228 SECTION 3 • MEDICAL PROBLEMS IN THE ATHLETE
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Immunol89(5), Nov. 2002.38 OVERTRAINING SYNDROME/
CHRONIC FATIGUE
Thomas M Howard, MDINTRODUCTION•Overtraining has been described and has been well
known to athletes and trainers for decades. In 1923 Dr
Parmenter described overtraining as “a condition diffi-
cult to detect and still more difficult to describe.
Evaluation should focus on training load, nutrition,
sleep, rest, competition stress, and psychological state”
(Parmenter, 1923).- It has only been in the last 10 years that there has been
a surge in the literature to further define the condition,
the pathophysiology and identify markers for treat-
ment and prevention.
•Overtraining, if left unrecognized or untreated, results
in injury and poor performance during key competi-
tions and early retirement.
TERMS- Training:A series of stimuli or displacement of home-
ostasis to provide stimulation for adaptation. A pro-
gressive overload in an effort to improve performance. - Adaptation:A physiologic response to stress which
results in an adjustment in function. - Recovery:Period of time following a training stimulus
when adaptation occurs resulting in supercompensation
to allow better performance in the future, i.e., the train-
ing effect. Recovery includes hydration, nutritional
replenishment, sleep/rest, stretching, relaxation, and
emotional recovery. - Periodization: Planned sequencing of increased
training loads and recovery periods within a training
program. - Overreaching/Overwork:Acute phase where train-
ing load (intensity or volume) is significantly
increased resulting in a short-term decrement in per-
formance (generally thought to be <2 weeks).
Physiologic Fatigue (Derman et al, 1997).