Overtraining syndrome (OTS), once primarily seen in elite athletes, is now increasingly affecting recreational athletes as interest in intense workouts and endurance events grows. OTS occurs when individuals push their bodies beyond their ability to recover, often by exercising too frequently or intensely without sufficient rest.
Kristopher J. Paultre, M.D., a family medicine and primary care sports medicine specialist with the UHealth Sports Medicine Institute, explains: “It happens when you exercise too frequently or too intensely without giving your body enough time to rest and recover.”
Unlike professional athletes who typically have access to a team of health professionals overseeing their recovery, recreational athletes may not recognize persistent fatigue or soreness as signs of a more serious issue. Dr. Paultre notes, “They are cognizant of the fact that these athletes put their bodies under a lot of strain. Whereas the lay person doesn’t have that help and may not recognize what is happening to their body.”
Estimates suggest that up to 30% of non-professional athletes training for endurance events like swimming, cycling, or running may experience overtraining at some point.
Symptoms of OTS can vary widely and include chronic fatigue, ongoing muscle and joint soreness that does not resolve with rest, frequent injuries, disrupted sleep patterns, hormonal imbalances, lack of motivation, depression or anxiety, and stalled or declining athletic performance. In severe cases, individuals may experience mental fog, immune suppression, insomnia, and cardiovascular strain.
Dr. Paultre distinguishes OTS from overuse injuries such as tendinitis or stress fractures. While overuse injuries result from repetitive motion affecting specific areas of the body, OTS is a systemic condition impacting both physical and mental health.
Diagnosis involves heart rate tracking, brain scans, blood tests, psychological questionnaires, and use of tools like the EROS scale—three diagnostic scores based on clinical signs and biochemical measures—to better identify OTS symptoms. However, Dr. Paultre emphasizes: “when OTS is on my radar, 90% of the diagnosis is based on the patient’s clinical history.”
Treatment can be challenging since many active individuals are reluctant to take extended breaks from exercise. Dr. Paultre recommends “active recovering,” which includes restorative practices such as prioritizing sleep, engaging in gentle activities like walking or yoga, focusing on nutrition for hormonal balance, participating in physical therapy, and addressing emotional fatigue through therapy or mindfulness exercises.
Prevention remains key; strategies include allowing adequate rest between intense workouts, maintaining a balanced diet aligned with caloric needs, and cross-training to reduce repetitive strain on muscles.
“You have to take time off [both physically and mentally],” Dr. Paultre advises. “It’s not worth risking your health over sports.”
For more information about overtraining syndrome—including its causes and management—see resources provided by Physiopedia: https://www.physiopedia.com/Overtraining_Syndrome
