Summary
Overtraining is an imbalance between training and recovery. Short term overtraining or ‘over-reaching’ is reversible within days to weeks. Fatigue accompanied by a number of physical and psychological symptoms in the athlete is an indication of ‘stateness’ or ‘overtraining syndrome’. Staleness is a dysfunction of the neuroendocrine system, localised at hypothalamic level. Staleness may occur when physical and emotional stress exceeds the individual coping capacity. However, the precise mechanism has yet to be established. Clinically the syndrome can be divided into the sympathetic and parasympathetic types, based upon the predominance of sympathetic or parasympathetic activity, respectively. The syndrome and its clinical manifestation can be explained as a stress response. At present, no sensitive and specific tests are available to prevent or diagnose overtraining. The diagnosis is based on the medical history and the clinical presentation. Complete recovery may take weeks to months.
Similar content being viewed by others
References
Aakvaag A, Opstad PK. Hormonal response to prolonged physical strain, effect of caloric deficiency and sleep deprivation. In Fotherby & Pal (Eds) Exercise endocrinology, pp. 25–64, de Gruyter, Berlin, 1985
Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Medicine and Science in Sports and Exercise 16(6): 529–538, 1984
Astrom E, Friman G, Pilstrom LJ. Effects of viral and mycoplasma infections on ultrastructure and enzyme activities in human skeletal muscle. Acta Pathologica et Microbiologica Scandinavica 84: 113–122, 1976
Baekeland F. Exercise deprivation: sleep and psychological reactions. Archives in General Psychiatry 22: 365–369, 1970
Barron GL, Noakes TD, Levy W, Smith C, Millar RP. Hypothalamic dysfunction in overtrained athletes. Journal of Clinical Endocrinology and Metabolism 60(4): 803–806, 1985
vander Beek EJ, Dokkum W, Schrijver J, Westra JA, VanderWeerd H, et al. Effects of marginal vitamin intake on physical performance in man. International Journal of Sports Medicine 5 (Suppl.): 28–31, 1984
Bruce RA, Kusumi F, Culver BH, Butler J. Cardiac limitations to oxygen transport and changes in components after jogging across the US. Journal of Applied Physiology 39(6): 958–964, 1975
Buchenko AA. Einige Grundlagen der elektrokardiographischen Untersuchung wahrend korperlicher Belastung in der Erholungsphase. Zeitblatt fur innere Medizin 22: 688–692, 1966
Buchenko AA, Kyshanovski MS, Zuravleva NB. Dystrophy of myocardium in sportsmen (in Russian), Medicina, 1980
Cannon WB. Bodily changes in pain, hunger, fear and rage, Appleton, New York, 1915
Carlile FF. Carlile on swimming, Pelham Press, London, 1966
Carlon BM. Regeneration research in the Soviet Union. Anatomic Research 160: 665, 1968
Cleroux J, Peronnet F, De Champlain J. Free and conjugated catecholamines in plasma and erythrocytes during exercise and recovery. In Dotson & Humphrey (Eds) Exercise physiology, pp. 61–68, AMS Press Inc., New York, 1985
Costill DL. Inside running, pp. 123–132, Benchmark Press Inc., Indianapolis, 1986
Counsilman JE. Fatigue and staleness. Athletic Journal 15: 16–20, 1955
Derevenco P, Florea E, Derevenco V, Anghel J, Simu S. Einige physiologische Aspekte des Uebertrainings. Sportartzt und Sportmedizin 18(4): 151–161, 1967
Dessypris A, Kuoppasalmi K, Adlercreutz H. Plasma Cortisol, testosterone, androstenedione and luteinizing hormone in a noncompetitive marathon run. Journal of Steroid Biochemistry 7: 33–37, 1976
Dressendorfer EH, Wade CE, Amsterdam EA. Development of pseudoanemia in marathon runners during a 20-day road race. Journal of the American Medical Association 246: 1215–1218, 1981
Dufaux B, Hoederath A, Heck H, Hollmann W. Serum testosterone levels during the first hours and days after prolonged physical exercise and the influence of physical training. Fourth International Symposium of Biochemistry and Exercise, Brussels. Abstract 47, 1979
Dufaux B, Hoffken K, Hollmann W. Acute phase proteins and immune complexes during several days of physical exercise. In Knuttgen et al. (Eds) Biochemistry of exercise, pp. 356–362 Human Kinetics Publishers Inc. Champaign, 1983
Dufaux B, Order U, Geyer H, Hollmann W. C-reactive protein serum concentration in well-trained athletes. International Journal of Sports Medicine 5(2): 102–106, 1984
Eberhardt A. Resistance against infections with intensive training and overtraining (in Polish). Sport Wyzycnowy Warszawa 8: 40–45, 1970
van Eegeraat B. Overtraining: its definition and possible valid physiological signs. Doctoral thesis, Interfaculty of Physical Education, Free University of Amsterdam, 1986
Fauci AS. Differential effects of in vivo hydrocortisone, prednisolone and dexamethasone in in vitro expression of lymphocyte function. Clinical and Experimental Immunology 24: 54–62, 1976
Friman G. Effects of acute infectious disease on circulatory function. Acta Medica Scandinavica (Suppl. 592): 6–45, 1976
Friman G. Effects of acute infectious disease in isometric muscle strength. Scandinavian Journal of Clinical and Laboratory Investigation 37: 303–308, 1977
Friman G, Schiller HH, Schwartz MS. Disturbed neuromuscular transmission in viral infections. Scandinavian Journal of Infectious Diseases: 99–103, 1977
Guyton AC. Textbook of medical physiology, WB Saunders Company, Philadelphia, 1981
Haggendal J, Johansson G, Jonsson L, Thoren-Tolling K. Experimental stress, blood levels of catecholamines and myocardial cell necrosis. In Usdin et al. (Eds) Stress, the role of catecholamines and other neurotransmitters, pp. 637–648, Gordon and Breech Science Publishers, New York, 1983
Hakkinen K, Pakarinen A, Alen M, Kauhanen H, Komi PV. Relationships between training volume, physical performance capacity, and serum hormone concentrations during prolonged training in elite weight lifters. International Journal of Sports Medicine 8 (Suppl. 1): 61–65, 1987
Hanson PG, Vander Ark CR, Besozzi MC, Rowe GC. Myocardial infarction in a national class swimmer. Journal of the American Medical Association 248: 2313–2314, 1982
Harre D. Trainingslehre, Sportverlag, Berlin 1973
Herxheimer A. Grundriss der Sportmedizin, Thieme, Leipzig, 1933
Hochrein M, Schleicher I. Das zirkulatorische Entlastungssyndrom. Medizinisches Monatzeitschrift 12: 234–240, 1958
Hollmann W, Hettinger T. Sportmedizin, Arbeits und Trainingsgrundlagen, pp. 549–552, F.K. Schattauer Verlag, Stuttgart, 1980
Israel S. Die Erscheinungsformen des Uebertrainings. Sportmedizin 9: 207–209, 1958
Israel S. Das akute Entlastungssyndrom des Leistungssportlers. Sportartzt und Sportmedizin 18 (H8): 185–190, 1967
Israel S. Zur Problematik des Uebertrainings aus internistischer und leistungsphysiologischer Sicht. Medizin und Sport 16(1): 1–12, 1976
Janssen E, Kuipers H, Keizer H. Plasma CPK and AST activity and plasma testosterone levels after 200 km speedskating. Abstract. Medicine and Science in Sports and Exercise 18(2): S42, 1986
Jetzler A. Sportaerztliche Aufgaben. Schweizer Medizinische Wochenschrift 7: 151–155, 1939
Jokl E. The immunological status of athletes. Journal of Sports Medicine 14: 165–167, 1974
Karpovich PV. Physiology of muscular activity, WB Saunders, Philadelphia, 1965
Keizer HA, Kuipers H, De Haan J, Beckers E, Habets L. Multiple hormonal responses to exercise in eumenorrheic trained and untrained women. International Journal of Sports Medicine 8 (Suppl. 3): 139–150, 1987b
Keizer HA, Kuipers H, De Haan J, Janssen GME, Beckers E, et al. Effect of a 3-month endurance training program on metabolic and multiple hormonal responses to exercise. International Journal of Sports Medicine 8 (Suppl. 3): 154–160, 1987c
Keizer HA, Menheere P, Kuipers H. Changes in pulsatile LH secretion after exhaustive exercise. Medicine and Science in Sports and Exercise 19 (Suppl.): 26, 1987a
Kelly FJ, McGrath JA, Goldspink DF, Cullen MJ. A morphological/biochemical study on the actions of corticosteroids on rat skeletal muscle. Muscle and Nerve 9: 1–10, 1986
Kereszty A. Overtraining. In Larson & Leonard (Eds) Encyclopedia of sport sciences and medicine, pp. 218–222, MacMillan, New York, 1971
Kindermann W. Das Uebertraining — Ausdruck einer vegetativen Fehlsteuerung. Deutsche Zeitschrift fur Sportmedizin H8: 138–145, 1986
Kuipers H. Overtraining in race horses. Lecture presented at the annual meeting of the American College of Sports Medicine, Las Vegas, 1987
Kuipers H, Verstappen F, Keizer H, Geurten P, VanKranenburg G. Variability of aerobic performance in the laboratory and its physiological correlates. International Journal of Sports Medicine 6: 197–210, 1985
Kuoppasalmi K, Adlercreutz H. Interaction between catabolic and anabolic steroid hormones in muscular exercise. In Fotherby & Pal (Eds) Exercise endocrinology, pp. 65–120, de Gruyter, Berlin, 1985
Kuoppasalmi K, Naveri H, Harkonen M, Adlercreutz H. Plasma Cortisol, androstenedione, testosterone, and luteinizing hormone in running exercise of different intensities. Scandinavian Journal of Clinical and Laboratory Investigation 40: 403–409, 1980
Kurowski TT, Capaccio JA, Hickson RC. Glucocorticoids override androgen-induced muscle growth. Abstract. Medicine and Science in Sports and and Exercise 18: 109, 1986
Kurowski TT, Chatterton RT, Hickson RC. Countereffects of compensatory overload and glucocorticoids skeletal muscle: androgen and glucocorticoid cytosol receptor binding. Journal of Steroid Biochemistry 21: 137–145, 1984
Levando VA, Suzdalnicki RS. Current problems of diagnostics, treatment and prophylactics of diseases in sportsmen (in Russian). Teori Prakt Fizuri Kultura 3: 21–23, 1983
Lewicki R, Tchorzewski H, Denys A, Kowalska M, Golinska A. Effect of physical exercise on some parameters of immunity in conditioned sportsmen. International Journal of Sports Medicine 8(5): 309–314, 1987
Liessen H, Dufaux B, Hollmann W. Modification of serum glycoproteins during the days following prolonged physical exercise and the influence of physical training. European Journal of Applied Physiology 37: 243–254, 1977
Maron MB, Horvath SM, Wilkerson JE. Blood biochemical alterations during recovery from competitive marathon running. European Journal of Applied Physiology 36: 231–238, 1977
Mason JW. Emotions as reflected in patterns of endocrine regulation. In Levi (Ed.) Emotions, their parameters and measurement, pp. 143–181, Raven Press, New York, 1975
McArdle WD, Katch FI, Katch VL. Exercise physiology, 2nd ed., pp. 356–361, Lea & Febiger, Philadelphia, 1986
McKechnie JK, Leary WP, Noakes TD, Kallmyer JC, Mac-Searraigh ETM, et al. Acute pulmonary edema in two athletes during a 90-km running race. South African Medical Journal 56: 261–265, 1979
Mellerowicz H, Barron DK. Overtraining. In Larson & Leonard (Eds) Encyclopedia of sport sciences and medicine, pp. 1310–1312, MacMillan, New York, 1971
Mellerowicz H, Meller W. Training, pp. 82–84, Springer Verlag, Berlin, 1975
Michael L. Overtraining in athletes. Journal of Sports Medicine and Physical Fitness 1(2): 99–103, 1961
Mies H. Erschopfung und Uebermuedung. Sportmedizin 8: 13–17, 1957
Miller RE, Mason JW. Changes in 17-hydroxy corticosteroid excretion related to increased muscular work, pp. 137–151, Walter Reed Institute of Research, 1964
Morgan WP, Brown DR, Raglin JS, O’Connor PJ, Ellickson KA. Psychological monitoring of overtraining and staleness. British Journal of Sports Medicine 21(3): 107–114, 1987
Niemela KO, Palatsi IJ, Ikaheimo MJ, Takkunen JT, Vuori JJ. Evidence of impaired left ventricular performance after an uninterrupted competitive 24-hour run. Circulation 70(3): 350–356, 1984
Noakes T. Love of running, Oxford University Press, Cape Town, 1986
Persson SGB, Larsson M, Lindholm A. Effects of training on adrenocortical function and red-cell volume in trotters. Zeitblatt fur Veterinar Medizin 27: 261–268, 1980
Persson SGB. Analysis of fitness and state of training. In Snow et al. (Eds) Equine physiology, pp. 441–457, Granta editions, Cambridge, 1983
Prokop L. Physiologie und Pathologie des Uebertrainings. Sportmedizin 9: 239–243, 1958
Riedman SR. The physiology of work and play, Dryden Press Inc., New York, 1950
Rivier C, Vale W. Diminished responsiveness of the hypothalamic-pituitary-adrenal axis of the rat during exposure to prolonged stress: a pituitary-mediated mechanism. Endocrinology 121(4): 1320–1328, 1987
Ronkainen H. Depressed folicle stimulating hormone, luteinizing hormone and prolactin responses to luteinizing hormone releasing hormone, thyrotropin releasing hormone, and metoclopramide test in endurance runners in the hard training season. Fertility and Sterility 40: 755–759, 1985
Ryan AJ, Brown RL, Frederick EC, Falsetti HL, Burke RE. Overtraining of athletes; a round table. Physician and Sports-medicine 11(6): 93–110, 1983
Sapolsky RM, Krey LC, McEwen BS. Glucocorticoid-sensitive hippocampal neurons are involved in terminating the adrenocortical stress response. Proceedings of the National Academy of Science in the USA: 6174–6178, 1984
Sapolsky RM, Krey LC, McEwen BS. The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocrinology Reviews 7: 284–301, 1986
Seene T, Viru A. The catabolic effects of glucocorticoids on different types of skeletal muscle fibres and its dependence upon muscle activity and interaction with anabolic steroids. Journal of Steroid Biochemistry 16: 349–352, 1982
Selye H. The stress of life, McGraw-Hill, New York, 1956
Smelik PG. Factors determining the pattern of stress responses. In Usdin et al. (Eds) Stress, Vol. 1, pp. l17–25, Gordon and Breach Science Publishers, New York, 1983
Sulman FG, Pfeifer Y, Superstine E. The adrenal exhaustion syndrome: an adrenal deficiency. In Melvy (Ed.) Annals of the New York Academy of Science, Vol. 301, The marathon, pp. 918–930, The New York Academy of Sciences, New York, 1977
Sundsfjord JA, Stromme SB, Aakvaag A. Plasma aldosterone, plasma renin activity, and Cortisol during exercise. In Howald & Poortmans (Eds) Metabolic adaptations to prolonged physical exercise, p. 308 Birkenhauser Verlag, Basel, 1975
Thompson JK, Blanton P. Energy conservation and exercise dependence: a sympathetic arousal hypothesis. Medicine and Science in Sports and Exercise 19(2): 91–99, 1987
Verma SK, Mahindroo SR, Kansal DK. Effect of four weeks of hard physical training on certain physiological and morphological parameters of basket-ball players. Journal of Sports Medicine 18: 379–384, 1978
Vigas M, Kvetnansky R, Jurcovicova J, Jezova D, Tatar P. Comparison of catecholamine and adenopituitary hormone responses to various stress stimuli in man. In Usdin et al. (Eds) Stress, Vol. 2, pp. 865–882, Gordon and Breach Science Publishers, New York, 1983
Viru A. The mechanism of training effects: a hypothesis. International Journal of Sports Medicine 5: 219–227, 1984
Viru A. Hormones in muscular activity, Vol. I. Hormonal ensemble in exercise, CRC Press Inc., Boca Raton, 1985a
Viru A. Hormones in muscular activity, Vol. II. Adaptive effect of hormones in exercise, CRC Press Inc., Boca Raton, 1985b
Wassiljewa WW. Einige Bemerkungen zu den Mechanismen der Ermuedung und des Uebertrainings. Theorie und Praxis der Korperkultur 4: 3–10, 1955
Webb ML, Wallace JP, Hamill C, Hodgson JL, Mashaly MM. Serum testosterone concentrations during two hours of moderate intenstiy treadmill running in trained men and women. Endocrinological Research 10: 27–38, 1984
Weinstein L. Poliomyelitis — a persistent problem. New England Journal of Medicine 288: 370–371, 1973
Wolf JG. Ein Beitrag zur Frage des Uebertrainings. Sportmedizin 2: 33–38, 1957
Wolf JG. Staleness. In Larson & Leonard (Eds) Encyclopedia of sport sciences and medicine, pp. 1048–1050, MacMillan, New York, 1971
Yakovlev NN. Die Bedeutung einer Stoning der Homeostate fur die Effektivitat des Trainingsprozesses. Medizin und Sport 12: 367–373, 1972
Yakovlev NN, Viru AA. Adrenergic regulation of adaptation to muscular activity. International Journal of Sports Medicine 6: 255–265, 1985
Yen SSC, Tsai CC, Naftolin F, Vandenberg G, Ajabor L. Pulsatile patterns of gonadotrophin release in subjects with and without ovarian function. Journal of Clinical Endocrinology and Metabolism 34: 671–676, 1972
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kuipers, H., Keizer, H.A. Overtraining in Elite Athletes. Sports Medicine 6, 79–92 (1988). https://doi.org/10.2165/00007256-198806020-00003
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-198806020-00003