4 simple ways to monitor athlete wellbeing and avoid overtraining
Monitoring for Overtraining
One of the major limiters of athletic performance is accumulated athlete fatigue. Overtraining Syndrome is something that can present slowly and insidiously, such that athletes and coaches may not realize that it has struck until it’s late in the process. Of course, this is not ideal, as the further one goes down this road, the longer it takes to return to optimal form.
Understanding this physiologic process and having a plan for monitoring can help the coach and the athlete to avoid unnecessary pitfalls throughout the season.
Overtraining Syndrome (“OTS”, also referred to as Underperformance Syndrome) is actually a spectrum of symptomatology. The earliest stages are referred to as Overreaching, and are divided into Functional Overreaching (FO) and Non-functional Overreaching (NFO).
When an athlete trains hard, the goal is to expose the body to physiologic and biomechanical overload. The desire is to push beyond what the body is capable of doing comfortably, and then allow that stimulus to cause adaptation during the rest and recovery phase of training. Most training plans will purposefully push the athlete into the early stages of this syndrome, termed Functional Overreaching, and then allow for a rest period during which the athlete recovers and adapts. At this point of FO, recovery occurs in a matter of days. If the athlete ventures further down the spectrum into NFO, it is generally an inadvertent progression which can take weeks to recover from. Overtraining is actually the furthest end of this spectrum. The symptoms and performance decline will be quite remarkable, and recovery can take months.
The diagnosis of FO, NFO, or Overtraining is made retrospectively based on the amount of time it takes an athlete to recover. That is not helpful to the coach or athlete attempting to avoid these states. After all, the goal should be to prevent NFO and Overtraining, not just react to it.
Athletes who venture into states of NFO or Overtraining suffer from fatigue, depression, insomnia, irritability, and lack of motivation. These symptoms are manifestations of hormonal and neurologic imbalances within the body.
Wouldn’t it be great if we could monitor for the early signs of these imbalances before they begin to negatively impact athletes? Then we would not be stuck with diagnosis that can only be made in hindsight. Well, you actually can employ a preventive strategy!
There are two types of data that can be monitored and reviewed with regard to OTS. Both subjective reports from the athlete and objective measures are useful. An athlete’s subjective measures of their fitness, fatigue, and mood can be great indicators of their training status. Communication between athlete, the coach, and the medical staff is crucial here.
Also available for monitoring are some objective measures of recovery and training status. Some of these are more feasible than others. For instance, regular lactate testing can be helpful, but it is often not within the resources of a team to provide such testing. There are, however, some very simple but powerful monitoring tools you can employ.
Simple ways to guard against overtraining
Take your Heart Rate
Every athlete should record a daily resting heart rate. It is easy to do! After establishing a baseline value, a deviation of +/- 10% should raise a red flag. Of course, this is not specific to OTS, as illness or other factors can cause deviation. But for a simple daily measure, this is hard to beat. There are even free smartphone apps that will allow the user to effortlessly check and record heart rate.
Heart Rate Variability
A bit more sophisticated is the measurement of heart rate variability (HRV). Without going into too much detail, HRV is a representation of the variation in time between heart beats. A person with a heart rate of 60 beats per minute might be assumed to have 1 second between each beat, but that is not the case. A higher degree of beat-to-beat variability is actually a good thing! This has to do with the balance between parasympathetic and sympathetic nervous systems, which is something that is directly affected by training status. It used to be the case that HRV measurement was only available in doctors’ offices and labs. Now, there are multiple high-quality smartphone apps that allow you to easily measure HRV daily. A decline in HRV can signal a need for more rest and recovery.
Recently, a paper was published in an American sports medicine journal looking at sleep patterns in overreached athletes. The paper suggested that sleep disturbance, as measured by decreased sleep quality and efficiency, was evident in athletes that had been purposefully trained into a state of FO. Quantification of sleep is something that is now readily available by any number of wearable devices. This could turn out to be one of the more sensitive initial indicators of OTS in athletes, and the data is now easy to collect.
When it comes down to it, the best guard against an athlete entering NFO or OTS is regular communication with their coach and medical staff. Subjective measures are very important, and the athlete must have a clear avenue for passing this information to those caring for and training him. Various objective measures can certainly help to further interpret the subjective sensations, but these too must be adequately communicated to team staff. The best solution is to make your athletes aware of what they should be looking for, what they should be monitoring, and how they can effectively communicate those things with you. Such a proactive strategy will help to keep your athletes health and performing well.
Written by Dr Kevin Sprouse of Provision Sports Medicine
Dr. Kevin Sprouse is a sports medicine physician in Knoxville, TN, USA. He has board certifications in both Sports Medicine and Emergency Medicine, in addition to a degree in Exercise Science. Dr. Sprouse can be contacted at Provision Sports Medicine, where he operates his clinic and a sports performance laboratory. He is also a team physician for Team Garmin-Sharp Pro Cycling.