The Overtraining Syndrome in Soldiers
Written by Ben Bunting: BA(Hons), PGCert. Sport & Exercise Nutrition. British Army Physical Training Instructor.
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Overtraining syndrome is a common disorder among athletes and soldiers.
It is caused by various factors, including the high level of activity, low motivation, fatigue, muscle and bone injuries, and anorexia and depression. Here is an overview of the causes, symptoms, and treatments for the disorder.
Musculoskeletal injuries
Musculoskeletal injuries in soldiers are a significant problem throughout the world's military organisations.
The burden of these injuries on the medical chain impacts on organisational effectiveness and productivity, and compromises operational capability. In addition, they increase risk of subsequent medical discharge and temporary downgrade.
There is a need to understand the prevalence and characteristics of these injuries in order to develop effective injury prevention and management strategies.
A large number of studies have been conducted focusing on the incidence of musculoskeletal injuries in soldiers.
Some interventions have been shown to be effective in decreasing the frequency of these injuries, but others have demonstrated little or no effect.
In order to obtain a better understanding of the factors contributing to the high rate of musculoskeletal injuries in recruits, a systematic analysis of injury data from a large cohort of British Army recruits was performed.
A chi-square test was used to examine differences in injury frequency between training phases.
The incidence of injury specific diagnoses was also studied. Musculoskeletal injury-related diagnoses were recorded by body region and type of injury.
For example, medial tibial stress syndrome was the most common condition, accounting for 20% of all rehabilitation days.
Stress fractures were found to account for 2% of injuries. These conditions are pathological due to the body's inability to dissipate load.
Injury-related musculoskeletal diagnoses were classified as inflammation and pain (overuse), joint derangements and other diagnoses.
Musculoskeletal injuries are a leading cause of disability in the British Army, and prevent the recruit from returning safely and physically capable for duty.
Fatigue
Overtraining syndrome (OTS) is a maladaptive response to excessive training volume. It results in underperformance, increased vulnerability to infection and chronic fatigue.
The condition is characterized by a sudden and unexplained decrease in performance. OTS is difficult to diagnose and treat with conventional procedures.
Although research has focused on endurance sports, the problem is more widespread. It affects both military personnel and athletes in anaerobic and power sports.
In some athletic contexts, periodisation of training has been implemented. However, this has only recently been applied to the whole military training program.
This is a problem, particularly because overtraining has a systemic effect, affecting the immune system and other specialized cells.
As part of the military recruitment process, recruits are exposed to elevated stress levels. Moreover, their work schedules include prolonged wakefulness and sustained physical activity. They must also be prepared for combat operations.
In order to address the problem of fatigue and overtraining, studies have explored the psychophysiological impact of overtraining.
Psychophysiological monitoring has been used in elite sports to determine recovery status and sleep quality.
Several studies have found that the presence of burnout has a negative effect on the athlete's physical performance, decision-making performance and mental state.
Studies have shown that poor sleep can lead to reduced physical performance and increased perceived stress and depression.
A previous study has found that the sleep environment during field training causes broken sleep cycles.
Low motivation
Overtraining is a condition affecting athletes and military personnel. This condition is characterized by an increase in fatigue.
It can last for weeks or months. Symptoms include insomnia, muscle pain, fatigue, and a decreased performance. The best treatment is rest, but this may not be enough.
A more sophisticated evaluation of the condition is warranted. Typically, an athlete's body is assessed via a combination of subjective, objective and laboratory measurements.
What is less obvious is how to identify the presence of overtraining. In a sample of elite athletes, one study suggested that a balanced biomarker panel could be used to monitor the state of health of an athlete.
A review of the literature is in order. One can cite several etiological theories, but a standardized definition would make for a more comprehensible treatment.
While this review does not cover all aspects of the disease, it does highlight a few of the etiological factors.
Aside from the well-known maladies, there is an equally important group of ailments attributed to the training regimen.
These include non-battle musculoskeletal injuries, which represent a growing threat to operational readiness in today's military.
Some studies have shown that a standardized approach to risk assessment and treatment can prevent such injuries.
Another interesting tidbit is that of the overtraining syndrome. While this condition is characterized by an intense subjective state of fatigue, the most notable symptom is the loss of performance.
Luckily, there is some evidence to suggest that the best course of action is to rest.
Anorexia
Overtraining is a major problem among the military. Soldiers are exposed to harsh training regimens which can lead to systemic pathologic consequences.
The result is an overtraining syndrome (OTS), a condition characterized by detriment to performance that lasts for years.
To date, the exact causes of overtraining remain unknown. It is estimated that as many as 30 to 80 percent of athletes experience overtraining.
A better understanding of overtraining may lead to improved prevention, diagnosis, and treatment. Several methods have been proposed. Most notably, ISDN therapy can be used to treat overtraining.
This form of therapy is not a cure for overtraining but it can improve performance. In addition, prevention of overtraining can reduce the number of injuries sustained by soldiers.
In short, overtraining is an inflammatory state induced by prolonged or intense exercise. There are several physiological and psychological measures that can be used to detect overtraining.
One is the two-bout exercise test. Another, the Profile of Mood States (POMS), is a better-known test that measures mood and psychological states.
Despite its prevalence, overtraining is not easily detected. Even coaches and athletes are often unable to accurately determine if their athletes are suffering from overtraining.
The best way to identify overtraining is to rely on symptoms. Symptoms include fatigue, muscle soreness, drowsiness, and a loss of coordination.
These symptoms are associated with increased inflammation, increased intestinal permeability, and reduced performance.
Depression
Overtraining syndrome (OTS) is a debilitating condition that affects professional and lay athletes alike.
It is characterized by a prolonged decline in performance, a lack of recovery time between training sessions, and a variety of physiological and psychological changes.
These changes can have negative effects on both training and competition.
A number of studies have focused on the overtraining syndrome in sports, including endurance and anaerobic sports.
While these studies provide a good basis for understanding the physiological changes that occur in athletes, the exact causes of these changes are not clear.
However, proinflammatory cytokines have been suggested to be responsible for behavioral changes associated with overtraining.
The overtraining syndrome is a complex clinical disorder. To date, no standard diagnostic test has been developed.
Various theories have been proposed to explain overtraining, including oxidative stress, central fatigue, and glycogen depletion.
Although many studies have looked at overtraining in sports, little is known about the disorder in the military.
Military service tasks are physically and cognitively demanding, and repeated performance on these tasks can lead to cumulative fatigue and physical and mental exhaustion.
Developing a more accurate understanding of overtraining in the military could help to better promote efficient recovery.
There is also considerable interest in developing a risk-stratification model for MSKI. This could serve as a guide to identify those individuals at greatest risk.
Previous reviews have summarized the physiological stress involved in sustained operations, as well as the various biomarkers of stress. But what about the overtraining etiology and the diagnostics?
Glycogen hypothesis
The glycogen hypothesis in the overtraining syndrome in soldiers (OTS) states that intense training can deplete muscle glycogen, which is necessary for the rapid synthesis of ATP. Low muscle glycogen can result in muscular fatigue and diminished performance.
Glycogen storage in the muscles directly affects exercise performance. In the current study, muscle glycogen was lower in an exhaustive exercise group, compared with the regular and sedentary groups.
Muscle glycogen content was measured through colorimetric assessment of glycogen-iodine complexes.
Overtraining is a common problem in athletes and military personnel. During intense training, the body's stress response can become imbalanced, leading to increased rates of attrition.
These effects have been shown to have long-lasting consequences in the operational environment.
There are several etiological theories about the causes of overtraining. Common mechanisms include autonomic imbalance, central fatigue, relative energy deficiency in sport, and muscle glycogen depletion.
Some of these theories are well established, while others remain enigmatic. It is important to understand the underlying biochemical mechanisms of overtraining in order to prevent its negative effects.
Anxiety and depression are associated with overtraining. Increased levels of TNF-a and IL-1b may be responsible for these symptoms.
Cytokines act on the hypothalamus and limit glycogen stores. Other symptoms of overtraining can include insomnia and restlessness.
High levels of GLUT-4 transporters are primarily found in muscles. Down regulation of GLUT-4 transporters can lead to chronic 'heavy leg' feelings.
The Overtraining Syndrome in Soldiers Conclusion
Overtraining syndrome is a long-term decrement in physical and psychological performance.
It affects athletes and lay sportsmen and can impair their health and career. Athletes can experience symptoms such as fatigue, anorexia, insomnia, depression, irritability, and bradycardia.
Military combat operations are physiologically demanding. Repeated military service can lead to cumulative fatigue, which may contribute to overtraining.
In addition, repetitive military service can also cause psychological stress. The effects of overtraining are not well understood.
Previous reviews have summarized the understanding of the underlying mechanisms of overtraining.
They have identified serious physiological impairments, and compared functional overreaching and nonfunctional overreaching.
However, a model of overtraining has not yet been established. Animal models of overtraining are needed to understand the etiology of overtraining.
These animal models may provide a basis for the identification and prevention of overtraining.
Recent studies have shown that overtraining can have serious negative impacts on the mental and physical health of athletes and soldiers.
For example, repeated bouts of intensive training can raise stress hormones and damage muscle cells. Excessive training can also reduce blood glucose levels in specific organs.
Musculoskeletal injuries are a frequent and significant risk to operational readiness in today's military. Non-battle musculoskeletal injuries are often due to poor training and poor recovery periods.
This study examined the prevalence of musculoskeletal injuries among active operators.
Recurrent musculoskeletal problems were noted in 88% of screened operators. Only a small percentage of these injuries were due to actual battle.
