29/01/2016
 Training - Overtraining : definition
 Which markers exist ?
 Monitoring
Prof Dr Romain Meeusen
Human Physiology Research Group - Vrije Universiteit
Brussel
School Of Public Health, Tropical Medicine &
Rehabilitation Sciences, James Cook University,
Queensland, Australia
Unexplained
underperformance
syndrome (UPS)
Burnout
Staleness
Etc…
Overtraining as a verb
Designed by J. Hough
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Chronic fatigue
Designed by J. Hough
Designed by J. Hough
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2006
2013
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PROCESS
TRAINING
INTENSIFIED
TRAINING
(overload)
OUTCOME
ACUTE
FATIGUE
FUNCTIONAL OR
(short-term OR)
NONFUNCTIONAL
OVERREACHING
OVERTRAINING
SYNDROME
(OTS)
(extreme OR)
RECOVERY
PERFORMANCE
PERFORMANCE
Day(s)
INCREASE
Days – weeks
Temporary
performance
decrement (e.g.
training camp)
Weeks – months
Months - …
STAGNATION
Or
DECREASE
DECREASE
Meeusen, et al MSSE; Eur J Sports Sci 2013
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
> VARIATION

Depending on sport (e.g. 10% per season Collegiate swimmers)
(Raglin and Wilson, 2000)

Functional
overreaching
Non-functional
overreaching
days to weeks
weeks to months
The overtraining
syndrome
Old literature  up to 91% of swimmers who developed NFOR/OTS
during first season diagnosed 1 or more times in following 3
years

Runners 33% - 60%

1 episode of NFOR/OTS over career
months to years
(Morgan, O’Connor, Ellickson and Bradley, 1988; Morgan, O’Connor, Sparling and Pate, 1987)
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
Identification of initiating
events or triggers :
 Training error
 Imbalance between load and
recovery
 Monotony of training
 Too many competitions
 Personal and emotional
(psychological) problems
 etc...
Exclusion of :
 Organic diseases or
infections
 Dietary caloric
restriction (negative
energy balance)
 Iron, magnesium, …
deficiency
 Allergies
 Injuries
 etc...
Team Work !
Meeusen, et al MSSE; Eur J Sports Sci 2013
Psychological
Physiological
Performance
Hormones
Disbalance Training &
Recovery
Performance 
!!Exclusion Diagnosis !!
Team work
Search for Clear and simple
markers
Meeusen, et al MSSE; Eur J Sports Sci 2013
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Measure: The Profile of Mood
States (POMS), a 65-item
Likert format scale that
assesses the total mood
disturbance experienced
 32 items
TENSION
DEPRESSION
ANGER
VIGOR
FATIGUE
(Confusion)
POMS scores across a season of swim training
Raglin et al. (1991) IJSM
295 college swimmers
14,000
Raglin & Morgan, (1994) IJSM
175 college swimmers
Distance (m/day)
12,000
10,000
8,000
150
Kentta, Hassmen & Raglin (2001) IJSM
272 Swedish age group athletes
140
NFO
Swimmers
130
Healthy
Swimmers
120
6,000
110
4,000
Sept.
Oct.
Nov.
Dec.
Jan.
Total Mood Disturbance (POMS)
Raglin et al. (2000) Ped. Sports Med.
231 age group swimmers
 Psychological tests e.g. POMS are sensitive tools to
monitor changes in Mood, Fatigue, Vigour, Anger,
Depression
 Other psychological questionnaires are also sensitive
e.g. Dalda, RestQ
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 Is this a simple measure to monitor
(over)training status of an athlete ?
 Is resting heart rate a possible alternative ?
 What other measures do we have to monitor
(over)training status of an athlete ?
Meeusen, et al MSSE; Eur J Sports Sci 2013 Achten et al 2003,
Definition
Parasympathetic & Sympathetic form of Overtraining
Bosquet et al 2009, Meeusen et al 2006
No sign. results
Negative adaptation to training stress  disturbance of
ANS  alterations in HR
PROCESS
TRAINING
INTENSIFIED
TRAINING
(overload)
OUTCOME
ACUTE
FATIGUE
RECOVERY
Day(s)
PERFORMANCE
FUNCTIONAL OR
(short-term OR)
Days – weeks
INCREASE
Temporary
performance
decrement (e.g.
training camp)
NON-FUNCTIONAL
OVERREACHING
(extreme OR)
OVERTRAINING
SYNDROME
(OTS)
Weeks – months
Months - …
STAGNATION
Or
DECREASE
DECREASE
There is no real proof for the existance of two
different forms of Overtraining
Meeusen, et al MSSE; Eur J Sports Sci 2013
Changes in HRV are related
to Volume & Intensity of training
Meeusen, et al MSSE; Eur J Sports Sci 2013
Earnst et al 2004
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Immune System : sensitive to stress
Intensified training (OR) : increases ‘open window’ &
degree of resultant immunodepression
 LIMITED SCIENTIFIC EVIDENCE
 Might be a strong ‘triggering’ factor (one of the
‘extra’ factors)
 NFO – OTS ?
Designed by J. Hough
Meeusen, et al MSSE; Eur J Sports Sci 2013
Why hormones?


Acute bouts of exercise and stress elevate stress
hormone secretion
Excessive training (stress) may lead to hormonal
imbalance
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Hormones
Resting
CRH
ACTH
Cort
Adr
Noradr
Testost
B-end
PRL
LH
Tyroid H
=
=
   ==
 ==
  =
==== 
==
=
===

After stimul Effect
?



   =
   =
=
=

== 

?
?
??
?
?
??
??
??
??

What do Hormones tell us ?
 Sampling conditions : conservation, stress, assey, …
 Food intake
 Pulsatility of the secretion
 Menstrual cycle
 Exercise protocol : (an)aerobic
 Timing : FO, NFO, OTS ??
…
Meeusen, et al MSSE; Eur J Sports Sci 2013
Physiological disturbance :


Training & Recovery disbalance
 ? Normal recovery
B1
M1
VO2max
B2
M2
B3,VO2max B4
More than one exercise trigger




Max test
Different exercise
Aerobic – anaerobic
…
Meeusen, et al MSSE; Eur J Sports Sci 2013
7:00
8:00
9:00
10:00
11:00
12:00
13:00
14:00
 B1 - B4 = Bloodsamples 1 - 4
 M1 + M2 = Meals
Meeusen et al 2004, 2010
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pre camp
post camp
Controls
14
12
10
8
 Controls :
6
 Experimental group : Training Camp (Spain)
 Control group : trained at home
14
2
rest 1
post ex
pre camp
35
rest 2
post ex
post camp
 F-OR :
F-OR
30
post camp
25
Test 1
Test 2
15

10
5
10
0
rest 1
post ex
rest 2
post ex
8
6
 Overtrained :
300
ACTH (pg/ml)
4
2
0
rest 1
post ex
rest 2
post ex
Meeusen et al 2004
pre camp cfr. Contr
post camp decreased
answer to max exc
 second test markedly
decreased

20
12
comparable hormone
values
 lower second test

0
 2max Test before and after this period
pre camp
4
OTS

200

100
0
Rest
Exc 1
Rest
Exc 2
High response first test
blunted response in second
test
Meeusen et al 2004

Ten athletes : ? Exclusion of OTS ?
Clinical diagnosis : suspicious of OTS
 Different ‘triggering’ factors
 Medical screening
 Common features :

disturbances
 First test = POMS
 performance
 Mood
TOP-test (double max test)
Meeusen et al Br J Sports Med 2010
Meeusen et al Br J Sports Med 2010
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 Pituitary Hormones
seem to be sensitive to
extreme ‘stress’
 NFO : overreaction in
second exercise test
 OTS : depletion after one
exercise test, no effect in
second test
Meeusen et al Br J Sports Med 2010
Recovery from NFOR/OTS
2 months – 1 year
1 year to no recovery
2 weeks – 5 months
1 to 6 months
Meeusen et al., 2010
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Retrospective monitoring
What went wrong ?
Training  improve
performance
Prospective monitoring
Which signs and
symptoms are important ?
Which “load” is necessary ?
And which load is excessive ?
 Individual monitoring at
all times
20 players (4th devision)
Basic medical screening
Treadmill test (pre-season)
Blood values
Urinary catecholamines
Psychological tests (POMS)
Age (yrs)
Weight (kg)
Height (cm)
BMI
VO2max
23.4 ± 3.1
75.8 ± 6.6
179.7 ± 5.9
23.5 ± 1.1
56.8 ± 6.1
(ml.kg-1.min-1)
!! Keep it simple or Make
it simple !!
Trainer
Player
Trainer
Player
7
6
6 wks training
Intensity score
INTENSITY
5
4
3
2
1
Decreased
performance
Sleep problems
Mood state
0
7
6
INTENSITY
5
4
3
2
1
0
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Information on :
Sleeping patterns
Eating (disorders)
POMS
General complaints
Injuries
Combination of objective
values and subjective
feelings on several
aspects.
Quantify :
Training Load
Physiological Load
Psychological Load
Other stressors
(Lehman et al. 1990, Lehman et al. 1993, Hooper et al.
1995, Eichner 1995, Foster and Lehman 1997, Foster
1998, Piacentini et al 1999)
 Early signs of training distress
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Functional
overreaching
Non-functional
overreaching
days to weeks
weeks to months
The overtraining
syndrome
months to years
Designed by J. Hough
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Athlete  central
Fingerprint :
Biological
Psychological
Endocrinological
…
OTS : Exclusion diagnosis
Symptoms : individualised
Combination of different
markers :
Performance,
immunological,
physiological,
psychological,
endocrinological,
Biochemical
…
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