Dr Iñigo’s prescription for Overtraining

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This article is the second of a series by esteemed Medical Director and Physiologist Iñigo San Millán of the Saunier Duval-Prodir Pro Tour Team. Wanna get really scientific about your training? Consider getting the man himself in your corner here.
Here it comes, finally the end of the season. I am a sure that at this time of the year many readers of this article are fried. They wake up tired in the morning, their heart rate doesn’t go up when they push it, legs hurt, don’t know if they need to train more, or more intensity training, their mood got worse, some are depresed…they just don’t know what’s going on! If any of you have several of this “ symptoms”, you are overtrained. They do an analysis of the season and the conclusion is that they where fried most of it!.
@##=#<1,C>@##=# There are several ways to qualify overtraining. Many authors differentiate among overtraining and overeaching. In my opinion, and from 10 years experience of working with both extremes of cyclists from world class cyclists to weekend warriors, there are two kinds of overtraining: Acute and Chronic.
I would define acute overtraining as the type of overtraining reached after an acute week or small program load where a cyclist has trained too much and arrives to the goal he/she trained for more tired than normal. This type of acute overtraining is mostly seen in fresh cyclists who have in mind an important event and think that training hard the week before the event will help them to get that competition pace or reach final peak form.
The second kind of overtraining and the most common is chronic overtraining which affects the vast majority of cyclists, especially at this time of the year.
This overtraining is the results of many weeks or months of constant training leading to many “small” acute overtrainings, which in turn lead to a chronic condition. To put it this way, it is like an acute tendonitis (as a result of a hard or several hard training rides with wrong equipment, shoes, cleats, changes in seatpost…etc) vs a chronic tendonitis where that condition has been sustained for several weeks leading to a much harder and longer recovery of the injury.
Many times, chronic overtraining is wrongly diagnosed by the “sufferer” of that condition since he/she does not realize that they have that condition. That is fairly normal due to the lack of “diagnosis” possibilities that many cyclists have making it impossible to detect the cause of overtraining. Also, the psychological game comes into play. Many cyclists say: “OK, I am a cyclist. This is a hard sport, I don’t feel good and hurt a lot, but hey!, that is what a cyclist is supposed to be…..a sufferer!”. And they go on thinking that their condition is normal.
@##=#<2,L>@##=# How to diagnose overtraining.
We don’t need to go to Dr. House’s Diagnosis Unit to identify an overtrained condition, although many times the diagnosis of ovetraining becomes more of an art than a science and becomes a detective’s job. There are many, many variables we can analyze to detect overtraining. By far the best way to analyze overtraining is blood! Yes, blood. Something very strange for many cyclists used to reading books about psycological charts, heart rate changes, mood changes…etc. OK, that can help, but we need to see overtraining from a scientific and objective point of view and for that blood is the way to do it. As a small summary I will name a few blood parameters we can use to find and/or we should check for overtraining.
Full Red bood Cell Count (Complete Hemogram)
In this test we can see if it has been a drop in red blod cell (RBC) count as well as hematocrit (% of RBC) or a dicrease in the content of Hemoglobin. Red blood cells have inside a component called hemoglobin which transports oxygen (O2) to the tissues. The lifespan of a RBC in a normal person is between 90-120 days, after that period the cell membrane gets very fragile and it ends up being trapped and destroyed in the spleen. The lifespan of a cyclist is between 50-80 days!. To put it this way. The lifespan of a Taxi in NYC which carries tons of passangers (Oxigen) daily through the patholes of the city is a lot shorter than the lifesan of a taxi in a small town in the midwest where the number of passangers daily are very very small.
Every day we destroyed millions and millions of RBC. An average amount of RBC in a regular person is from 4 to 5 million RBC per cubic milimeter (mm3). If we have an aproximately 5 Liters of blood do the math!. But human’s and in general mamal’s amazing physiology has the capacity of replenish them so that the amount of RBS created equals or should equal the ones destroyed.
In chronic overtraining status the RBC destruction exceeds the creation and that leads to a drop in general RBC count and therefore O2 transport to tissues so our muscles will receive less O2 and will be more fatigued. This can be cause by different things from a general hormonal depression and catabolism status which leads to a smaller decrease in the production of Erythropoietin (EPO), a vitamin deficit, specially B12 and Folic Acid or an Iron deficit. In order to produce a red blood cell we need 4 critical components: EPO, B12, Folic Acid and Iron. Any deficit of these components will lead to a poorer production of RBC..
Blood Biochemistry Pannel
In a blood biochemistry pannel we can find and amazing quantity of components of blood. We can check for levels of Iron, Ferritin (Iron storage), Folic acid and B12 as discribed above as well as many other components that would be way to large to name as well as difficult to explained. To be simple on top of the latter ones mentioned we can look for certain muscle enzimes which indicate us muscle destruction. Overtraining leads to an excessive muscle work and that will create microruptures in the muscle cell membrane and we can target special enzimes in the blood which will indicate a muscle destruction and a catabolic status. So as we can see here we can see so far a possible excess of RBC destruction and/or muscle destruction. Not allways both go together necessarelly at all. A cyclist can have a very low RBC count but normal muscles or viceversa.
Hormonal Profile
Since our whole physiology is pretty much governed by hormones which are the governors of the many, many different biochemical signals produced in our body a hormonal profile is important as well in order to rule out or targer overtraining.
There is one hormone called Cortisol which is also called “the fire or fight” hormone. This hormone is critical for life and used daily in many differentt processes but it is released in excess under any kind of psychological and/or physiological stress . Cortisol it is pretty much a catabolic (breakingdown) hormone and will end up wasting muscle protein, as well as red blood cells. It is a catabolic (destruction) hormone and will interfere with any anabolic (construction) processes in our body like protein synthsis for muscle build up and repair, erythropoiesis, growth hormone release…etc. Counting that the vast majority of cyclists in NYC work and train at the same time, the psychological stress from work and the physiological stress from training and competition will increase the chances of getting overtrained.
So with all this in mind it is of crutial important not only do these kind of tests when feeling overtrained but also to monitor them trought the year to make sure that everything is in place and we can still train.
Overtraining can be for the most part cought on time and the impact on our results can make the difference.
As mentioned earlier, the combinaton of working full time and training and competition can easily put you over the edge and cause a chronic overtraining so be aware of that next season and if you feel tired think about it twice before you go on with your ride and do your training. Many times resting will be the best training you can do!. Most cyclists don’t get enough rest and train without resting periods throught the whole season. That if you work at the same time is “suicidal”!. If this is your case now or in the future try to get some help and find out what is going on in your body.
Best wishes,
Iñigo San Millán. Medical Director and Head Physiologist
Saunier Duval-Prodir UCI PRO Tour Cycling Team.
www.saunierduval-prodir.com