Skip links

Overtraining Fatigue Syndrome


I work in areas where there are a lot of athletes and athletic clubs of many kinds: Hammersmith, Holland Park, Shepherd’s Bush, Chiswick, Ascot, Bracknell, Windsor – these areas are chuck full of athletes who are pretty serious about their sport. So I hear this a lot….

‘You’re training too much’.  

Your husband says it.  Your wife says it. Your boss says it. Your friends say it.

Your teammates probably don’t say it.  

Your coach definitely does not say it.  

Your general practice doctor probably doesn’t know the difference between training too much and TRAINING TOO MUCH.

And, most importantly, you probably think you’re not working hard enough and your problems mean you just simply must work harder.

But…..Isn’t training too much the sign of a committed athlete?  

That’s your thinking.  After all, you have a goal in mind and are totally and relentlessly focussed on it.

You are in it to win it.  Of course!

You are working hard. Maybe harder than ever.

And…maybe you *are* just fatigued….

What is overtraining fatigue?

Athletes work hard, especially ahead of a competition or in training for successive competitions.  It is a fact.

In fact, it’s a necessary part of stimulating the physical adaptations in your body that improve your physical performance.  You want to train in a way that promotes fatigue to some degree so that you create a period of ‘supercompensation’ where performance is at your maximum. Ideally, you can then train in that period and get the maximum out of your body, and continue your upward performance trajectory. I would call this kind of fatigue a ‘functional’ kind of fatigue.

Nonfunctional fatigue serves no purpose. Nonfunctional fatigue creates a short term physiological decrease in performance capacity, with or without longer term physiological and psychological consequences.  Nonfunctional fatigue can be managed with a few days or weeks of rest, followed by returning training and progressing again to maximum performance. 

Why is it important to know if you have overtraining syndrome

It is very important to notice non-functional fatigue. Why?  Because the impact of progressive nonfunctional fatigue can have devastating consequences for athletes with short and medium-term athletic goals.  Progressive nonfunctional fatigue can lead to overtraining syndrome.  Overtraining syndrome is a long term progressive physiological and psychological adaptation deficit which can require months of recovery time.

The problem is that overtraining can really only be ‘diagnosed’ (as different from non-functional fatigue) after the fact because the time needed to truly restore performance can only be measured retrospectively.   You can’t know if you are overtraining or just non-functionally fatigued without taking a break – hence the importance of watching and listening to your body as you progress through training all the way up until competition.  You don’t want to be having to take a break at the wrong time. 

What are the consequences of overtraining?

Overtraining is a complex metabolic problem caused by various stressors, particularly not allowing the body to fully recover after periods of intense and prolonged training. It is made worse by other stressors such as training boredom, successive competitions, stress-related insomnia, inadequate fueling and nutrition, relationship problems, illness, and other physiological stressors such as recovering from sports injury.

Overtraining syndrome causes numerous physiological and psychological problems which can require prolonged recovery. In addition to the everyday impact of these changes on daily life, work and relationships, overtraining syndrome symptoms can also significantly interfere with an athlete’s goals.

Recovery from overtraining can take months of rest and stress management so recognising it early in a training cycle is critical.  The longer you are suffering from overtraining the longer a recovery period is required before training becomes effective again.

How do you know if you are overtraining?

Person A : You may be overtraining if you have had a lot of fatigue and performance problems which have not sorted themselves out over 2-3 days of rest or by reducing your training load for 2 weeks.  Very often you will have observed your performance slump and decided to train even more vigorously, resulting in a vicious circle.

Person B: You may have been in a series of competitions and started off strong but have performed less well than expected over subsequent outings. You might have observed these changes but have not made changes to your routine due to a competition on the horizon or worry about letting down fellow teammates or coaches.

Person C: You have progressed toward competition over the past several months and have reached high levels of performance, but you catch a virus right at the time of a major competition.  You rest because you are forced to, resume training, and this cycle repeats itself with frequent illness right at the worst time. Instead of illness, you may suffer injury repeatedly right before a competition.


How do you know if you are overtraining? There is no ‘magic bullet’ list of symptoms or diagnostic test which can tell you.  The ‘Person Descriptions’ above are a story-guide, but follows are some symptoms associated with overtraining syndrome which can affect any athlete.  It’s important to note these symptoms can be signs of other serious illness so please see your doctor.

Symptoms of Overtraining

Symptoms of overtraining can be broken down into both physical, psychological/emotional categories.  

Physical Symptoms

  • Feeling tired – prolonged fatigue
  • Flu like symptoms – aches/chills/lethargy/gastrointestinal problems
  • Catching viral infections like colds more easily, especially at critical times (esp in team athletes)
  • Unrefreshing sleep – especially difficulty staying asleep
  • Having DOMS (delayed onset muscle soreness) for much longer than usual despite not changing training routines
  • Poor sporting performance over time
  • Increased rates of injury/slower injury recovery
  • Low libido or difficulty/inability to achieve orgasm
  • Infertility in both sexes
  • Menstrual problems in females
  • Loss of appetite plus/minus unusual cravings
  • Excessive sweating (ie night sweats)
  • Enlarged lymph nodes
  • Anemia


In extreme but rare cases: rhabdomyolysis (in plain english: your muscle breakdown from exertion and lack of recovery is excessive enough that your kidneys fail). This is more a risk in sport with little to no recovery times (ie long ultramarathons).

If you are being monitored, these measurable indicators can point to (but not diagnose) overtraining syndrome

  • Early morning rise in resting heart rate
  • Slower heart rate recovery
  • Decreased lactate production during exercise
  • Higher than normal cortisol
  • Higher levels of creatine kinase in your blood chemistry
  • Reduced lymphocyte activity in the presence of infection
  • Reduced adrenocortical hormone (ACH), prolactin (PL)  and growth hormone (HGH) on a second exercise test (whereas if non functionally fatigued people there is an increase)


In some athletes, there is an altered response to insulin in the body, which results in early or more chronic hypoglycaemia (low blood sugar). This state can affect carbohydrate metabolism, causing further problems with fatigue.  There is inconsistent information on the effects of overtraining on the immune system when it comes to any specific and reliable measurable factors aside from repeated coincident infection during the run up to competition. Low glutamine plasma levels are one of the only consistent markers associated with overtraining syndrome.  Glutamine is important for protein synthesis and immune cell function. Unfortunately, oral glutamine supplements are not definitively associated with rises in plasma glutamine levels.

Psychological Symptoms

  • Increased perceived effort in a workout that used to be easier
  • Feeling blue/low without reason
  • Feeling flat, even about your sport
  • Feeling overly emotional/irrational – irritable
  • Lack of motivation, particularly about activities or people outside your sport
  • Inability to find joy in your sport or make small achievements meaningful
  • Extreme frustration or feelings of being trapped
  • Restlessness and anxiety


These are common psychological symptoms that you may recognise as being a part of depression and in fact overtrained athletes will often score highly on some mood inventories designed to screen for depression. If caused by overtraining these mood symptoms will improve along with performance throughout and after a period of rest and recovery. If not, seek help.

Many of these symptoms will be be made worse by poor nutrition and low glycogen stores (insufficient carbohydrate intake, particularly in athletes who are simultaneously trying to lose weight), dehydration, emotional stressors, and infection.

How is overtraining diagnosed?

There is no gold standard test for overtraining. Initially, it is a tentative diagnosis of exclusion (ie ruling out any other physical or mental cause of symptoms).  This exclusion should be done by everyone in order to rule out other serious illness which could be a cause of some or all of the symptoms.

You may have bloodwork done, to include complete blood counts, chemistry panels, inflammatory markers (ESR and CRP), thyroid panels, iron studies as well as growth hormone and kidney studies via urinalysis.

You are likely to be ‘tested’ with 2 weeks of total, absolute physical and mental rest.

If you feel better, training adjustments can be made to prevent nonfunctional fatigue from setting in again.

If you are not feeling better, overtraining could be diagnosed and will require further significant rest and follow up with a sports psychologist, nutritionist and sessions with an exercise professional focussing on the frequency of low volume and low-intensity training to start.

If you are on your own, there are ways to spot the signs of overtraining which could lead you to getting the support you need to recover fully.

The best ‘test’ is a combination of the symptoms above, plus what is called the Rusko test:

  1. Lay flat and rest for 10 minutes at the same time every day in the morning.
  2. At the end of the 10 minutes, record your heart rate in beats/min
  3. Stand up
  4. After 15 seconds, take a second heart rate in beats/min
  5. After 90 seconds, take a third heart rate in beats/min
  6. After 120 seconds, take a fourth heart rate in beats/min

In well rested athletes, there will be a consistency in these measurements.  In poorly rested athletes, there may be a change of more than 10 beats/min in the 120 second post standing measurement.  

If you see such a recorded beats/min, OR are experiencing some of the above symptoms, you should take the day off and consider that you might be on the verge of experiencing overtraining syndrome.

It is important to know that even if your measurements above don’t show a difference, you could be overtrained if you are experiencing the symptoms listed above.  Overtraining should not be taken lightly.

What is the treatment ?

The main treatment for overtraining syndrome is rest.  The more serious the overtraining, the more rest is needed in order for an athlete to return and achieve peak performance.

It is very hard to persuade athletes to rest for the period required to recover from the metabolic changes which cause overtraining syndrome.  Total rest for 3-5 weeks can often be required, followed by a prolonged period of progressively retraining over a period of a few months.  You can see why it’s better to rest, fuel and recover adequately as you go, rather than let overtraining affect your competition run-up period!

A longer period of relative rest is often suggested to be a different activity, with no performance measurement available or involved at all.  This will reduce the tendency to ‘self monitor progress’ and reduce stress, as well as providing some physical activity.

An ideal activity is gentle and aerobic, such as walking. This relative rest exercise phase should be light considered therapeutic rather than as a means to retain fitness and reduce return to sport delays.

No anaerobic or intense exercise should be allowed.

If recovery is going well, training could be resumed after a few months and under careful supervision to avoid relapsing, which is commonest around the 3 month mark.  Close coaching or cognitive behavioural therapy approaches could be helpful in promoting healthy self monitoring when resuming training.  Competition should ideally be avoided for at least 4 – 6 months.

Nutritional advice typically includes reduction of high glycemic index foods such as sugar and flour, incorporation of a balanced carbohydrate/protein/fat diet of whole foods, avoidance of stimulants and incorporation of omega 3 fatty acids (though I prefer the whole food route of eating cold water fish). 

In people seriously affected by overtraining syndrome, cognitive behavioural therapy or help with symptoms of depression may be required.  

All athletes suffering from overtraining would benefit from relaxation, stress management and similar approaches, both during their recovery as well as their re-entry into training and back to sport.

The primary way to prevent overtraining syndrome is to not overtrain – which is easier said than done.  Monitor your body and your mind and don’t dismiss your niggles (physical and mental) or the concern expressed by loved ones.

Happy and healthy training!

If you need support with your recovery or training, you can book in to see me at the Ascot Bracknell clinic or the Kensington Clinic today.



Leave a comment