East Jefferson General Hospital

Feeling exhausted from a bout of high intensity exercise? This situation could result from a job well done, or from conditions referred to as over-training and over-reaching.

According to University of Vermont physician and triathlete, Alex M. McDonald, over-training "results when stress from both training and non-training stressors, overwhelms the body's ability to recover adequately."

There are two types of over-training: short-term over-training (STO) and long-term over-training (LTO). STO is commonly referred to as "over-reaching," a fatiguing condition that lasts anywhere from a few days to a few weeks.

LTO is similar to STO in the sense of fatigue, however, as the name suggests, the body's ability to overcome this effect may take weeks to months. It appears from research that STO is more easily reversible than LTO.

The symptoms of over-training are categorized as either sympathetic or parasympathetic. McDonald notes that "sympathetic symptoms are those of excitation and restlessness, whereas parasympathetic symptoms include apathetic behavior and inhibition.

"The parasympathetic form of over-training is far more common in endurance athletics."

McDonald also observed that, "When an athlete approaches an over-trained state, they may have an elevated resting heart rate. Additionally, in (a) workout, heart rate variability (variation in the time interval between heartbeats) may be decreased and an athlete may not be able to elevate their heart rate."

In order to determine your own recovery status from training, I recommend using the research of Tudor Bompa, the father of periodization - alternating or cycling aspects of a training routine right up until the start of a competitive season for the purpose of adjusting the training stress and preparation of the athlete throughout the year. Noting your morning resting heart rate, here is what to do.

Using a heart rate monitor that you keep by your bed, first thing in the morning take your resting heart rate lying down. Then, get out of bed, stand up, wait one minute and take it again. You are theoretically recovered if the difference between your standing and lying down heart rate is in a window of 9-16 beats per minute.

If the difference is above 16 beats per minute, you may want to hold off until the afternoon to train, or skip the workout for that day (remembering to follow up with a re-test the next morning). You potentially could be heading toward an STO state, if not addressed in your exercise frequency, volume, and intensity.

It is also good to track your morning resting heart rate during intense, extended training periods, as I have done with many pro fighters in training camp, to look for a 10 percent upward change in your morning resting heart rate on a daily basis - another potential sign of a how the cumulative load of training may have a negative outcome on your performance.

Consider also having your physician test your testosterone to cortisol ratio with a blood or saliva sample. Cortisol is a stress hormone that is released by the adrenal gland, when the body perceives its muscles and brain to be under stress (i.e. high intensity exercise).

If cortisol levels are too high, due to continued stress placed on the body, it will potentially inhibit muscle growth and proper repair, influenced by testosterone. The increase in this stress related hormone (cortisol) may also predispose you to an upper respiratory track infection (which many over-trained runners experience).

This test is especially helpful in adult men. A physician will be able to properly determine where you stand in regards to this ratio, and if, in fact, it is out of balance due to excessive physiologic stress from over-training.

Besides the physical effects over-training can have on the body, there have been psychological effects noted, as well. For example, an athlete who has over-trained can be prone to mental tiredness - a sluggish, "stale" feeling, according to McDonald. Eating habits and sleeping habits can also be affected by over-training, causing a gain or loss in body weight, and a change in personality.

Glutamine – an essential amino acid found in, among other sources, whey protein and cottage cheese – has been tied to immune response in the gut. Athletes who are over-trained may have lower plasma glutamine concentrations due to stress. It is not clear, however, whether this was a result of over-training, or if it will prevent over-training in the first place.

Besides glutamine, magnesium glycinate has been shown to effectively address some of the symptoms of chronic fatigue, but individuals with chronic kidney problems should consult with their physician first before using, since magnesium may be contraindicated in certain kidney conditions.

The BCAA (branch chain amino acid) Leucine, has been demonstrated, when taken before and immediately after a bout of resistance training, to hasten the recovery process needed for growth and repair.

If you can learn to focus on understanding your limits of athletic participation and training, then only push them at a reasonable intensity and volume, you should be able to avoid LTO. However, it is always important to seek professional medical help, if you find your fatigue levels are too high to overcome. When in doubt, always consult with your physician if you are experiencing said symptoms, because chronic underlying fatigue may be related to more serious conditions.