Wednesday, November 11, 2015

Overtraining Syndrome (OTS) - My Experience

It's a warm Thursday morning in August of 2015. I'm tired. The night before I raced two local criterium races, managing a break that stuck in one of them and holding onto the peloton for a pack finish in the other. It was a tough night, and my body has a dull ache from the exertion. I buckle on my Polar HR strap and set down to check my HRV, as I've been doing every day at the same time for months at this point. (I use the Elite HRV app with a Polar Bluetooth strap) Slightly elevated towards the Parasympathetic scale... today will be an easy recovery spin. (To greatly dumb down keeping up with your HRV, over a long enough timeline higher parasympathetic is usually considered good, but from day to day readings most agree a balance without major deviation is ideal.) This is the kind of detail I never thought I would sweat over in my training... but then I never thought I'd have Overtraining Syndrome (OTS) either.

There are two questions I get asked from basically everyone who I talk to about OTS. "How did you know" and "What were the symptoms." The former is a loaded question, because I didn't know. With the help of Dr. Kevin Sprouse (Provision Sports Medicine, Cannondale-Garmin Pro Cycling) it was eventually diagnosed, but one of the problems of OTS is that there is still not a set in stone line you can cross of "This is OTS" and "This is not OTS" (or Overreaching) which makes diagnosing it frustrating. This also leads into the latter question, which only adds to the frustration. The "symptoms" of OTS are only easy to pinpoint retrospectively, (and even then easy is a stretch) since symptoms like "tiredness" and "apathy" literally apply to basically every ailment in existence from terminal cancer to a common cold. Looking back I am able to draw conclusions and signs, but it's completely possible those are results biased conclusions.

Let's be clear here, I'm not a professional endurance athlete. When I'm "peaking" I'm decent, probably the higher end of middle of pack, but looking at my history you won't see workout logs chock full of 40, 30 or even (many) 20 hour weeks of training. I'm not an Ultra Marathoner, my biggest month of running was 100 miles (pedestrian for most "runners") and even with added swim and bike training I was still logging way less training than many "recreational" triathletes. Of course, OTS is not only caused by physical stress, but by the buildup of all stessors in a person's life. (sleep, diet, life in general, etc) Sounds great... I mean, endurance athletes are all very laid back people in general...right?

Here is my story, in a hope that it will help other's shed some light on a very real and very vague, misunderstood condition.

I'm not sure where the beginning is, so it's difficult to start there. Instead, let's pick up at the end of 2010. I had just finished the inaugural Rev3 Cedar Point Full Rev (140.6, and "Ironman" for those who aren't snobs about branding) in a little over 12 hours. Considering the training (or lack thereof) I put into the race, I was excited for the future. I had skimmed through, never running over 16 miles until race day (not that I ran much of that...) and felt like I had a long way to go to the ceiling of my fitness. After a couple of weeks off (I paid for my lax training) I hired a coach and dove headfirst into training.

If I have a *unique characteristic, it's that I can turn my mind off and just grind. Maybe it was growing up when MMORPG's first became a thing...where you were rewarded for grinding on and on through the levels, monotonous actions that would drive any sane person off the edge. Not me. As it turns out, that kind of mindset works well for endurance training as well. When normal people would re-schedule a 3 or 4 hour ride when it was pouring down rain, I would lock my bike onto the trainer and ride on. 100°+ days of high humidity and a long run, no problem... heck I generally didn't even take a water bottle with me. The only gym with a decent pool was nearly an hour away, but that didn't stop me from waking up at 3a.m. a few days a week to get my yards in. I was a machine. Holidays, vacations, births, deaths, sickness, it didn't matter, my workout was getting done, the rest (and often rest itself) be damned.

We're endurance athletes, suffering isn't just something we do, it's a badge of honor. Where the guy that beats you in the race is often misrepresented as the guy who suffered more in training. More early mornings, more late nights, more tempo, more speed, more more more. We brag about our suffering, it's part of our culture. I remember seeing a picture when I first started training of an athlete who had had a mechanical in an Ironman race deep into the bike portion (but still a good few miles from the the finish) and, being the stoic hero he was, took off his shoes, slung his bike over his shoulder and walked his bike back to transition barefoot, only to put on his running shoes and start off on his marathon. That was awesome.

Ironman Augusta 2011 was my first 70.3. I didn't know what to expect with my increased and focused training, so when I crossed the line in 4:45 and in the top 100 finishers (counting pro's) I was beyond excited. I had crushed my set goal, suddenly 70.3 World Championships didn't look like a far off goal, it was on the horizon. 2012 would be my year! I felt like I had so much potential and low hanging fruit still to be plucked.


I don't think I bothered taking a week off. Immediately I dove back into training, working on my weaknesses. I focused on running faster by adding more miles. The winter months came and went, I screwed screws into the bottom of an old pair of running shoes so I could run on the slick trails before the sun came up when it got icy out. Augusta 2012 didn't go as expected... I knew I was fit, but I wasn't firing on all (or hardly any) cylinders. I began my taper two weeks out, but despite the decreased volume and supposed extra "rest" I was getting, I didn't feel good. I actually ended up cutting my final lead up week to almost no volume due to how I was feeling. Despite better conditions and focused training, I limped in at a disappointing 4:57. We chalked it up to having a bad day. It wouldn't be the last. That may have been my first indication something was wrong. After the race I felt a lingering depression over my results. I vowed to make 2013 a "fun, no stress" year of racing. Ironically, this gave me plenty of excuse to "train through" the year and really started to ramp up my run mileage. My results continued to confuse... I was like a yo-yo of results, having good days and bad days with seemingly no rhyme or reason. In retrospect I think this is a big warning sign... training days that were supposed to be pretty easy I would sometimes struggle to complete, then a day later I'd have a threshold workout that I felt like I was breezing through. More than once I questioned my Powertap and Garmin and their accuracy. (they were accurate) Of course, in my twisted thoughts I could only reason that I was losing fitness... the solution? More.

2014 was to be my year. The fun was over, it was time to buckle down and put in some big performances. Again, running was my focus in the early season, and I had high hopes after breaking 1:30 at the Knoxville Half Marathon. (a fairly tough course to start with) and having my best finish ever at the Trideltathon sprint, (a race I had struggled with in the past.) however that was followed and soured by a very lackluster race at the Rev3 Olympic in Knoxville. My run split particularly at that race was nearly a minute and a half off of my expected pace for a 10k, even off a fairly tough bike. Then I seemed to bounce back, doing some of the best racing I had ever done in the following months. As August rolled around I felt ready for the AG Nationals double.

This pictures says a lot
While I did not expect to qualify for Worlds, I figured I had a shot if I had a good day. I certainly did not have a good day. Again, I started off feeling pretty good but quickly fizzled on the back half of the bike and felt quite flat on the run (again running much slower than my predicted pace... much slower than my 1/2 marathon pace actually) I was pretty upset, enough that I nearly pulled out on racing the sprint on Sunday.

Disappointment Evident

Sunday was like a light switch. Despite feeling pretty sore all over, I ended up racing much better throughout. Even my run pace was nearly 30"/mi faster. (Not that it was good, or that it shouldn't be faster for a sprint) I was pretty confused at that I admit. Of course there are a lot of reasons I could have a bad Saturday and pretty good Sunday, but looking back it fits pretty easily into my on/off symptoms.

Following that I raced AQ Nationals in Cedar Point, and despite the drama that ensued (I'll not rehash that story) I had felt pretty good. Only a short sprint and some foot races left for the season. Again I raced the local end of season sprint (same course as the early season trideltathon) but this time I got a real surprise. Quite a few guys I had been beating all year had dominated me in this race. It was a pretty rough blow and I didn't have a good answer to why other than they had been working hard! As my poorest performances by far had been in my running, and I had already been doing a pretty solid amount of volume, the solution was pretty simple... more intensity.

Looking back (or reading this) it's pretty easy to place blame on me or my coach for not seeing where this was leading... but really, who thinks OTS is a thing that happens to mortals. We slowly start adding speed work to some of my runs... and then... I started getting faster. I felt tired more than usual, but it was working, my 200's and mile repeats were dropping time, and I was still doing well keeping up my swimming and biking. I was excited for the local Turkey Trot, as it would be my chance to finally break 19 minutes in a 5k, something I had been chasing for a while.

As you might guess from the recurring theme of this, that race didn't go as planned. I raced on pace the first half, but the back half of the race I just didn't have any turnover. I sailed home about 30 seconds slower than my last 5k, and this time it shook me that something didn't feel...right. Generally after a 5k I am sore, but back to running (easily) the next day. This time it was accompanied by a deep cough and a lingering tiredness.  I took Friday off, Saturday easy and short and planned to get my long run in Sunday. I ran 6 of the 12 miles I was supposed to do Sunday... then I walked 6 miles back to my house.

That was the wake up call that I needed to take a serious look and figure out what was wrong. I begrudgingly took a few days off and started the search for a doctor who dealt with athletes. I was extremely fortunate that Dr. Kevin Sprouse  is local and was able to see me. After a short meeting I was sent to have blood work done and told to rest until our next meeting to discuss the results.

Those tests showed the truth that I was not taking care of myself. These results shown to most people would not have indicated they were from a 31 year old man who should have been in prime fitness. They were, to be honest, a frightening eye opener and reminder that it's not always what you see on the outside. I was given a recommendation on diet changes and vitamins to start taking and given yet another suggestion/order to rest.

Time passes slowly for an idle athlete, suddenly you have all this time that used to be dedicated to training to fill... I learned a lot about "allowing" myself to take a break in that time, but let me assure you, it went against my nature to the fullest. My house was the cleanest it had ever been, the yard was mowed, I cleaned my garage, took up painting again... it's crazy what kind of gap was left. And the worst part of it all... I didn't feel any better.

One of the scariest things (for me) about OTS became apparent only after I had already taken some time off of training. I realized I wasn't recovering. What I mean by that is, when you are seriously in a training block, you expect to feel pretty beat up... it's just part of the deal. However, I had been doing NO physical training for weeks at this point and I still had the effects/feeling like I had been putting in serious mileage. I had a hard time falling asleep, but for the first time in years I had to set my alarm to make sure I didn't sleep past time to get up for work. (My internal clock usually wakes me up before 6, but I was easily sleeping until almost noon on weekends with no alarm... and that's considering I was going to bed by 10p.m.) When I did wake up I had a "deep" tiredness. I wish could think of a good way to explain it but everything falls short. The best I can do is to imagine how you feel a little later in the day after you finish a 10 mile tempo run. Not in pain or so tired you want to take a nap, just a lingering weary feeling that reminds you that you did some pretty serious work that day. That's how I felt every day, except I hadn't done a 10 mile tempo run. Or anything for that matter. That's when I really internalized that I hadn't just toed the line of overreaching.

The next couple of months I had a lot of low points. I know I'm not the smartest guy, but I have a fairly good grip on how the body works when it comes to time off, especially extended periods. I was also becoming fairly knowledgeable about just what OTS could mean long term. Like sand slipping through my fingers, I knew that most of the work I had done over the last season (or even longer) was gone. Being a realist and possibly even a pessimist, I understood that many people who sink into OTS are simply done. Not for a couple of months, but permanently. More than a few of the limited number of OTS stories you can find online end with the athlete completely removing him or herself from endurance training and racing. Why? I don't have a good answer to that question... I'm not even sure they themselves do. If I were guessing, I would say part of it is the long term effects of OTS... not that we know exactly what those are, but one can only speculate that doing something like this to your body has some long reaching repercussions. The other part is likely the mental damage that is done. I understood that part particularly well. How many of those early mornings, late nights, long runs, tempo rides and air gasping swims were all squandered. It's a mountain that may very well seem insurmountable, especially when it's so hard to remember starting the climb the first time.

I remember talking to Kevin in one visit and I said "I don't know if I'll ever be the athlete I was." and his reply was something along the lines of "Maybe that's a good thing." I really credit that as one of the most important turning points in regards to how I handled my recovery. My job became getting healthy again, and I took it as serious (probably more so) as I had ever taken training. I learned more about my body and how it worked in those couple of months than I had learned in the preceding 31 years. Most importantly, I made myself start thinking of the athlete I was up to that point as a completely different person, someone whose accomplishments (and failings) were removed from me. I even "symbolically" deleted all my power files so that when I started again, there would be no constant reminder to compare myself to.

Finally, after another round of blood work I was cleared to start slowly training again. March 24th 2015 was my first workout. All in all my ordeal had been nearly 5 months, most of that completely inactive. (besides some yoga) That first workout was humbling despite my already being prepared for the worst. I had lost over a hundred watts from my previous threshold power, watts that had been hard work to earn the first time around. We (myself and David, my coach) decided that I would focus only on cycling for the foreseeable future, both because I enjoy cycling the most and because I could do it at home with very low impact. And while I said above I removed myself from my former self, I made sure not to forget all the experiences and knowledge he had accumulated. I was a newbie with some great advantages.

My first race (a short TT) after my ordeal. I believe I finished last
Unfortunately, if you have read this far expecting a neatly packaged happy ending, you're going to be disappointed. Every answer I get opens up two more questions. Currently I feel good, I've been racing well (I managed second place in the Cat5 TN State Criterium in July, which I think was one of the toughest races I've ever done, this life or past) and have managed to bring my FTP back to close to where it was when I was at my prime. However, I am still only riding around 10 hours a week. I still need at least a day off, usually two, and an easy day in the mix to keep from feeling thrashed. (and throwing my HRV off, which I now keep track of to monitor my recovery) I still have many self doubts to battle, and no amount of bravado can smooth over an anxiety that I am always standing near the edge of the chasm, ready to plunge back into OTS. So there is no happy ending here... but there is hope. I'm hungry to return to a high level of racing, and I plan to be a better athlete than I ever was. I am also tempered with the wisdom to now savor whatever victories I achieve, as I now have firsthand knowledge of how quickly it can go to ruin. I feel like I am now a much more "complete" athlete than I was... I have internalized that this is an important part of my life, but it is not my life. It's OK for me to allow myself a break every now and then. It was a hard lesson, taught to me probably the only way I would have ever listened, with a stern hand. I can gladly say this isn't the end of my story as a triathlete, a cyclist, a runner, a swimmer or a person. I will not be one of the stories that end with a clean break from endurance sports. You'll hear from me again. There will be more.

There always is.





2 comments:

  1. Thanks for your story! Very interesting to see your experience. What I was wondering, what did they see from your blood values to find you have OTS? And what changes in diet did you do?

    Keep up the good work, you still have plenty of potential for great results!

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    Replies
    1. Hey Tim,
      First thanks for the kind words, to try to answer your questions
      Blood isn't the only indicator (my lactate test was also an indicator, along with the fact that taking 2+ weeks off did not result in a positive change in how I felt) but some things I think can be indicators in blood work include
      - hormone levels (Testosterone and Thyroid looking "bad" can be symptoms of a lot of stress on the CNS.)
      - Vitamin D
      - Magnesium
      - Iron (and Ferritin)
      - Insulin

      Again, that's not an exhaustive list and many/most of those can have other causes (or cause some of the other as well) but a test that covers those should be comprehensive enough to give you a good idea what's going on in your body.

      As far as diet goes, nothing terribly revealing. I cut a lot of sugar from my diet (some training days I was closing in on 100g or more, some of which was from healthy fruit and some of which was from... less healthy options) and replaced a lot of it with healthy fats and more fiber... no "crazy" eating plans. I also began making all of my own training nutrition. (Feedzone cookbook was a great help) so I could micromanage all of what I was putting in my body.

      Cheers,
      Chris

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