Fatigue is a common reason for people to attend a Doctor at The Melbourne Sports Medicine Centre. Overtraining is a particular syndrome that can include fatigue that occurs in highly active people and athletes.
Most commonly, athletes and active people suffer fatigue for the same reasons as the general population.
Therefore each person needs to be assessed adequately with a comprehensive history including
- lifestyle factors such as sleep, diet, supplement use and alcohol or drug intake
- level, frequency and intensity of activity, rest, recreational time, work and study commitments
- psychological factors like stress or depression
- timing of onset and factors that aggravate the fatigue
- associated symptoms like flat mood, poor concentration, headache, muscle pain, heat/cold intolerance, recurrent infections, menstrual irregularities
A targeted physical examination is then conducted.
It is usual to assess various blood and urine tests to further refine the diagnosis.
This process enables the diagnosis of causes of fatigue such as anaemia, low iron stores, increased muscle cell damage, abnormal liver or renal function, abnormal blood sugar response or infection as well as nutritional deficiencies. Depression is also a prominent cause.
In an athlete, Overtraining Syndrome may be diagnosed by the above process by excluding reversible causes and revealing an over- intense or too rapidly increasing training regime along with unexplained symptoms such as muscle soreness, changes in weight, appetite, motivation, concentration and mood .
Overtaining Syndrome is best managed by an experienced Sports Doctor (and sometimes Allied Health Practitioners such as Dietitians, Exercise physiologists, Physiotherapists and Psychologists). This is done in conjunction with the athlete/patient and if applicable, their coach, fitness advisor or manager. The management plan should facilitate an adequate rest time to recover and then a modified graduated training/rehabilitation regime to enable a full and lasting recovery as well as preventing recurrence .
A daily logbook (recording things such as training schedules, mood, energy levels, recreational time, diet, well- being, muscle soreness, injury, illness and time to recover after activity) may assist in preventing recurrence of overtraining.
Ongoing monitoring is essential .
Dr Philip Perlstein
MBBS(Hons), FRACGP, FSDrA