The Overtraining Syndrome

  • Davide SustaEmail author


The overtraining syndrome (OTS) is a complex, systemic clinical condition affecting athletes exposed to a combination of high training loads and insufficient recovery. OTS could be described as a failure of the athlete’s body to cope with increasing conditioning loads, usually administered to stimulate adaptations leading to enhanced performance. During conditioning programmes, performance may be reduced, temporarily, this condition being a physiological response to training known as ‘functional overreaching’. In this case, performance is reduced for up to few weeks and fully restored after an adequate recovery. When the athlete’s body fails to adequately react to training loads and performance is not restored/improved after a longer period of recovery, ‘non-functional overreaching’ (NFOR), and OTS should be considered as potential diagnostic options.

The chapter aims to provide guidance on how to manage triathletes presenting with common signs and symptoms of OTS, and on how to use specific tools to make a diagnosis of OTS. The last part of this chapter is focused on ‘monitoring’ triathletes: in particular, emphasis is placed on the most effective preventive approaches reflecting the clinical complexity of NFOR/OTS and aiming at preserving triathletes’ health status.


Overtraining syndrome Athlete’s monitoring Training overload Overreaching Athlete’s stress 


  1. 1.
    Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, Raglin J, Rietjens G, Steinacker J, Urhausen A. Prevention, diagnosis and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science (ECSS) and the American College of Sports Medicine (ACSM). Eur J Sport Sci. 2013;13(1):1–24.CrossRefGoogle Scholar
  2. 2.
    Korkia PK, Tunstall-Pedoe DS, Maffulli N. An epidemiological investigation of training and injury patterns in British triathletes. Br J Sports Med. 1994;28:191–6.CrossRefGoogle Scholar
  3. 3.
    Zwingenberger S, Valladares RD, Walther A, Beck H, Stiehler M, Kirschner S, Engelhardt M, Kasten P. An epidemiological investigation of training and injury patterns in triathletes. J Sports Sci. 2014;32(6):583–90.CrossRefGoogle Scholar
  4. 4.
    Migliorini S. Risk factors and injury mechanism in triathlon. J Hum Sports Exerc. 2011;6:309–14.CrossRefGoogle Scholar
  5. 5.
    Birrer D, Lienhard D, Williams CA, Rothlin P, Morgan G. Prevalence of non-functional overreaching and the overtraining syndrome in Swiss elite athletes. Schweiz Z Sportmedizin Sporttraumatol. 2013;61:23–9.Google Scholar
  6. 6.
    Matos NF, Winsley RJ, Williams CA. Prevalence of nonfunctional overreaching/overtraining in young English athletes. Med Sci Sports Exerc. 2011;43(7):1287–94.CrossRefGoogle Scholar
  7. 7.
    Kenttä G, Hassmen P, Raglin JS. Training practices and over- training syndrome in Swedish age-group athletes. Int J Sports Med. 2001;22:460–5.CrossRefGoogle Scholar
  8. 8.
    Hynynen E, Uusitalo A, Konttinen N, Rusko H. Cardiac autonomic responses to standing up and cognitive task in overtrained athletes. Int J Sports Med. 2008;29(7):552–8.CrossRefGoogle Scholar
  9. 9.
    Le Meur Y, Pichon A, Schaal K, et al. Evidence of parasympathetic hyperactivity in functionally overreached athletes. Med Sci Sports Exerc. 2013;45(11):2061–71.CrossRefGoogle Scholar
  10. 10.
    Susta D, Dudnik E, Glazachev OS. A programme based on repeated hypoxia-hyperopia exposure and light exercise enhances performances in athletes with overtraining syndrome: a pilot study. Clin Physiol Funct Imag. 2017;37(3):276–81.CrossRefGoogle Scholar
  11. 11.
    Banfi G, Dolci A. Free testosterone/cortisol ratio in soccer: usefulness of a categorisation of values. J Sports Med Phys Fitness. 2006;46(4):611–6.PubMedGoogle Scholar
  12. 12.
    Meeusen R, Nederhof E, Buyse L, Roelands B, de Schutter G, Piacentini MF. Diagnosingovertraining in athletes using the two-bout exercise protocol. Br J Sports Med. 2010;44:642–8.CrossRefGoogle Scholar
  13. 13.
    Rietjens GJ, Kuipers H, Adam JJ, et al. Physiological, biochemical and psychological markers of overreaching. Int J Sports Med. 2005;26:16–26.CrossRefGoogle Scholar
  14. 14.
    Urhausen A, Gabriel H, Kindermann W. Impaired pituitary hormonal response to exhaustive exercise in overtrained endurance athletes. Med Sci Sports Exerc. 1998;30:407–14.CrossRefGoogle Scholar
  15. 15.
    Le Meur Y, Hausswirth C, Natta F, Antoine Couturier A, Bignet F, Vidal PP. A multidisciplinary approach to overreaching detection in endurance trained athletes. J Appl Physiol. 2013;114:411–20.CrossRefGoogle Scholar
  16. 16.
    Saw AE, Main LC, Gastin PB. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. Br J Sports Med. 2016;50:281–91.CrossRefGoogle Scholar
  17. 17.
    Kellmann M, Kallus KW. Recovery-stress questionnaire for athletes: user manual. Champaign, IL: Human Kinetics; 2001. p. 35–64.Google Scholar
  18. 18.
    Coutts AJ, Wallace LK, Slattery KM. Monitoring changes in performance, physiology, biochemistry, and psychology dur- ing overreaching and recovery in triathletes. Int J Sports Med. 2007;28(2):125–34.CrossRefGoogle Scholar
  19. 19.
    Hausswirth C, Louis J, Aubry A, Bonnet G, Duffield R, Le Meur Y. Evidence of disturbed sleep and increased illness in overreached endurance athletes. Med Sci Sports Exerc. 2014;46(5):1036–45.CrossRefGoogle Scholar
  20. 20.
    Cadegiani FA, Kater CE. Hormonal aspects of overtraining syndrome: a systematic review. BMC Sports Sci Med Rehabil. 2017;9:14.CrossRefGoogle Scholar
  21. 21.
    Duclos M. A critical assessment of hormonal methods used in monitoring training status in athletes. Int Sport Med J. 2008;9(2):56–66.Google Scholar
  22. 22.
    Tanskanen M, Atalay M, Uusitalo A. Altered oxidative stress in overtrained athletes. J Sport Sci. 2010;28(3):309–17.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.School of Health and Human PerformanceDublin City UniversityDublinIreland

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