Richard Budgett opened the batting for the symposium – his experience as an Olympian, long-time team physician and researcher leads him to look at ‘unexplained underperformance’ as a key issue.  ‘Labelling it as overtraining can make coaches twitchy’ and he explained that the topic has to be dealt with sensitively with coaches.  A good point. Remember that there is also that a long list of other conditions that impair performance (like hypothyroidism – Carl Lewis before the 1996 Olympics, diabetes mellitus – Stephen Redgrave).

Treatment of overtraining can take 6-8 weeks of relative rest. He also made the point that exercise – but ‘ridiculously low’ levels – is an important part of treatment. Still a tough problem.

Romain Meeusen also has great credibility on the science of overtraining – an expert on neuorendocrinology in exercise. He proposed a two-stage test diagnosing overtraining in 2010. At the symposium he highlighted that there are more review paper than original data papers on this topic! What I hadn’t realised was that the neuroendocrine profile of overtraining was the same as that in Post Traumatic Stress Disorder (PTSD).  Fascinating! The similarity between overtraining and depression was also discussed. But the take home message was that there was no obvious ‘magic marker’ to characterize overtraining from a blood test. It remains a clinical diagnosis and one of exclusion.

Anca Ionescu shared long-term Romanian data that suggested athletes have a ‘personal profile’ – variables that signal early overtraining that are reproducible within the same athlete – an argument for ‘personalized medicine’.