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_. Heavy training in combination with inadequate recovery actions can result in the overtraining/staleness syndrome and burnout. Even young and aspiring elite ...
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Training Practices and Overtraining Syndrome in Swedish Age-Group Athletes G. Kentt~j1, P. Hassmen 1•2, J. S. Raglin] lDepartment of Psychology. Stockholm University. Sweden

2Stockholm University College of Physical Education and Sports. Sweden

3Department of Kinesiology. Indiana University. USA

Kentta G, Hassmen P, Raglin 1S. Training Practices and Over­ training Syndrome in Swedish Age-Group Athletes. Int 1 Sports Med 2001; 22: 460 - 465 Accepted after revision: February 5, 2001

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Heavy training in combination with inadequate recovery actions can result in the overtraining/staleness syndrome and burnout. Even young and aspiring elite athletes develop stale­ ness. The aim was therefore to determine the incidence and na­ ture of staleness, and its association with training behavior and psychosocial stressors in young elite athletes. A sample of 272 individuals from 16 sports completed questionnaires on train­ ing, staleness, and psychosocial stress and 37% reported being stale at least once. The incidence rate was higher for individual sports 48%) compared with team 30%) and less physically de­ manding sports 18%). Stale athletes reported greater percep­ tual changes and negatively elevated mood scores in compari­ son to healthy athletes. Staleness was distinguished from burn­ out on the basis of motivational consequences; 41 % of the ath­ letes lost their motivation for training, which in tum indicates a state of burnout. Further, 35 %of the athletes reported low satis­ faction with time spent on important relationships, 29% rated the relationship with their coach as ranging from very, very bad to only moderately good. The results indicate that staleness is a widespread problem among young athletes in a variety of sports, and is not solely related to physical training. but also to non-training stressors.

when the training is too strenuous, or the recovery insufficient (14,26). Hence, staleness can be defined as a severe outcome resulting from an imbalance between the total stressors and total recovery, largely determined by the overall capacity of the individual (10]. A widely acknowledged hallmark of stale­ ness is a decrease in the ability to perform at customary levels. This performance decrement can persist for several months, given that the state is severe enough (10,13.14,19,22]. Addi­ tionally. staleness is associated with a variety of symptoms that often vary considerably across affected individuals. This in tum has led to disagreements in the literature as to which symptoms must be present for an athlete to be defined as stale or "overtrained" 1cf. 13]. Some symptoms nevertheless seem to be common for most stale athletes. among these are mood dis­ turbances and increased perceptions of effort 110,30).

Regularly occurring periods of intensified physical training are integral parts in most sports requiring high levels of physical working capacity [10). When a period of hard training is fol­ lowed by a period of rest or reduced training. performance im­ provements typically result. However, maladaptive responses, referred to as overtraining syndrome or staleness can result

While staleness is widely acknowledged to be of concern for athletes both in endurance and non-endurance sports (13], empirical data regarding incidence rates are relatively sparse. The potential for differences in staleness risk between team and individual sports has also received little attention so far. In the few studies available, incidence rates for athletes in in­ dividual sports have ranged between 10 and 64 %, and between 33 and 50% in team sports. Morgan and colleagues [19], for ex­ ample. reported that approximately 10% of collegiate swim­ mers who overtrain go on to develop staleness, but rates of up to 21 %have been noted in other studies of swimmers [9.24]. Research on runners 120.21] revealed that 60% ofelite women. and 64% of elite men, reported having experienced a bout of staleness at least once during their running career. In contrast, only 33% of non-elite women runners had experienced stale­ ness. In team sports, 33 %of the athletes in a basketball team developed staleness during a six-week training period (34). More than 50% of the athletes in a soccer team. followed dur­ ing the first four months of their competitive season. were similarly affected [16]. As for young and aspiring elite athletes. even less information concerning staleness rates is available 17]. In the only published study to date, 35% of 13 -18 year old swimmers sampled from several different countries had experienced staleness at least once 130]. The rate of staleness among young athletes in other sports remains unexplored.

IntJ Sports IVIed 2001; 22: 460-465 © Georg Thieme Verlag Stuttgart· New York ISSN 0172-4622

While it has been found that a signifICant percentage of stale athletes retain the motivation to train 130], it has also been hy­ pothesized that repeated bouts of staleness may increase the risk of burnout (26]. wherein athletes lose their interest for

• Key words: Athletics. staleness. burnout. motivation, and psychosocial stress.

lot j Sports Med 2001; 22 _

Overtraining in Age-Group Athletes

continuing participation in their sport. Moreover, factors such as chronic lack of progress in perfonnance, inability to tolerate previous training loads, frequent injuries and illnesses, depres­ sed mood states, and conflicts with team-members and coach­ es are all potential contributing factors that can lead to with­ drawal from competitive sports [35]. These factors may also be viewed as outcomes ofa negative overtraining process, ulti­ mately reSUlting in staleness and - in the worst case scenario leading to a total loss of motivation to train and compete - that is experiencing burnout [10,141.

training load and symptoms associated with overtraining across the previous macrocycle i. e.. year of training). Further, participants were instructed to identify the periods during the previous year in which their training had been: a) easiest. b) average. and c) hardest. They also indicated their total number of training hours per day during the hardest training period. Perceived training load was assessed using a modified version of the Ratings of Perceived Exertion RPE) scale [1], originally devised by Borg 12,3]: the modified RPE scale ranged between 2 "Very. very easy") and 14 "Very, very hard").

Staleness and burnout in young athletes are particularly con­ sequential for small countries such as Sweden with a limited population. Sport high schools were instated for talented youths between the ages of 16 to 20 years in order to promote the development of elite athletes at the international level. These schools select promising athletes in a large number of sports, including both individual and team sports. Since the main goal for the majority of these young athletes is to reach the absolute top in their chosen sport, negative overtraining and stressors contributing to burnout may be major obstacles on their road to success.

Several questions involving the presence of psychosocial stres­ sors related to relationships with family. friends, and coaches, as well as academic pressure were also included in the ques­ tionnaire because these factors may contribute to the risk of staleness (cf. 31].

Hence. the primary purpose of this investigation was to deter­ mine the incidence and nature of staleness across a variety of sports in young Swedish athletes, and further to relate stale­ ness to training practices and psychosocial factors. Recalled mood state responses associated with different training levels were assessed by means of a Swedish translation of the Train­ ing Distress Scale TDS), an instrument developed to identify overreached or stale athletes based on mood state responses to overtraining [27.301. By including questions related to moti­ vation. an effort was also made to differentiate between stale­ ness and burnout. Method

Participants A total of 287 young Swedish elite athletes. studying at sport high schools the Swedish tenn being "Idrottsgymnasier"). volunteered to participate in this study. Initially. the Swedish National Sports Federation was contacted to gain pennission to conduct the study and to obtain names and addresses to the specific sport high schools. The purpose of the study was explained to coaches and athletes in accordance with the ethi­ cal standards of the APA. Athletes who subsequently agreed to participate were asked to complete a battery of questionnaires. Because some of the questionnaires were incomplete. the final sample included 272 athletes 108 females and 164males) from 16 sports. Mean age was 17.9 years range 16-20). Sports were categorized into 1) team-sports. 2) individual sports. and 3) low physically demanding sports. and this infonnation is summarized in Table t.

Measures and procedures Participants first completed a questionnaire involving items related to various aspects of training. This questionnaire was specifically developed for the present investigation. but a number of items were adapted from previous overtraining studies (19.22.30). The survey included items regarding ath­ letic background sporting event. years in the sport. skill level).

To assess staleness, participants weJ;e asked if they at some

point had experienced a significant perfonnance decrement

that persisted for at least two weeks, and that without a doubt

was caused by too much physical training i.e., not by illness or

injury ~ This criterion is admittedly conservative since it is

likely that some cases of staleness were precipitated by injury

or illness directly caused by overtraining. However. it was

decided a priori to limit cases to those that could definitely be

attributed to training instead of any number of extraneous fac­

tors. This is in line with Mackinnon's [17] suggestion that it is

important to rule out illness when diagnosing staleness. The

persons who responded 'yes' to this item were therefore asked

to indicate how many times this occurred, and the length of

the most recent episode. These subjects also rated how severe­

ly they experienced a list ofsymptoms using a five-point Ukert

scale. The symptoms chosen were among the most commonly

cited in the literature and included sleep disturbances. chang­

es in appetite. sensations of heaviness, muscle soreness. and

perceived effort of training 16.14). An open ended item allowed

subjects to indicate any additional symptoms experienced.

All subjects completed the Swedish language version of the Training Distress Scale [27.30) at baseline and with instruc­ tions to respond according to how they recalled feeling at the three training stages. This scale was derived from the Profile of Mood States (18). It consisted of seven items that have been found to be particularly sensitive to changes in training load. Research with Swedish swimmers [30) found it useful in dis­ criminating between different training loads in a dose-re­ sponse fashion. Responses were made on a five-point Ukert scale. Stale subjects also completed a version asking them to respond according to how they felt while stale. Finally. stale athletes were asked to recall motivational consequences in conjunction with their latest period of staleness. Athletes re­ ported whether they were still motivated to continue their training. or lost their motivation for training. or felt like quit­ ting sport participation, or experienced multiple consequences on motivation during the phase of under perfonning. This was made in an attempt to distinguish between staleness and burnout based on motivational aspects. Results The participants reported having been involved in serious ath­ letic training for an averageof3.3 years SO = 1.8), and 22%had been selected for a national team within the previous year. The

II1II _In_t~____M_e_d_2_0_01_:_2_2_______________________________________________________________K_en_tt_a_G__et_a_1 majority of athletes 93 %) followed an individually planned and systematic training program, and of these, 54% named the coach as having the sole responsibility for this program. About one third 37 %) stated that they shared responsibility with their coach in planning the training program, whereas 9% planned their training all by themselves. Of the total sam­ ple, 50% reported pre-scheduled periods of extremely heavy training in their program which required an average of 3.1 hours of training a day SO .. 1.3). This sample of 16 different sports resulted in a fair amount of variation in training practic­ es. Average training hours per day ranged between one and seven hours, but with 52 %of the athletes averaging between three and five hours a day.

Slightly more than one third of the athletes 37 %) reported having experienced staleness at least once. Statistics for each sport group are presented in Table 1. The incidence ofstaleness was higher for individual sports 48 %) than for team sports 30%). The staleness rate did not differ between the female and male athletes 35 % versus 38 %), consequently gender is not included as a factor in the forthcoming statistical analyses. Athletes who reported having experienced staleness were also asked to state the length of time they had attended the sport high school on average 2.4 years, SO .. 0.8), and the length of the most recent staleness episode. The athletes had on average experienced staleness on two occasions SO -1.4) during this limited time; the most recent episode lasted an average ofsev­ en weeks SO .. 10.7). The recall of experiences during under Table 1 Number of participants categorized in team sports, individual sports. and low physical sports, and the corresponding number of stale athletes Sport

Total Number

Number stale

% stale

Soccer Ice hockey Roor ball Volleyball Handball Basketball Team sports total Kayaking Wrestling

56 17 7

16 3 2 0 10 7 38

29 18 28 0 32 58 30

8 4

34

Athletics Skiing Cycling In'dMdual sports total Saifing Golf low physical sports total Grand total

Stale athletes were also asked to rate the intensity with which they experienced selected staleness symptoms, and these are displayed in Table 2. Notably, the stale athletes perceived the effort oftraining to be the most salient factor with a mean rat­ ing of 4.1 on the five-point Ukert scale), closely followed by feelings of heaviness. Sleep disturbance and loss of appetite were affected to a lesser degree. Table 2 Symptoms associated with staleness five..point Likert scale)

Staleness incidence

Swimming Figure skating Badminton

performance was limited to the most recent episode. Based on the modified RPE-scale scale, the overall training load at the most recent staleness incidence was rated as 9.9 SO .. 2.4) by the athletes Le., "Hard" on the scale).

3 31 12 126

23 11 18 4 16 12 26 8 118 5 23 28 272

6 3 15 7 11 3 57 4 5 100

36 33 75

94 58 42 37 48

20 17 18 37

Increase in perceived effort of training Feelings of heaviness Muscle soreness Sleep disturbance loss of appetite

Mean

SO

4.1 4.0 3.2 2.3 2.0

1.0 1.0 1.3 1.4 1.3

The athletes were also given the opportunity to list other sig­ nificant symptoms, besides the ones displayed in Table 2, that were perceived to be problematic during their staleness peri­ od. A number of additional symptoms were provided by 50 athletes. these were predominantly of a psychosocial nature. Seven athletes reported problems of a social origin i. e., related to family, boyfriend/girlfriend, coach, and/or friends). Negative motivational consequences were reported in nine cases. These were for example expressed by feelings such as: I feel like tak­ ing a break. decreased interest in training. being unmotivated, training and competing is boring, it feels pointless to continue training. Psychological problems such as decreased self-confi­ dence and ability to focus, short temper, heightened levels of irritability, depression, sadness, and elevated levels of per­ ceived stress were repeated in 15 athletes. Academic problems were reported in six athletes. Somatic complaints, such as muscle aches and soreness, pain in the whole body, and elevat­ ed heart rate were listed by seven athletes. Four athletes re­ ported problems maintaining a previously well tolerated train­ ing load. Seven athletes indicated experiencing chronic fa­ tigue. Mood state responses

The participants were instructed to identify the a) easiest, b) average, and c) hardest training levels during their latest year of training. The TOS was completed on the basis of how the athletes recalled feeling at each of these periods, and at base­ line. Those who had experienced a bout of staleness were also instructed to recall their mood states at the latest occasion, see Table 3. For the whole group, recalled mood states did signifi­ cantly differ between the three training levels, i. e., easiest, average. and heaviest F2•50o .30.7, p