
  137. Oxidative Stress in Training, Overtraining and Detraining: from Experi...
    Go to citation Crossref Google Scholar
  138. l -glutamine and l -alanine ...
    Go to citation Crossref Google Scholar
  139. Activité physique et cancer : mise au point et revue de la littérature
    Go to citation Crossref Google Scholar
  140. Common causes of dyspnoea in athletes: a practical approach for diagno...
    Go to citation Crossref Google Scholar
  141. Weight control practices of Division I National Collegiate Athletic As...
    Go to citation Crossref Google Scholar
  142. Effects of Methane-Rich Saline on the Capability of One-Time Exhaustiv...
    Go to citation Crossref Google Scholar
  143. Variants of the Solute Carrier SLC16A1 Gene (MCT1) Associated With Met...
    Go to citation Crossref Google Scholar
  144. Overtraining and Overreaching Syndrome in Athletes
    Go to citation Crossref Google Scholar
  145. Potential ergogenic activity of grape juice in runners
    Go to citation Crossref Google Scholar
  146. Tactics to Sustain Training and Competitive Performance during Fasting
    Go to citation Crossref Google Scholar
  147. Skateboarding injuries: An updated review
    Go to citation Crossref Google Scholar
  148. Placebo Effect
    Go to citation Crossref Google Scholar
  149. A framework for prescription in exercise-oncology research
    Go to citation Crossref Google Scholar
  150. Coenzyme Q10 supplementation downregulates the increase of monocytes e...
    Go to citation Crossref Google Scholar
  151. Consequences of Single Sport Specialization in the Pediatric and Adole...
    Go to citation Crossref Google Scholar
  152. Plasma Vitamin D Metabolites and C-Reactive Protein in Stage-Stop Raci...
    Go to citation Crossref Google Scholar
  153. Effects of Hibiscus sabdariffa Linn. on insulin-like growth factor bin...
    Go to citation Crossref Google Scholar
  154. Physical Abuse of Adolescent and Young Athletes
    Go to citation Crossref Google Scholar
  155. Exercise Physiology
    Go to citation Crossref Google Scholar
  156. Overtraining Syndrome
    Go to citation Crossref Google Scholar
  157. Response to the Letter to the Editor
    Go to citation Crossref Google Scholar
  158. A Neuroinflammatory Model for Acute Fatigue During Exercise
    Go to citation Crossref Google Scholar
  159. Intestinal Parasitic Diseases in Junior Wrestlers: Imitation of Overtr...
    Go to citation Crossref Google Scholar
  160. Amino acid supplementation and impact on immune function in the contex...
    Go to citation Crossref Google Scholar
  161. Fighting Insomnia and Battling Lethargy: The Yin and Yang of Palliativ...
    Go to citation Crossref Google Scholar
  162. Urinary biomarkers of physical activity: candidates and clinical utili...
    Go to citation Crossref Google Scholar
  163. Physical Abuse of Adolescent and Young Athletes
    Go to citation Crossref Google Scholar
  164. Improving Training Condition Assessment in Endurance Cyclists: Effects...
    Go to citation Crossref Google Scholar
  165. Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Healt...
    Go to citation Crossref Google Scholar

Figures and tables

Figures & Media

Tables

View Options

Get access

Access options

If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:

AOSSM members can access this journal content using society membership credentials.

AOSSM members can access this journal content using society membership credentials.


Alternatively, view purchase options below:

Purchase 24 hour online access to view and download content.

Access journal content via a DeepDyve subscription or find out more about this option.

View options

PDF/ePub

View PDF/ePub

Full Text

View Full Text