Doctor Visit – Overtraining Syndrome Diagnosis

I so appreciate my sports doc!  He has been with me since I first started triathlon at age 60 – ten years ago.  At that point, I was new to sports and thought that every little ouchie was a broken bone or heart attack.  He taught me how to assess pain and provide guidance regarding my ideal race weight.  

A year ago, before I started working with a new coach who I knew would push me harder than I’ve ever been pushed in the past, I scheduled an appointment with my doc.  Several of my friends told me I was nuts as a 70-year-old to be pushing myself so hard.  I wanted to see if my sports doc agreed.  If so, I would not go down the road I was planning to go down.  My sports doc said that there was always the possibility of an injury, like a broken hip, that would require a long recovery and end my triathlon career.  But since I was a healthy 70-year-old, he didn’t see any injuries that would be life changing.  Of course, he added that he didn’t have a crystal ball and could never say never.  I always appreciate how my doc tells me the risks, but then lets me make the decisions about risk vs benefit.  Since he didn’t feel there was a life-changing risk, I decided to go ahead with the new coach.  I have no regrets about that decision.

The difficult thing about Overtraining Syndrome (OTS) is that there are no biomarkers.  Diagnoses are made by 1) noting the symptoms and their duration and, 2) ruling out all other causes.  I’ll write in another blog about the lead-up to my coach deciding that I was overtrained and pulling me from overtraining.  But once he did mention overtraining, I wanted to touch base with my trusted sports doc.  

The first thing my doc did was to ask me about my symptoms.  I told him about performance dropping in workouts – how I struggled in long rides to hit 65 watts when 90-110 was normal, how I pooped out after running for 10 minutes.  I told him about my irregular sleep – how I’d sleep for one hour and then wake up and not be able to get back to sleep for several hours even though I was crazy-tired, or . . . I’d sleep for 12 hours and then wake up exhausted — day after day after day.  I shared that I cried for no reason and was cranky.  I told him that I had stopped training two months prior and had been really focusing on sleeping, but the symptoms persisted.

Next, my doc ruled out all other possibilities for the symptoms:  Iron deficiency, mono, sleep disorder, mood disorder, heart issues, etc. 

Once OTS was diagnosed, my doc emphasized strongly that rest and nutrition were key – adding firmly that this was NOT the time to lose weight.  He said he’d rather me error on the side of gaining weight, rather than losing weight.  He advised that I get lots of sleep at night and take naps during the day.  My body needed proper sleep and nutrition to heal.

While supporting my recovery through sound rest and nutrition, he also wanted me to decrease stress.  He advised me to engage in mindfulness exercises, yoga, and talking with trusted friends.   Of course, exercise adds stress to the body too.  My doc wanted me to keep training lightly.  More than keep me from losing fitness, he felt that would keep my spirits uplifted.  

I had a lot of questions about the journey back from OTS.  He said the road back would not be a straight line.  There’d be good days and bad days.  When the good days became more frequent and closer together, I’d know I was on the right track.  He warned that when I do have a few good days, to be patient – to not get carried away and push too hard too soon.  He added that since there were no bio-markers for OTS, things like resting heartrate (RHR) and heartrate variability (HRV) were not good indicators that I was pushing too hard or of progress.  He said I should just note the frequency of good and bad days.

As the good days began occurring more frequently and the bad days less frequently, my doc said to work my way back by 1) adding frequency (increasing the number of sessions), and then 2) adding volume to sessions, and finally 3) adding intensity within sessions.  When I asked how long it would take to come back, he said it could take months or years (!) depending on how deep the hole was when my coach pulled me from training, and how consistently I make good decisions with regard to rest and nutrition, and the degree to which I avoid unnecessary stress.

So now, recovery IS my training.  Instead of applying mental strength to pushing through pain and fatigue in hard workouts, I’m applying mental strength to maintaining the discipline required to make sound recovery choices.  Instead of striving to set PR for pace or watts, I’m now striving to set PRs for the number of consecutive days with 100% sleep performance (duration, quality, and consistency)!  

DISCLAIMER:  OTS is a medical condition involving the endocrine system.  I am not a doctor or a researcher.  I am simply sharing my story as an athlete.  If you think you have or are approaching OTS, please talk to your coach and doctor.

Road to Worlds 2024 (Torremolinos, Spain) . . .

Training Update:  Week 13 of Overtraining Recovery – Added a little more volume on Monday and Tuesday of this week which was encouraging – and then took an extra off day on Wednesday to make sure I’m getting enough rest.  After having such good days on Monday and Tuesday, it was a little discouraging to not train on Wednesday.  But I know my coach is being conservative about bringing me back.  This is not the place to take risks.  Trying to use each workout as an opportunity to practice technique and mental tools.  

Writing Update:   Wrote a tentative table of contents for my book #2, STRONG Enough.  It’s a book about my quest over the past four years to discover if a level of mental strength existed that was so far above me, I didn’t even know it existed – and the lessons I learned along the way about myself and the world of high-performance sports.

Speaking Update:    I loved presenting the Opening Keynote this spring at a conference hosted by the Seminole Public Schools in Sanford, Florida.  Had a great time talking about the process of improvement with a group of energized educators!  Instead of accepting the speakers fee, I asked them to use the funds to create scholarships for educators to attend leadership training.  Eight educators were able to attend a state conference.  Yay!  Love learning.  Love helping others learn.

CHASING DREAMS features blogs about lessons I’ve learned about high performance and the process of improvement from my first career with the American Student Achievement Institute, a non-profit organization that I founded and directed for 20 years prior to my early retirement, and my second “career” as a serious age-group triathlete, transitioning from dead last at local 5K events (while weighing 335 pounds) to standing on the top podium at the Triathlon Age Group World Championship as a two-time world champion.    NEWSLETTER SIGN-UP:  Click here to be notified about future blogs.


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