Novel insights of overtraining syndrome discovered from the EROS study, 2019, Cadegiani and Elias Kater

[Andy]

Abstract
Background Excessive training and inadequate recovery could cause ‘overtraining syndrome’ (OTS), which is characterised by underperformance and fatigue. The pathophysiology of OTS is unclear. We aimed to describe novel mechanisms and risk factors associated with OTS, and thereby facilitate its early identification and prevention, from a comprehensive joint qualitative analysis of the findings from all the four arms of the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study.

Methods We compared the types and proportions of behavioural patterns of 67 evaluated parameters of OTS from 51 participants—athletes with OTS (OTS, n=14), healthy athletes (n=25) and healthy non-physically active controls (n=12). We performed overall and pairwise comparisons for statistically significant differences between the three groups (p<0.05).

Results A total of 44 (65.7%) markers exhibited significant differences between the three groups: 32 (72.7%) showed a loss of the conditioning effect of exercise (‘deconditioning’), 7 (15.9%) showed changes exclusive to OTS, 3 (6.8%) maintained the exercise-induced conditioning effects and 2 (4.5%) revealed an exacerbation of the adaptive changes to exercises.

Conclusion Our findings suggest that OTS is likely triggered by multiple factors, not restricted to excessive training, resulted from a chronic energy deprivation, leading to multiple losses in the conditioning processes typically observed in healthy athletes, as a combination of ‘paradoxical deconditioning’ processes, which explains the gradual and marked loss of physical conditioning found in OTS. We, therefore, suggest that the term ‘paradoxical deconditioning syndrome’ better represents the features of this syndrome.

https://bmjopensem.bmj.com/content/5/1/e000542.full

 

[Ravn]

The EROS study

Taking the search for sexy study names to extremes...

We, therefore, suggest that the term ‘paradoxical deconditioning syndrome’ better represents the features of this syndrome [OTS].

Bother, they've beaten me to it! I've always thought ME, too, should have the word 'paradoxical' in its name, somewhere. Or maybe PPEM = Paradoxical post-exertional malaise. Or something.

Anyway, it's a very interesting study. Some of the main points:

• Each OTS-affected athlete had a different mix of triggers in addition to overtraining. So different triggers can lead to the same outcome. Sounds familiar...
• One of the triggers can be excessive concurrent cognitive effort. Sounds familiar...
• They hypothesise that the physiological processes which normally result in increased fitness after exercise do not work in individuals with OTS, leading to 'paradoxical deconditioning', i.e. the more you train the less fit you become. Sounds familiar...

Dysfunctions in OTS were neither overt nor absent, but ‘relatively altered’, as the majority of the parameters were altered when compared to healthy athletes, but normal when compared to the reference ranges for general population.

That reminds me of the recent McGregor PEM vs non-PEM vs HC study* where, counterintuitively, some findings for subjects with PEM lay between those for non-PEM and HC.

*Thread about the McGregor study here: https://www.s4me.info/threads/post-...on-in-me-cfs-cases-2019-mcgregor-et-al.10260/

 

[Amw66]

Can we put the Nottingham exercise researchers in touch with these ones?