Training Fatigue - Are You Recovering Enough?

author : AMSSM
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Member Question

I train regularly and can handle volume and intensity but the other day I had something happen that hasn't happened before. I noticed my heart rate dropping while on the bike. Not a big deal, I figured I was just a little tired so I cut it short. While swimming the next evening the same thing happened. I felt my workout getting more and more laboring after 2,000 meters which is very strange. I typically swim 4,000 meters three times per week, sometimes more. Why is this? This has never happened before and never happens on my morning workouts - only my second workout of the day? Any suggestions? If I were just getting tired no big deal push through but this is different. Breathing is more difficult and my body just doesn't want to go. Is it lack of calories? Exhaustion? This has happened two days in a row and is kind of strange.

Answer from Dr Michael Jonesco, DO
Member AMSSM

Triathlete,

Thanks for the question. Let’s look into your rather “strange” experience and hopefully lead you to your next logical steps for recovery.

Many athletes know that regular vigorous physical activity can decrease your resting heart rate. This is a beneficial effect related to conditioning and improved efficiency of the heart. However, a drop in heart rate during exercise is more concerning.

Without knowing your cardiovascular risk factors (like age, sex, family history, etc) it is hard to rule out the chances of heart disease. A dropping heart rate, or failure to increase ones heart rate to an expected rate, may be a sign the heart is unable to keep up with demand. This would also account for your labored breathing and feelings of fatigue. If your symptoms have persisted, be sure to contact your physician and inform him or her about your situation. An exercise stress test, in which a cardiologist can watch your electrical rhythms via ECG, would provide valuable information and help to rule out a more serious explanation.

Now that I’ve scared you, there are other possible and less ominous explanations. First of all, the fact that your symptoms are only in the afternoon are somewhat reassuring and may lead us away from the above and more towards training error, specifically nutrition. Two high energy workouts daily like you are doing burn an enormous amount of calories and soak through a lot of dry fit clothing! If you haven’t already, there are nutritionalists and exercise physiologists who would love to work with someone as motivated as yourself. Adequate caloric and water intake are essential, and failure to match supply and demand could certainly cause your lethargy and poor workouts.

Your symptoms of fatigue and lack of heart rate response may also be related to “Overtraining Syndrome”, or exhaustion, as you mentioned. This syndrome is a spectrum of disease that is as frustrating to diagnose as it is to treat. Typically while training we stress our body beyond its baseline resting state. The body learns to adapt and during a recovery phase supercompensation occurs, enabling the body to achieve greater performance in the future. It is vital during this recovery phase the body receives adequate nutrition, hydration, sleep/rest, as well as physical and emotional rest. If the body is pushed or overtrained before adequate recovery, there are negative effects on the body’s metabolic, immune, endocrine, and psychological systems that can lead to breakdown of the athlete. Oftentimes, the only symptoms include losses in appetite, poor mood, fatigue, and reduced performance. If monitored, we may also see objective findings, such as elevated resting heart rate, decreased lean body mass, and poor scores on psychological tools, such as the RESTQ-sport. While blood work may be suggestive, there is no single test that has been accepted as diagnostic for Overtraining Syndrome. Treatment is simply rest. I typically recommend two or three weeks of absolute rest for my athletes, to allow for recovery. While no one likes this advice, it is oftentimes all the athlete needs to allow their body to adapt.

It is import to note the diagnosis of overtraining syndrome is one of exclusion. This means that until you look into other explanations and rule out other things (like the aforementioned heart disease) we cannot assume your symptoms are related to overtraining. If your symptoms have persisted, I would urge you to meet with your physician to elicit his or her help in determining which avenues will lead you back to safe and happy training.

Best of health,

Dr Michael Jonesco, DO

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date: April 17, 2014

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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