OVERTRAINING:

Undermining Success?
by Paige Kinucan and Len Kravitz, Ph.D.

LEARNING OBJECTIVE
To recognize and understand overtraining syndrome and know
how to prevent and care for it in clients.

Key words:
Excessive Training, Performance Decrements, Fatigue, Stress,
Staleness

vertraining. Burnout. Staleness.

These are descriptive words used
by fitness professionals to describe
the phenomenon that sometimes affects fit
individuals. Overtraining is a major concern
with highly active fitness enthusiasts because
it is responsible for decreased or impaired
performance and increased fatigue, both during
training and daily life. Overtraining syndrome
(OTS) usually occurs as a result of a training
schedule that is dramatically or suddenly increased, lasts for sustained periods, and is
performed at high volume or high intensity
or both without a sufficient recovery period.
Although some personal trainers and highly
motivated exercisers may abide by the principles of go hard or go home and constantly
giving 110%, it is crucial to realize that a
varied training program and regular evaluation are necessary for improvement and prevention of OTS. This article will review
OTS, including the physiological, psychological, immunological, and nutritional signs
and symptoms. Examples of burnout (low
workout enthusiasm) also are discussed to
help identify such characteristics in conditioned individuals. Most importantly, health/
fitness professionals will be given contemporary information necessary to prevent, detect, and care for physically active clients
with OTS.

WHAT PHYSIOLOGICAL FACTORS ARE

ASSOCIATED WITH OTS?
Before a fitness professional can care for a
client with OTS, he or she must recognize
and understand the physiological factors associated with OTS. Endurance-trained individuals who work out for hours at a time have
been shown to have an overactive pituitary
gland, which, through a series of biochemical
reactions, results in abnormally high levels of
cortisol secretionVthe stress hormone that
may impair muscle growth (1). The human
reproductive system may be compromised;
women sometimes become amenorrheic (abnormal lack of a menstrual cycle), and men
may have decreased testosterone levels (2).
M. B. Johnson, Ph.D., ATC, and S. M. Thiese,

Photo courtesy of Banayote Photography and the

500 Festival.

ACSMs HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org

Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

VOL. 11/ NO. 4

M.S. (2), also note that overuse injuries such as posterior

tibialis syndrome, lower limb stress fractures, and tendonitis
may occur. Many other physiological changes, summarized
by M. L. OToole, Ph.D., FACSM, (3), are presented in Table 1.

WHAT PSYCHOLOGICAL FACTORS ARE

ASSOCIATED WITH OTS?
Mood changes are an early and sensitive marker of OTS.
Emotional disturbances usually occur before a noticeable
drop in performance and parallel an increased training load
(4). Depression and chronic fatigue represent the most common OTS condition observed in highly fit individuals (5).
Research (3,6,7) has shown that clinical depression and
OTS have numerous symptoms in common (Table 2), including changes in neurotransmitters, immune responses, and
hormones.
Personal trainers should discuss their observations with
clients to openly resolve concerns together. Consultation with a
sports medicine psychologist or qualified health expert may be
necessary if the condition does not seem to improve with time.
Fitness professionals should realize that their clients also may

TABLE 2.

Psychological Function Symptoms of OTS

changes in personality
decreased self-esteem and motivation to work out
difficulty concentrating during work, school, or training
emotional instability
fear of competition
feelings of sadness and depression
general apathy
giving up when the going gets tough
easily distracted during tasks

Adapted from OToole, M.L. Overreaching and overtraining in endurance

athletes. Overtraining in Sport, Kreider, R.B., A.C. Fry, and M.L. OToole
(Editors), Champaign: Human Kinetics, 1998. (3)

be dealing with stressful conditions involving work, family,

school, or social environment situations, which may contribute
to OTS.

HOW DOES THE BODYS IMMUNE SYSTEM

RESPOND TO OTS?
TABLE 1.

Physiological Performance Symptoms of OTS

altered resting heart rate and blood pressure
chronic fatigue
decreased efficiency of movement and
physical performance
decreased lactate response
decreased maximum work capacity
frequent nausea/gastrointestinal upsets
headaches
impaired muscular strength
inability to meet previously attained performance
standards or criteria
increased frequency of respiration
insatiable thirst
insomnia
joint aches and pains
lack of appetite
lower percent of body fat
menstrual disruptions
muscle soreness and tenderness
prolonged recovery from exercise
reappearance of previously corrected mistakes

A telltale sign of OTS is immune suppression expressed in

increased rates of illness (especially upper respiratory tract
infections [URTIs]), swollen lymph glands, flulike symptoms
(body aches and upset stomach), bruising, and slow healing
of scratches and wounds (4, 8). Although an individual may
already be very fit, the trigger for illness or injury may be a
result of the following two factors: 1) a sudden increase in
exercise volume (i.e., increased running distance and/or
frequency or increased repetitions  sets in resistance exercise)
and/or 2) an abrupt increase in intensity (i.e., elevated heart

Adapted from OToole, M.L. Overreaching and overtraining in endurance

athletes. Overtraining in Sport, Kreider, R.B., A.C. Fry, and M.L. OToole
(Editors), Champaign: Human Kinetics, 1998. (3)

VOL. 11/ NO. 4

ACSMs HEALTH & FITNESS JOURNALA

Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

Overtraining
rate during cardiovascular exercise or increased intensity
[higher %1RM] in resistance exercise). This period of
immunosuppression is referred to as an open window
because an individual is most susceptible to contracting
infections or getting injured immediately after and during times
of increased mental and physical stress. According to David C.
Nieman, Dr.P.H., FACSM (1), the open window is a 3- to 24hour period after prolonged endurance exercise when host
defense is decreased and risk of URTI is increased. The
bodys immune system functions are directed toward aiding
whatever damage is done by the training overload; thus, overall
immunity is lowered. Studies have shown that physiological
changes take place in cells specifically related to immune
function during times of increased training stress and volume
(6). The open window for increased susceptibility to illness
has been observed after high-volume and high-intensity
exercise sessions.
The decreased immune function/OTS connection also has
been linked to nutritional deficiencies, as discussed in further
detail in the following section. Failing to eat enough healthy
sources of protein, carbohydrate, and fat compromises immune
function by not allowing the body to repair itself and recover for
continued bouts of exercise.
Recreational enthusiasts who enjoy competing in athletic
events or are adamant about daily workouts should be
aware that a string of illnesses may be linked to OTS.
Oftentimes, individuals who are serious about training may
attempt to work through an illness, only to prolong
symptoms or cause a recurrence, which further delays
training at optimum levels. An appointment with a physician
is in order for any client who has an especially severe illness,
cannot shake a prolonged ailment, or has recurring bouts
of poor health.

DOES NUTRITION IMPACT OTS?

Many fit individuals who follow a strict workout schedule also
adhere to strict dietary regimes. Societal pressures may
influence these individuals to limit caloric intake, with the
(mistaken) belief that they are maintaining a sleek physique and
aiding performance in the gym. However, not sufficiently
fueling (and refueling) the body is detrimental to training and
recovery and a contributing factor to OTS.
After a hard workout, intramuscular stores of glycogen are
depleted, which makes carbohydrate consumption essential.
Consuming foods such as a bowl of cornflakes with raisins, a
handful of vegetables (with baby carrots, broccoli, and
cauliflower), a fruit salad (with strawberries, bananas, and
pineapple), or your favorite pasta dish can speedily refill
glycogen stores. In fact, consumption of sufficient and
healthy sources of carbohydrate, protein, and fat is necessary
to continually perform at a high level day after day.

10

ACSM Photo/Tanya Van Skyock

Nutritional imbalances may result from reduced dietary

intake and exaggerated energy expenditure. Overall fatigue
and injury often occur when energy expenditure continually
exceeds caloric intake, and the body is not properly fueled to
sustain exercise. Early warning signs include loss of appetite
and unnecessary or unwanted weight loss. Recreational
enthusiasts should be aware that exercising, even at moderate
efforts, stresses the body and results in increased metabolism,
additional heat production, and a multitude of physiological
and hormonal changes requiring an increased demand for fuel
and a balanced diet (9). Consultation with a Registered Dietitian
with a background in sports nutrition is recommended for clients
who need guidance in meal planning and nutritious food choices
to sustain an active lifestyle.

WHEN DOES RESISTANCE TRAINING

LEAD TO OVERTRAINING?
Resistance training workouts are designed by combining choice
of exercise, order of exercise, exercise volume (sets 
repetitions), load or intensity (percent repetition maximum),
and rest between sets. According to A.C. Fry, Ph.D. (11), the
two most common triggers of OTS in resistance training are
workout volume and intensity.

ACSMs HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org

Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

VOL. 11/ NO. 4

1. Excessive training volume over an extended period: This

occurs when an individual adds exercises, performs more
exercise sets, and/or increases frequency of workouts. The
signs and symptoms that appear, because of this type of
overtraining, are similar to those seen in endurance exercise.
Fry (10) adds that high training volume often results in a
decrease in the ratio between testosterone to cortisol, thus
impairing muscular fitness gains.

professional to help his/her client avoid burnout (and OTS) is to

prevent boredom and unreasonable training overload. Workouts
should be designed, if possible, around an individuals
preferred activities and regularly mixed up to give the
exerciser variety. A change in scenery (i.e., outdoors vs.
indoors) and day-to-day or week-to-week schedule variation
(as used in periodization programs) enhances variety and
minimizes burnout.

2. Excessive training intensity: This occurs when an exerciser

uses too much resistance (%1RM) for prolonged periods. It
may cause increased sympathetic (the accelerating branch of
the autonomic nervous system) nervous system activity to
adjust for decreased muscular strength.
Perhaps one of the best design strategies a personal trainer
can incorporate to prevent overtraining in resistance training is
to use a periodization training program with clients. Periodization is most widely used in resistance program design to
avoid overtraining while maximizing performance gains and
recovery. Traditional models of periodization describe a
progression from high-volume and low-intensity (%1RM) work
toward decreasing volume and increasing %1RM during the
different cycles. A reduction in volume and an increase in
intensity in steps during the training cycle is referred to as
stepwise periodization. In the overreaching periodization
model, there is periodic short-term (1 to 2 weeks) increase in
volume or intensity, followed by a return to normal training.
During undulating periodization, training volume and intensity
are increased and decreased on a regular (weekly) basis but not
in the general pattern of always increasing intensity and
decreasing volume as the training period progresses. Periodization training is typically divided up into three types of cycles:
microcycle, mesocycle, and macrocycle. The microcycle is generally up to 7 days. The mesocycle may be anywhere from 2
weeks to a few months and can further be classified into
preparation, competition, peaking, and transition phases. The
macrocycle refers to the overall training period, usually representing a year. For a comprehensive article on periodization and
other resistance training design ideas, the reader is referred to
the article by Paul Sorace, M.S., and Thomas LaFontaine, Ph.D.,
FACSM, on Resistance Training Muscle Power: Design Programs
that Work (ACSMs Health & Fitness JournalA 6Y12, 2005).

WHAT EVERY PERSONAL TRAINER AND FITNESS

PROFESSIONAL SHOULD DO TO COMBAT OTS
Personal trainers who are aware of the signs and symptoms of
OTS have an opportunity to care for and/or prevent the
condition in recreational enthusiasts and athletes. Initially,
educating clients on the perils of doing too much, too soon or
neglecting to get adequate rest and healthy foods between
training bouts (as well as other contributing factors of OTS) is
essential (2). Research suggests that the following ideas may be
helpful in preventing OTS (7):
Keep accurate and detailed records of each clients workout.
This allows the personal trainer to effectively monitor and
adjust training volume and intensity depending on an
individuals current training status.

Be sure clients know how to eat a healthy diet, drink enough

fluid to stay hydrated, and get enough sleep for optimum
performance every day. Each days habits contribute toward
overall health and well being.

Encourage and allow clients to openly communicate about

concerns, both physical and mental.

Physical training is affected by emotional health. Explain to

your clients and students that job stressors, interpersonal
relationships, and other environmental stressors may have a
harmful effect on physical performance. Maintaining health
and wellness in all areas of life will help to prevent OTS.

Overtraining syndrome is most successfully treated with rest

and/or meaningful changes in the volume and intensity of a
clients present exercise program. The rest and decrease in
exercise needs to be individualized for each client. For
instance, some individuals may just need one or more
recovery days added to their weekly program. Other
individuals may need a significant drop in exercise volume
(number of sessions, exercises, sets, and reps) in addition to
lower exercise intensities (heart rate in cardiovascular
exercise and %1RM in resistance training). Indeed, other
clients may need sustained days of rest from all physical
activities to recover from OTS.

Highly fit individuals sometimes find complete rest a greater

source of stress. Personal trainers should initiate alternative

WAIT, WHAT IS BURNOUT?

Burnout is the term used to describe a lack of motivation or
dissatisfaction in an activity that was previously enjoyed (11).
A. W. Meyer and J. P. Whelan (11) note that other symptoms
are mental exhaustion, lowered self-esteem, emotional isolation, and increased anxiety. However, the physiological
symptoms that accompany burnout are the same seen with
OTS. A key application for the personal trainer or fitness
VOL. 11/ NO. 4

ACSMs HEALTH & FITNESS JOURNALA

Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

11

Overtraining
activities that keep individuals active but aid in recovery.
Emphasis toward lower intensity physical activities such as
walking, stretching, mind-body programs, balance, and core
and stability training may be very suitable program options.

An appointment with a physician specializing in sports

medicine may be the final direction if OTS persists.
Paige Kinucan, is an undergraduate student
enrolled in her third year of the exercise
science program at the University of New
Mexico, Albuquerque (UNMA). In addition to
writing about topics in the exercise physiology field, Ms. Kinucan enjoys competing for
the UNMA triathlon team and is interested in
clinical research.
Len Kravitz, Ph.D., is the coordinator of
Exercise Science at the University of New
Mexico. His research interests include energy
metabolism, exercise product evaluation,
and exercise program measurement and
assessment.

References
1. Nieman, D.C. Effects of athletic endurance training on infection rates
and immunity. Overtraining in Sport. R.B. Kreider, A.C. Fry, and M.L.
OToole (Editors). Champaign: Human Kinetics, 1998.
2. Johnson, M.B., and S.M. Thiese. A review of overtraining syndrome:
recognizing signs and symptoms. Journal of Athletic Training 27(4):
352Y354, 1992.
3. OToole, M.L. Overreaching and overtraining in endurance athletes.
Overtraining in Sport. R.B. Kreider, A.C. Fry, and M.L. OToole
(Editors). Champaign: Human Kinetics, 1998.

of overreaching and overtraining research. Sports Medicine 34(14):

967Y981, 2004.
5. Puffer, J.C., and J.M. McShane. Depression and chronic fatigue in
athletes. Clinical Journal of Sports Medicine 11(2):327Y38, 1992.
6. Urhausen, A., and W. Kindermann. Diagnosis of overtraining. What
tools do we have? Sports Medicine 32(2):95Y102, 2002.
7. Armstrong, L.E., and J.L. VanHeest. The unknown mechanism of
overtraining syndrome. Sports Medicine 32(3):185Y209, 2002.
8. Smith, L.L. Overtraining, excessive exercise, and altered immunity.
Sports Medicine 33(5):347Y364, 2003.
9. Vennkatraman, J.T., and D.R. Pendergast. Effect of dietary intake on
immune function in athletes. Sports Medicine 32(5):323Y37, 2002.
10. Fry, A.C. Overtraining with resistance exercise. American College of
Sports Medicine Current Comment, January 2001.
11. Meyers, A.W., and J.P. Whelan. Systematic model for understanding
psychosocial influences in overtraining. In: Overtraining in Sport.
R.B. Kreider, A.C. Fry, and M.L. OToole (Editors). Champaign: Human
Kinetics, 1998.

CONDENSED VERSION AND BOTTOM LINE

The ability to identify and possibly prevent OTS is key in
the course of designing progressive overload training
programs. Overtraining syndrome impacts physiological,
psychological, immunological, and nutritional well being,
and an abundance of signs and symptoms exist for the
keen professional observer to identify. If an individual
avoids overtraining, he or she is more likely to improve
fitness, avoid burnout, and avoid illness or injury that
prevents one from working out. The personal trainer and
fitness professional has an arsenal of useful information
and tips to prevent OTS, a syndrome that is detrimental
to a physically active population of exercisers who seek
regular physical activity as a way of life.

4. Halson, S.L., and A.E. Jeukendrup. Does overtraining exist? An analysis

12

ACSMs HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org

Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

VOL. 11/ NO. 4