Welcome to the PT Rebels Podcast.

This is the place to learn how you can become a PT rebel and take charge of your own health and wellness. We will help you find answers to your questions about pain, injury, and the path towards healing in the most efficient and effective way possible.

I’m your host, Dr. Gina F.

On today’s episode, I wanted to talk with you all about a concept. Term called over training, over training syndrome occurs when an athlete doesn’t adequately recover after repetitive intense training. And this can in include several symptoms such as fatigue, declining performance, and potential injury. So our athletes especially are cross country athletes. Football athletes are starting to train over the summer for the upcoming fall season. So I thought it would be important just to discuss. What is over training? What can, what signs can we be looking for in our athletes in order to recognize red flags or things that we can do to help prevent further over training syndrome from becoming a real problem in our athletes? So many of our athletes that we work with in the clinic are very intense, high level athletes. They’re very driven, very type A, very OCD. Oftentimes they work in programs that are elite level and so that the demands day after day can be very high. So we know that over training can occur when too much training without significant recovery really starts to hinder progress and leads to a decline in overall performance and practice and competition. When our athletes are trying to improve their performance, they really have to push their limits. But sometimes there’s a line that’s crossed and oftentimes that’s difficult to determine what line or boundary that is, that is crossed. And so for coaches and parents and athletes alike, it’s important for us to recognize the signs and symptoms of when you’ve gone a little too far Over. Training often occurs when strenuous training without adequate recovery leads to. Negative effects and negative impacts on how the athlete feels and how they perform, whether that be in practice, workouts, weight training, et cetera. So what are the warning signs and symptoms of over training and how can you prevent it? There are two classifications for too much exercise, and those are termed overreaching and over trading. Overreaching is when. Your muscle soreness is just above and beyond what you normally experience after your workouts when you don’t sufficiently recover between workouts and you just feel this ongoing muscle soreness that’s unusually bad. Overreaching usually happens after several days of hard training, and you start to feel really just run down. So it’s important to communicate these symptoms to your parents, to your coaches. To your athletic trainers, to your physician, but luckily the effects of overreaching can be easily reversed with rest or unloading over. Training occurs when oftentimes the athletes ignore signs of overreaching and you just continue to train. So most athletes that we work with who experience that disbelieve that weakness or poor for poor performance means that they need to train even harder. They continue to push themselves and they think, well, I’m just weak. I need to just get stronger. I just need to get tougher. However, when they reach this point in their training, this only breaks the body down further. So the importance of full recovery from training is essential, and it’s really important to monitor that. Some athletes monitor that just by. Rate of perceived exertion. They monitor that, how they feel immediately after practice, an hour later the next morning and 24 hours later. That’s one way to monitor it. There’s some fancier methods which include, you know, some of the Garmin watches, or the whoop or the R ring. This can give you data just in terms of how well are you recovering after your tough workouts or competition. Healthy sleep, nutrition and mental mental wellness are critical in preventing over training, so it’s often important to include a multidisciplinary approach to avoid overreaching and over training. Sleep is really a priority. I see so many athletes in the clinic who don’t get adequate sleep. Nutrition can be a big problem. Even if you’re eating the right types of food and healthy foods, sometimes you just aren’t fueling enough or getting enough. And mental to wellness as we, as we’ve talked about on this podcast before, is really crucial in overall wellbeing and physical performance. So incorporating a sports performance, mental health professional is really critical oftentimes in helping to identify things in your life that may be. Making you feel even more tired or even more stressed, that also contribute to overreaching or over training. Many of us use exercise to mean stress, and it can be a great, great way to clear your head or enhance your mood. But oftentimes athletes become almost obsessed with this as well. So, so oftentimes you can have just too much of a good thing. So it’s important to recognize the symptoms and warning signs of over training. So I wanted to talk with you guys about that. So that you can be prepared when these symptoms arise if they arise. Training related signs of over-training include unusual muscle soreness after a workout, which persist with continued training, the inability to train or compete at a previously tolerable level or manageable level. So if you’re at practice and you’re on an easy run and usually you know, just a recovery or easy run, it feels like you can barely even get through it or can’t get through it, that’s a red flag and you need to talk with your coach about that. If you feel heavy legs. I often hear this in the clinic from, especially female athletes that I’ve worked with, with over training. They say their legs just feel really heavy, and even at lower exercise intensities, they just feel like they can’t even finish a, a easy run. Their legs just feel like they’re dragging or very heavy. Another warning sign is a delay in recovery from training. So if normally you recover well within 24 hours, but yet it’s taking you sometimes 48 to 72 hours to even feel like you’re able to recover from that, that’s also a red flag. Another training related sign of overarch training is just performance decline. So if you notice that you’re not hitting the normal times in practice, your competition. You’ve, you’re doing the same types of training workouts. You’re not ill, no major life changes, but that your performance just starts to decline. That’s also a pretty big red flag that you could be over training also. I’ve seen this several times in our high school and collegiate athletes when they start feeling thoughts of skipping or cutting short training sessions, especially for our elite athletes who are just really driven and committed. That’s a red flag, that’s a warning sign. It’s not that they’re just trying to get out of the workout or that they’re lazy. It’s a, they’re so exhausted. They, they just start thinking, man, maybe I’ll just skip this workout, or maybe I’ll just cut this workout short, or maybe I’ll, I’ll start walking. I’ve known athletes in high school who their coach says they can never finish a workout, and sometimes you know that you start to ponder and go, well. Do they just really not wanna compete in this sport or, and, and honestly, I think in this case, this athlete’s case or other athletes that I’ve seen, they’re doing two or three other sports at the same time and they’re just physically exhausted and they don’t have the capacity to keep training at that level or to even finish one of the workouts in that sport. So again, that’s a red flag. Lifestyle related signs of over training can be prolonged, general fatigue, just feeling exhausted. Also, another lifestyle sign of over training is just an increase in your overall feelings of anxiety or tension, depression, anger, or confusion. So parents, if you notice, your athletes are. More irritable than normal. Oftentimes, teenagers can be quite irritable. I know mine is at times, I love him, but he can be quite irritable. But if you notice there’s an increase in that and just an increase in overall frustration, pay attention to that and look into whether or not they need more recovery time. Also, an inability to relax or poor quality. Sleep can be a sign of over training. As we mentioned earlier, lack of energy. Energy, decreased motivation or moodiness beyond what is normal for that athlete can be another sign of lifestyle related signs of overtraining. Also not feeling joy from things that were once enjoyable. You know, I think we’ve all experienced just being phy, just physically push to the edge or limit, and just really on the fringes and not being able able to tolerate much more. Depending on your situation, whether it be an athlete, a parent, a business owner, what, what have you. But in these athletes, they just feel like they’ve reached the edge where they, nothing really feels too enjoyable anymore. And when their start, when their sports starts to not feel enjoyable, that is a red flag to us to pay attention and to have a conversation with that athlete and look at their overall training loads. Other health related signs of overtraining are increased occurrences of illness, sickness, flu. Holds, just not able to get healthy, increased blood pressure and at rest. Heart rate increased or irregular menstrual cycles. Most of the time that’s missing periods. Weight loss or appetite loss. Also, constipation and diarrhea. So when your system just doesn’t seem to be functioning very well, it’s time to probably get some blood work. Talk to your general physician, talk to your nutritionist, talk to your coaches and find out. What things are going wrong and what areas you can make improvements in. It’s very important to identify these symptoms early on and to adjust training to accommodate, and if the symptoms become more severe and prolonged, the recovery honestly just takes much longer. There’s athletes that I know recently who have been dealing with over training syndrome for six months or more, and it’s significantly impacted their professional writing career. So if you can identify these signs early on, you can help to prevent some of the longer lasting effects. So how do you recover from over training as an athlete? First, as I mentioned earlier, super important to talk with your coach, your athletic trainer, your doctor, your parents. These professionals can help you identify personalized guidelines or metrics. To optimize your recovery and prevent further problems down the line. It’s also really important coaches to help your athletes identify these issues and not be quick to blame them on other things, such as just being a moody teenager or teenager not wanting to finish the workout. Or if you notice a drastic difference in your athlete, really pay attention and look further into the situation in order to best help that athlete. It’s also. Important for coaches to have an open dialogue with their athletes and for their athletes to feel safe to come talk with them about these issues that they may be having. Oftentimes, they feel like athletes feel as if they need to hide these symptoms because they feel like their coach may see them as weak or vulnerable. And these athletes don’t wanna lose their position on the team. They don’t wanna lose their position on the relay. For instance, if you’re a runner, you don’t want to lose your position on the cross country team and, and miss going to the state track meet or national track meets. So maybe you, they could, might be best to keep quiet so that your coach doesn’t think there’s anything wrong and put someone else in your place. So coaches, I think it’s extremely important in your program. That athletes feel the safety, that there’s open communication for them to be able to come to at any time with the symptoms that they may be experiencing. I know one thing that I try to encourage athletes to do is keep a journal. So they’re journaling their recovery after workouts immediately after the workout, 24 hours later after the workout, just so they can track how they’re feeling and they can communicate. To their coaches, to their athletic trainers, to their parents, how they’re feeling. So if there’s a big dip or decline in that, you can identify that and start to treat that right away. Once you’ve acknowledged and addressed over training syndrome, it’s time to, you know, take action and again, have a team approach to that, whether that be with your physician who’s maybe doing blood work, sitting down and talking with you. Doing certain testing in order to determine how significant this Overtraining syndrome is. Meeting with the nutritionist to examine your eating habits, are you intentionally or unintentionally depriving your body of calories? A protein of vitamins and minerals it needs for that high intensity training. And the, a very good sports nutritionist is able to identify a correct eating plan for you to, that can provide your body with the right energy and nutrients it needs for. Healing moving forward. Mental health. We’ve talked with Brooke Ewart a few episodes ago about how emotionally challenging injury or even taking time off from training can be, and mental health professionals can help you with recovery from over training by offering you just a safe place and space to discuss your feelings and to get the support that you need in order to help. You feel as athletes feel less overwhelmed or discouraged by taking a break or deloading or addressing the issues that you’re having Related to the over training, mental skills and other psychology skills can be taught and used during the break, such as mindfulness, visualization, and other techniques that have been shown to be really helpful in. Preparing and returning to sport after inter any injury, but especially after this type of injury and challenge, it’s important that you have a gradual return. So if you’ve addressed over training, you’ve sought help, you’ve recovered, and you wanna return back to running into your full training program, it’s unlikely that you’re going to be ready just to jump in and resume full training. So it’s really important that you go slow and you start low. Your training volume, your training volume really should be probably reduced by at least 50 or 60% when you experience over-training syndrome. And that’s a general guideline, but based on, you know, findings of blood work. And after meeting with mental health and nutritionist, you can decide, like with your, with your team, what would be most beneficial. Your doctor and coach will help you determine when you’re ready to begin training again, and that those signs that. If you’re ready to resume training are just a renewed interest and ability to train hard with normal responses, but it’s important to go low and to go slow, go low in your training volume and increase how much you train by no more than about 10% each week. So tools that we have in order to help with a gradual return to training are cross training. You can do training on an anti-gravity treadmill, for instance, or pool. Do water running or unloaded running in the alter G treadmill on alternate days that you, you know, may resume land training two or three times a week, but also incorporating days where you offload and do training in the alter G, the anti-gravity treadmill that helps unload body weight or pool training so that you can gradually increase your overall load and training volumes throughout the weeks to avoid another situation of over training is essential. Even though easing back into training can be probably one of the more difficult things that an athlete can do, I know for myself, one of the hardest things I had to do as an athlete was when it became time to jump back into training was not just go 125%. Again, it was really being disciplined to gradually return to sport and gradually return to training and to have discipline to do that so that you don’t. Get back into another situation of over training your injury. The recovery will be different for every athlete that has experienced over training. So it’s important to be aware of symptoms as you progress back to activity. And remember those red flag lists and those signs that we talked about. And if you start to feel those again, and it’s important that you talk with your medical team about that as well. How do you avoid over training as an athlete? It’s somewhat tricky, especially when you’re getting back into preseason. Oftentimes, you just don’t really feel very good and you are sore. Here’s some tips to help you keep your training regimen and your return to sport safe and realistic. Number one is to listen to your body. Number two, visualize your workouts. If you can visualize and rehearse your training, you can think about not overloading your body and risking injury and making that a priority as you return back to your training program. As I mentioned earlier, keeping a training log to record your feelings of how well you feel after you’ve exercised or worked out. It is important in your ability to recognize signs of over-training so that if you start to feel like you’re not recovering well, you can reduce that load and prevent those symptoms that you once experienced. Also, balanced training with time for recovery. Oftentimes athletes struggle with this, but adequate rest is not a sign of your weakness as an athlete. It’s actually the opposite. Some of the most high level athletes that I’ve met have a very elaborate recovery regimen and routine, and I think that as we mature as athletes, it’s important to realize that adequate rest is a sign of empowerment, not weakness. You need at least one complete day of rest each week. I’m gonna repeat that again. You need at least one complete day of rest every week. I know programs in this area where we work who do not have a rest day built in, and oftentimes they’re doing a couple of workouts per day, seven days a week, and so that just leads to problems. It seems pretty obvious. Apparently it’s not obvious enough for some of these programs not to stop doing that, so please realize that it’s essential to have a day of rest. Also, if you’re training for a specific activity, alternate hard and easy days. Most coaches who are good coaches understand this and they’ll incorporate either a form of cross training or easy runs or easy workouts into the training so that you can adjust your training load accordingly. Also acknowledge when you’re overdoing it and talk to someone about it. You know, it’s one thing to just be gritty and tough and resilient, but you have to know when enough’s enough, and you have to, as you mature as an athlete, start to develop, develop ideas of what those boundaries are, and it’s important to know where those boundaries are and communicate when you feel like you’re overdoing it. If you find yourself becoming obsessed with training. Exercising despite injury or pain or feeling guilty. If you go a day without vigorous exercise, it’s important to talk with a, a sports psychologist about your feelings because you wanna have a healthy relationship with exercise. And this is a really common thing that we see with our high school collegiate and professional athletes. The next thing I wanted to discuss is really essential and it leads into the next discussion we’ll have in the next episode, but make sure you’re getting enough calories and nutrients. A lot of our athletes just eat very well. They’re very in tune with their nutrition. They have met with nutritionists and they eat well, but they’re not necessarily eating enough to fuel their body in order to meet the needs of training and to help with muscle repair after those hard workouts. If you’re not getting enough calories and nutrients that can lead to relative energy deficit in sports. That is another problem that we will discuss, as I said in the next episode, but that can lead to a whole cascade of other events. Also, drink lots of water. Dehydration contributes to muscle fatigue, so be cautious with fluids that add to dehydration, such as caffeinated or alcoholic beverages. It’s really important to ensure adequate fluids with. Electrolytes and with the goal of having just that light colored urine. So if you go to the bathroom and your urine’s pretty dark, you know you have a problem. If it’s really light, then you’re good. That’s a really easy way to measure that. Also, do what you can to reduce your stress. Everyone in this world right now, I don’t really know. Well, yeah, I don’t, I don’t think I personally know of anyone who doesn’t really have any stress. We all have stress. The world’s getting more and more stressful, I think. On a daily basis sometimes, and we have to realize that one way to avoid over training is to help reduce our overall stress load. Everyone deals with stress differently, so when your stress levels exceed, your ability to cope, your body will begin to break down. That’s why some of the best coaches that I know incorporate mental health professionals into their programs to help their athletes deal with stress. Look for opportunities to rearrange your priorities. Also to help reduce the effects of your stressors. There’s things that we can all do in our lives to help decrease the overall amount of stress that we have, and whether that’s making choices and making, creating boundaries to help push those stressors out of our lives, or taking more time to just take care of ourselves to reduce those stressors. Those things are essential in order to help with overall recovery. Finally, I’ve mentioned it a few times, but when you can get help from a mental health professional to work through your issues related to training, job, family, social life, audio image, anything else that impacts your mental wellbeing, please consider getting help from a mental health professional. And Brooke Ewart is a mental health professional that I highly respect at Rocky Mountain Sports Counseling and her episode. A few weeks ago was really key in helping to the importance of getting help from a mental health professional. So just to recap, if you’re an athlete trying to improve your performance and getting back into season, just know that you do have to push your limits to a certain extent. But there are boundaries to that, and being able to recognize the signs and symptoms of over training is essential in helping to avoid further injury and performance decline. Please make sure that you’re meeting with your coach and your athletic trainer, physical therapist, nutritionist, about any signs and symptoms that you may be feeling to help avoid a longer term problem in the future.