Considerations for coaches and physicians
OTS: Overtraining syndrome, OR: Overreaching
Until a definitive diagnostic tool for the OTS is present, coaches and physicians need to rely on performance decrements as verification that an OTS exists. However, if sophisticated laboratory techniques are not available, the following considerations may be useful:
- Maintain accurate records of performance during training and competition. Be willing to adjust daily training intensity/volume or allow a day of complete rest, when performance declines, or the athlete complains of excessive fatigue.
- Avoid excessive monotony of training.
- Always individualize the intensity of training.
- Encourage and regularly reinforce optimal nutrition, hydration status, and sleep.
- Be aware that multiple stressors such as sleep loss or sleep disturbance (e.g., jet lag), exposure to environmental stressors, occupational pressures, change of residence, and interpersonal or family difficulties may add to the stress of physical training.
- Treat OTS with rest. Reduced training may be sufficient for recovery in some cases of OR.
- Resumption of training should be individualized on the basis of the signs and symptoms because there is no definitive indicator of recovery.
- Communication with the athletes (maybe through an online training diary) about their physical, mental, and emotional concerns is important.
- Include regular psychological questionnaires to evaluate the emotional and psychological state of the athlete.
- Maintain confidentiality regarding each athlete’s condition (physical, clinical and mental).
- Importance of regular health checks performed by a multidisciplinary team (physician, nutritionist, psychologist, etc.).
- Allow the athlete time to recover after illness/injury.
- Note the occurrence of URTI and other infectious episodes; the athlete should be encouraged to suspend training or reduce the training intensity when experiencing an infection.
- Always rule out an organic disease in cases of performance decrement.
- Unresolved viral infections are not routinely assessed in elite athletes, but it may be worth investigating this in individuals experiencing fatigue and underperformance in training and competition. Moreover, when OTS is suspected, it is also of utmost importance to standardize the criteria used for diagnosis and/or, at least, as tools for the diagnosis of OTS are lacking, to standardize the criteria of exclusion of OTS
A primary indicator of OR or OTS is a decrease in sport-specific performance, and it is very important to emphasize the need to distinguish OTS from OR and other potential causes of temporary underperformance such as anemia, acute infection, muscle damage, and insufficient carbohydrate intake.
The physical demands of intensified training are not the only elements in the development of OTS. It seems that a complex set of psychological factors are important in the development of OTS, including excessive expectations from a coach or family members, competitive stress, personality structure, social environment, relationships with family and friends, monotony in training, personal or emotional problems, and school- or work- related demands. Although no single marker can be taken as an indicator of impending OTS, the regular monitoring of a combination of performance, physiological, biochemical, immunological, and psychological variables would seem to be the best strategy to identify athletes who are failing to cope with the stress of training. We therefore propose a “check list” that might help the physicians to decide on the diagnosis of OTS and to exclude other possible causes of underperformance.
The fundamentals and suggestions above form part of The Athlete Clinics basic tool kit in developing the athlete. We have coached and developed athletes to World and European medals and standards in various sports. Our coaching programs are tailored to the individual athlete wether one is a full-time athlete or just getting back into sport or fitness. We offer free consultations at our clinic in Galway or by appointment throughout the country. We can be contacted through our contact page above. Remember your an individual why not get treated like one.
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