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ABSTRACT: Overtraining syndrome is Physiological Indicators stress fractures, and tendinitis conditions
common in athletes. It manifests itself with Numerous physiological characteris- in the lower extremities (4, 19). It is un-
both physiological and psychological tics of overtraining syndrome are docu- clear whether overuse injuries associated
symptoms, and can adversely affect an mented in the literature (3,10,14; Table 1). with overtraining are the result of exces-
athlete'sperformance. This article reviews In an overtrained athlete, an overactive sively high training loads or the body's
the physiological and psychological signs pituitary gland is primarily responsible for impaired ability to recover from training
and symptoms ofovertraining syndrome in physiological responses to overtraining. bouts.
order to help the athletic trainer recognize Stimulation of the hypothalamus causes Still another of the body's systems
the condition. With an understanding of the pituitary gland to secrete excess adre- affected by overtraining syndrome is the
overtraining syndrome, the athletic trainer nocorticotropic hormone. This, in turn, cardiovascular system. Overtrained ath-
can better aid coaches and athletes in stimulates cortisol secretion by the adrenal letes exhibit elevated exercise heart rates
preventing and treating this phenomenon, cortex, which aids the body in adapting to and require longer for their heart rate to
and thus maintain the athlete's optimal stress. Barron et al (2) reported that corti- return to normal following activity (4).
performance level. sol levels were significantly higher in ath- Early studies found both increased (15)
letes who had overtrained than in the same and decreased (25) resting blood pressure
athletes after they had4 weeks of rest. The in overtrained athletes. More recently,
O vertraining syndrome has been re- elevation of cortisol levels in overtrained Henschen (10) reported that higher sys-
ferredto as "staleness," "overreach- athletes in this study was observed imme- tolic blood pressure was a physiologic char-
ing," and "chronic fatigue" (21). It can diately following exercise, as well at 15 acteristic of overtraining. Verma et al (24)
result in mental lassitude and/or physical and 30 minutes postexercise. observed a lengthened time to return to
injury and therefore a declining perfor- The humanreproductive system also basal blood pressure levels after exercise
mance (21). Most simply put, overtraining is adversely affected by overtraining syn- in overtrained athletes.
syndrome is the point at which an athlete drome, with luteinizing hormone (LH) Finally, overtraining can lead to de-
exceeds his/her capacity for exercise (22). levels decreasing when the athlete is creased immunity (17). One report docu-
It has both psychological and physiologi- overtrained (5,7,12). In women, LH de- ments a decrease in C-reactive protein af-
cal components that should be recognized crease is associated with decreased per- ter intense exercise (11). An acute phase
by those working with athletes. cent of body fat and associated decreased response may be exhibited in overtrained
The athletic trainer is in a unique levels of estrogen. Overtraining in fe- athletes, detectable as fever, leukocytosis,
position to recognize symptoms of males is often manifested by amenorrhea a drop in serum iron and zinc, and a rise in
overtraining. Acting as a health care (7,12). In men, decreased LH results in serum copper and erthyrocyte sedimenta-
liaison, the athletic trainer can work with decreased testosterone and a resultant in- tionrate. In addition, increasedheadcolds,
the physician, the coach, and the athlete ability to build muscle mass (5). allergic reactions, and other infections have
toward returning the athlete to optimal Overtraining also affects the muscu- been associated with overtraining.
performance levels. The purpose of this loskeletal system. One report documents
paper is to review the physical and psy- that serum creatine kinase (CK), an enzy- Psychological Indicators
chological manifestations of overtraining matic marker of muscle tissue injury, is The psychological factors associated
syndrome and to outline those signs and elevated in athletes on mornings after run- with overtraining syndrome are more dif-
symptoms that could be monitored by the ning (4). The researchers hypothesized ficultto detectthan the physiological ones
athletic trainer. that the athlete who loses weight andmuscle (9; Table 1). According to one sports
girth while training is undergoing catabo- psychologist, psychological overtraining
Mary Black Johnson is an assistant lism, metabolizing muscle protein stores is characterized by sleep disturbances (and
professor in the Department of Physical for energy. The net result is a decrease in associated drowsiness), prolonged exces-
Education (Athletic Training) at San Di- performance. sive weariness, chronic fatigue, and loss
ego State University in San Diego, CA. The musculoskeletal system also re- of vigor (9,18,23). In addition, loss of
Steven Thiese holds a master's degree sponds to overtraining with overuse inju- self-confidence, apathy, irritability, de-
in athletic management from the Univer- ries. The three most common overuse pression, anxiety, and confusion also are
sity of Utah, Salt Lake City, UT. injuries associated with overtraining are: exhibited (10,18). An overtrained athlete
posterior tibialis syndrome, lower limb may exhibit emotional and motivational