One Story of Overtraining

I’ve written a lot about various aspects of the health issues that I’ve been dealing with for some time now. To this point though, I haven’t said much about the specifics of what I’ve gone through physically. This has been in part because I think the specifics might be boring to the average reader, and in part because I have had such little understanding of what has been going on in my body that it’s felt like it would be impossible to put it into words in a way that would make any sense. Now though, as the light at the end of the tunnel has gotten generally brighter I feel like I have a better understanding of everything I’ve gone through, and I’ve had several people in the past several weeks tell me that they are curious as to more of the specifics of what I’ve gone through.

The story of all of this really goes back to 2011. Ever since sometime in the early part of that year things just didn’t quite feel right in my running. I felt great in everyday life, and I generally felt great when running slow and short, but anytime I tried to run hard (especially races) or long (over 5 hours) things just didn’t feel “right.” The problem was that things never really felt that bad either, just not all that good. So I tried to rest a bit more than usual, but mostly just powered through.

This all came crashing down though in the later part of the summer of 2012. I was feeling decent enough most of that summer, but sometime in late July or early August I started to have some very unusual things happening in my body. The first acute symptom was excessive urination, initially only when I was running. I can recall some runs at that time when I would need to take a piss every 10 or 15 minutes for four or more hours! For several days I didn’t think much of this, but then it started to occur all the time (not just when running), and then a week or two later I started to feel some dizziness, neck pain, and shooting pains in the back of my head. Again, these symptoms initially only occurred when I was running, but within a week or less I started to have them at numerous times throughout the day. By the end of August, I was also experiencing severe muscle weakness, fatigue, numbness, tingling, anxiety, random pains throughout nearly everywhere in my body, swollen eyelids, GI pain/issues, “brain fog,” severe lack of coordination/balance, and significant fluctuations in body temperature, appetite, blood sugar, and blood pressure. These were the things I remember most prominently. There were probably another dozen symptoms that I might have experienced in a given day at that time.

Around this time I was really scared. I was certain I had some sinister illness/condition and would be lucky to be alive in a year or two. I nearly went to the emergency room at least a half dozen times in August/September. Over time I saw about a half dozen doctors, tested for everything you can imagine, but no one was able to pinpoint any one specific thing. Slowly, I became better at living with my condition, and then, in very slow steps over time my condition seemed to be getting a little better.

By October or November, I began to consider the possibility of Overtraining Syndrome. When anyone had suggested this initially I just thought there was no way possible that I could have such acute and such severe symptoms simply as a result of too much physical stress/activity. I’m still not completely sure I trust this diagnosis, but as it is now eight months since the onset of acute symptoms, and I have not been able to nail down any other kind of diagnosis this seems more and more likely.

In the time since November, things have generally continued to improve, but it has certainly been a very up and down path. Most of December was a pretty good stretch, but then most of February I was feeling as bad as I had felt since September or October. March was the best I’ve felt since this all started, but now in the past week or so I seem to have gone back into a phase of feeling mediocre at best. The good news now is that a mediocre week would have been my best week back in September or October. On the good weeks now I feel almost “normal.” Fatigue, neck pain, heavy eyes, and muscle weakness seem to be the symptoms that have been the hardest to shake.

As you might imagine, I have read a lot about Overtraining Syndrome in the last several months. It’s a tough thing to completely trust as a diagnosis as there are no clinical tests that definitively show this condition. I have found a lot of things in my system that would back up the theory of Overtraining, most specifically poor adrenal function, low neurotransmitter levels, and poor fat and protein metabolism. Everyday though, I seem to have moments when I question if perhaps there is something else going on that I’m missing. Some lingering virus, or an autoimmune disorder, or even some kind of allergy or toxin. I have tested, and then retested, and then retested again for pretty much anything and everything that any doctors have come up with, but it’s still hard not to wonder if there’s something I’m just missing, some piece that would solve this whole mysterious puzzle.

With time though, I have come to trust the theory of Overtraining Syndrome more and more. A year ago I would have thought no way could overtraining possibly create the kind of medical condition that I have experienced these past eight months. However, when I started to read up on it, and started to talk to more doctors and more endurance athletes, there is in fact precedent for this kind of thing. I’m certainly nowhere near the first endurance athlete to go through something like this. I just always figured it wouldn’t happen to me because I trained a lot less than many people I know.

No one has been able to fully explain everything that goes on in the body when it is chronically overtrained, so I won’t attempt to either, but, essentially, overtraining occurs when the work-to-rest ratio is out of whack. That is when we do too much work with our body, as compared to the amount of rest we give it. In its simplest form pretty much every endurance athlete overtrains on occasion. Generally when this happens we get sore or fatigued to the point that our brain intervenes and effectively convinces us to give ourselves the necessary rest to rebound from this phase of overtraining. If done properly, this “overtraining” will actually make us stronger and faster for a period of time. The problems occur when we continue to overtrain on an ongoing basis. Eventually, this will lead us to what many sports doctors recognize as Stage 2, or sympathetic overtraining. This is when most people might start to notice some subtle symptoms: getting sick/injured easily; elevated resting heart rate; elevated cortisol levels; sleep issues; poor performance; etc. In hindsight, it’s easy for me to look back to that phase I mentioned above in early 2011 as the time that I almost certainly moved into this second stage. If we continue to push through this second stage (as I did for the second half of 2011 and the first half of 2012), we will eventually run up against Stage 3, or parasympathetic overtraining. This is when shit really hits the fan. This was last August for me. The good thing is that it’s pretty much impossible to go beyond this stage as your body loses its ability to train at all anymore. The bad thing is that once you go into Stage 3 it can take 6-12 months to feel mostly normal again. Many people are able to rebound with time and train and race hard again, while some people are never really able to do this again.

And so this is where I’m at now. Eight month into this third stage, and I’m certainly feeling significantly better than I was for the first several months. With time I feel confident that I will be able to live a fully healthy and very active life once again. I’ve already been able to take on a very moderate amount of light activity: hiking, running, biking, climbing, yoga, etc. I have no idea if I’ll be able to ever train and race at a high level again, but, overall, I’m really curious to see where this all goes. I feel too much in the midst of all of this still to say what the biggest things I’ve learned have been, but I know when I work through all of this and come out on the other end it will be one of the most valuable and educational things I’ve ever gone through.

Overtraining Syndrome is a very elusive and somewhat hypothetical condition, so much so that I still occasionally doubt if this is in fact what I’m dealing with. It is however, a legitimate enough of a concern that every endurance athlete should be aware of just how serious it can be. I’m sure I have bored some with the details of my experience here, but hopefully I have opened the eyes of at least a few people in a way that may help them from going through some of the scary, frustrating, and debilitating things that I’ve been through in the past eight months.

Anyone looking for more information on this topic, I would recommend checking out the sections in “The Lore of Running” dedicated to overtraining, and anything you can find on the subject by Phil Maffetone, most notably “The Big Book of Endurance Training and Racing.” Not the most creatively named book, and there are some things in it that I don’t necessarily agree with, but his sections on overtraining and the importance of proper rest, nutrition, and lifestyle contain a lot of valuable insight and advice.

Otherwise, as a last piece of advice, I would say to really truly listen to your body. If something feels like it’s “off” in your training and/or racing, it probably is. I “knew” something was wrong in my body for about 18 months, but didn’t do enough about it before it was too late.

There are 97 comments

  1. Charles Moman

    Great article and reminder for me. I started running after retiring from teaching for 37 years at the age of 58. 5ks, half marathons, full marathons and 8-hour ultras and then trail running. I DNF'd a 50-miler last August, but then decided to try for a 100-miler (less than 2 weeks away at the moment here in Indiana). I used Bryon's book again and one of his schedules and it seemed all was going well. Then everything got harder and harder and I just about gave up on the race. I was way overtraining for my age (almost 62) and running experience of only 2 years or so. The schedules are great for most, but not me. I took a big break and slowly went back into easy running and recently did a 50K at the race site and did ok. I will always be DFL in everything I run, but I am now fine with that. I cannot train like a 30 or 40-something. I am glad I caught it because I was spiraling down in a hurry. We will see what race day brings at the IT 100 on 4/20 and I will be rested and ready for it. Glad you are feeling better.

  2. Bartman

    Thanks for sharing Geoff. You have provided a very clear, concise and understandable statement of what you experienced; really a text book explanation and should save many readers from going down the same path IF they listen to what their body is screaming at them. Hopefully Bryon will include your article in the 2nd edition of RFP.

  3. Ultrawolf

    In my opinion the main reason for "overtraining" is not only that people train too much but do far too many races. There got to be a reason why top marathon runners limit themselves to 2 or maximum 3 races per year. Only we believe it´s okay to run 3 or 4 100 milers within a few months plus a bunch of 50 milers….

    Some (like the Speedgoat) can get away with it, most don´t. So many great athlets which had amazing results for 2, 3 years only to disappear completely from the radar.

    I really, really do hope that you are none of them Geoff.

    All the luck in the world and thanks for sharing your experiences with us !

    Wolfgang

  4. Brett

    The body taking several months to heal itself is a scary damned thing. All the best to you.

    These comments about over training and over racing got me going back through your blog in early to mid 2011. Go sift through some of those comments by Cloud. Its too bad he's such an arrogant a__hole, because underneath some of it I think he made some good points.

  5. Meghan Kennihan

    What steps did you take in August and September in terms of exercise and food to help you start getting better?

    I think I am at stage 3….

  6. Todd V

    Hey Geoff,

    Thanks for the article and glad you are feeling better. One thing you mention caught my eye: the diuresis (frequent urination). I've been trying to sort out that symptom. I have noticed that after most of my runs exceeding four hours or so in length I can expect a day or more of diuresis, especially the first night following the endurance event. In the absence of the other symptoms is this a common symptom that other runner and endurance athletes experience? (None of the five or six ultra running friends I've polled seem to experience this).

    I haven't been able to come up with a physiological explanation for what I think of as "post endurance event diuresis".

    Summing up: assuming there's not a more insidious cause going on, does anyone have that elusive physiological explanation? Assuming (I know, big assumption) proper rest, nutrition and lifestyle do others experience this?

    Thanks

    1. Geoff

      Todd,

      I wonder if you're just depleting yourself of salt so much on longer runs that you're not absorbing as much liquid as you should be until you get your salt levels back up to normal. have you noticed that this tends to occur more in warmer weather (when you are sweating out more salts), and do you tend to take any salt/electrolyte supplements during long runs? Personally I don't ever remember any frequent urination after long runs until all of this came on last summer. I guess the other question would be are you urinating frequently with full volume each time or are you needing to urinate frequently but there is very little volume each time?

    2. KenZ

      I get frequent, and LARGE volume urination after 100s, starting within 30 min of finishing even though I do pee at a reasonable frequency during the 100s. I chalk it up to the kidneys being under such immense stress (thus I always check the color of my urine to make sure I'm not getting rhabdo) that they just can't process it fast enough. Could also be that I've been drinking too much! Goes away for me after about 12 hours post race. Not sure if this is what is happening to you or not, but that's my input.

      1. Todd V

        Hi KenZ and Geoff, thanks for your responses, I appreciate your thoughts and this is really a help discussion to help me identify some of the variables in this. Geoff's hypothesis – depleted salt makes sense to me. I haven't noticed a correlation with weather, but than again, come to think of it I don't recall experiencing diuresis following those colder runs.

        I have to admit I've been a bit resistant to supplemental salt/electrolytes – I've tried supplements and done comparable runs without and I try to focus on keeping up good food intake. But perhaps salt excretion on these long runs simply exceeds my body's ability to pull replacements out of food at the rate they are consumed. I will experiment more with supplements.

        For what it's worth, the sequence of events for me usually goes something like this:

        -Do a long run, work hard to intake adequate food and water, but in reality probably get behind by the end. But verify adequate (but minimal) urine output.

        -Immediately post run: over the course of a couple of hours, eat and drink a bunch. Feel more or less back to normal.

        -lately though the diuresis has started say four hours post run and gone through the night. Now this makes me think the rebalance of h20 and salt curves probably have a longer wavelength than I have thought.

        Thanks again!

        1. KenZ

          Could be. Or maybe not. My first 100, I took 2-3 S-caps every hour (basically: one every 30 min, and one or two on the hour), for the entire race (18.5 hours). My last 100 I took ZERO electrolyte tablets the entire race (20.5 hours). No difference in peeing freq, volume, or the after-race onrush. No difference in the feeling of cramping onset (at which point I just slow down a tad). But that's just me. Still, I think I may still be over-drinking a bit? Or maybe it's what I surmised about the kidneys under stress, which of course they are.

  7. Danni

    I guess that's the benefit of being in a state of chronic undertraining syndrome. It is probably a lot more fun. Sorry you've been going through that.

  8. MDP

    Two really well written pieces in the last couple of days that would stand up in any publication, first Joe and now Geoff. Quality content and good writing. Well done Irunfar.

  9. Dean G

    Geoff,

    A few things

    #1) I appreciate the candor with which you've written about this experience. In many sports, athletes at the highest levels despise talking about any weakness, let alone a mysterious weakness, let alone one in which perhaps their own body said to them, "Dude! Enough!" It seems overtraining is sinister in that it almost counts on the athlete's brain to do what it does best: push itself, believe there are no limits, and minimize what the body is trying to tell oneself.

    I'm one of those people who has heard of overtraining syndrome and thought, "what's the worst that can happen, you take off a week, big deal"

    I suspect the fact that more elites haven't been as forthcoming in the past as you are now has contributed to the "mysterious nature" of this condition. So by you sharing your experience, I believe there will be many athletes, from slowbies like myself to elites, who will NOT end up as sick as you did.

    I only wish you had had a "you" to read about back when you were in stage two.

    #2) I find your attitude towards what's been happening these last 8 months inspirational. Your talking about it as a journey, your willingness to be curious, to treat it as a learning process, and be open to what may or may not happen is a great model for anyone dealing with adversity. Especially when it seems to come from out of nowhere – and strike at something so seemingly important to our own identity.

    I hope your patience and mindfulness will be rewarded in the best way possible.

  10. Neal Gorman

    Fascinating read. Sucks you have to deal with this in your life. Definitely a learning opportunity for the rest of us.

  11. Steve Pero

    This is a fantastic post, Geoff. I think right now all runners are beginning to learn about overtaining syndrome. I read about it 9 years ago after finding Phil Maffetone in my search about a running injury I had that I couldn't recover from. I now train exclusively with a HR monitor and follow Dr. Maffetone's recommendations on training HR. It has helped and this year I'll be 62 and training this way has kept me from injury and digging myself into a hole I can't get out of, plus I finish in the top third of most races and either win my age group or am in the top three. Yeah, I do speedwork (against Dr. Maffetone's suggestions), but when mixed in with mostly easy running, it works and works well. 90% of our running should be at a "conversational" pace. I decided this year to back off off racing, too. Usually by Hardrock I've run a few prep races, this year I'm only doing one and it's 8 weeks out from Hardrock.

    Hope you can dig out of this hole and get back to a healthy, normal life….whether that includes racing or not. There's more to life than running races ;-)

  12. Mic

    I recall reading one woman prose (she a 3hr marathoner) stated that her boyfriend ate like a horse. He was / is apparently a super fast marathoner. She said that she knows he eats like a horse because she grew up around horses.

    I think eating is a huge factor to staving off some of the effects of over-training. It's at the heart of recovery, along with sleep.

    All the best, it's great to have this stuff documented. Thanks for sharing.

  13. Adam

    I've been following your struggle for some time now, and I find your bravery, honesty, intelligence, and humility to be quite inspiring. I'm sorry that this happened to you, and wish you the best of luck for a return to running and racing (if that's what you want to do) in the near future.

  14. Simon Rousseau

    Dear Geoff,

    I join my voices to those that have congratulated you on your post. I think it is very important to talk about overtraining syndrome because of the consequences that are not trivial as you have well illustrated. Another aspect why it is be important that endurance athlete, especially ultrarunners, be aware of overtraining syndrome is the fact that to complete an ultra endurance events, we often ignore pains and signals coming from our body. Whereas this may not have major consequences for the most part acutely, when you develop the habit of constantly ignoring signs coming from your body, you risk missing some important warnings later on. The challenge is to find the balance between pushing through and knowing when to rest, both during a race and throughout the a season of running.

    Another aspect that is often overlook in the context of overtraining is mental exertion. Competing near your top capacity for your "A" race is very demanding and if repeated too often can also contribute to overtraining syndrome.

    I wish you all the best in your recovery and thanks again for bringing this important issue to the fore.

    Simon

  15. footfeathers

    I've always admired you as a runner and a person and look forward to you being 100% healthy again. It's a problem that builds on itself if you don't address it. Happy to see you're progress. Wishing you the best.

  16. Vertical Turtle

    Another well-written article, Geoff! Thank you for sharing and for being so open. This is very helpful for the running community. I am not a doctor, but, like most ultra runners, have had my fair share of injuries and health problems… just a thought: have you had the hypothalamus function tested? I wish you a solid recovery and look forward to hearing about your progress over the next few months!

  17. Kelly

    That's really crazy and thanks for outlining the whole thing. I don't think I ever realized there was this third phase of overtraining that could cause such damage. I definitely thought that it stopped at what you're describing as phase 2 and a certain amount of rest and recovery would get you back on track.

  18. Roy

    I had similar issues a few years back, although I was training as a cyclist at the time (I am now an endurance runner). Got all the tests, nothing came back. So I quit cycling, got fat and then got fit again – I started playing squash too. I was still having nervous system, brain, GI, and other issues along with fatigue and the doctors eventually ruled it "anxiety". Right. So one day I pulled my groin during one intense squash session and got an ultrasound. They found a good-sized cancerous tumor in my right testicle that incidentally was asymptomatic (usually they present as a lump or malformation, mine did not).

    Anyway, bottom line is, it turns out it was my immune system wreaking havoc. You might want to pony up for a PET scan. I hope this doesn't freak anyone out. My cancer, it turns out, was very treatable – surgery and chemo and I am in full remission four years later. And very healthy.

  19. tite

    Grazie Jeff! After a stellar 2012 now I feel stage 1 …but luckily yoga makes me feel clearly everything. "Yoga saves your life" said my guruji BKSIyengar and that s also why yoga is good for runners.

  20. thomas

    Hi Geoff, Thanks, I hope you come back. I just saw again the battle between you, Kilian and Tony at WS100 on DVD, its the best running DVD I ever saw.

    To you guys I look up, you give me so much motivation, I hope you gone come back and battle with Tim Olsen and Kilian, these guys are together with you for me the best ultra trail runners on this planet.

    thomas

  21. Doug K

    Geoff, good article.. best of luck with the ongoing struggle.

    Note it is not just the physical stress of training that has to be accounted for, but the total stress on the organism.. Hans Selye's theory of General Adaptation Syndrome is persuasive to me.

    A good overview is here:
    http://www.physsportsmed.com/issues/2001/05_01/uu

    Check out the triathlon viewpoint:
    http://www.slowtwitch.com/mainheadings/coachcorn/

    Joe Friel used to have an article up at:
    http://www.ultrafit.com/library/Other/Overtrainin
    but it's disappeared into that great Bit Bucket in the Sky..

    It was funny,

    "To accomplish this amazing feat you had to do too much training with too little rest, too

    much anaerobic training with too little aerobic and strength base, eat inadequately, try to

    train normally despite excessive psychological stress, or some combination of several of

    these. Less than one-tenth of one percent of the general population is capable of attaining

    such a feat. You’re an exceptional person to have done it. Congratulations!"

  22. Alan Beebe

    Hi Geoff,

    I could be way off base, but your symptoms seem to have much in common with those who have reactions to wheat (and other gluten containing grains). I read a book called 'Wheat Belly' (goofy title) by Dr. Wm. Davis. Probably just coincidental, but you may consider it.

    Alan

  23. Ian Campbell

    Geoff,

    With real thanks for sharing in such openness the struggle you have been going through. Ever since I heard that you were out from running it has concerned me. Lots of discussion, rumour about over training but no real facts and only you could tell the story. It goes deeper than I could ever have imagined and I feel the pain that you have been through these last several months but also the roller coaster journey you are going through. My minor in comparison bouts of injury, virus ailments etc that have taken me out of commission on and off during last year pale into insignificance. Your journey has a real message to all endurance athletes in that over training symptoms needs to be taken seriously. In a world where there is growing pressure to compete more regularly I am afraid that others will suffer the same over training syndrome.

    Once again thanks for being so candid, it helps spread the word.

    Good luck and recover well and be strong.

    Ian

  24. Plow

    Thanks for sharing Geoff. I think you will back bounce in due time. As, a self-described smart guy I recommend runners take at least one complete rest day away from running per week, even if this means tripling on the other six days. The rest day is for mental relaxation as the mind controls the body – whether we believe and practice it or not.

  25. Paul

    Geoff,

    Thanks for sharing…I know I'm pretty much guilty of not listening to my body enough and it's not til you hear something like this that you realise that the body really needs a good rest.

    Sounds mad but This could be the best thing that ever happened to you! I hope the recovery continues for you, you're a huge inspiration to so many.

    P.

  26. Luke Garten

    It sounds like it is hard to know the fine line between over-reaching and over-training. It is like drinking too much beer. 5 to 7 beers feels like fun until you get to the point of nausia and the hangover, then resulting in having to apaulagize to too many people from all the stuff you did that you can't remember. :)

  27. Chris

    Good post, thanks for taking the time. I went through something fairly similar in 2012, though it was primarily from "work overtraining". We were working 5 days / 3 nights a week (plus I was putting in 60-100 mile/wk running, raising 2 kids, etc) and finally the body said "enough". I woke up one morning partially paralyzed from a stress-induced viral infection that tends to only affect the very sick (end stage cancer patients, etc) and the very elderly.

    Stress (physical, mental, and emotional) in large quantities are incredibly hard on the body. The warning sings were there for a LONG time, but I fancied myself as invincible. I figured, hell I could run 100 mile races in the mountains, what's a little (ok, a lot) sleep deprivation while typing on a computer… that's kitten play. Sooner or later, something is bound to give, and the body is quite good at saying "uncle". :)

    Like you, I'm still recovering (16 months here) and will probably never see a full recovery at this point.

    Hang in there, keep resting and recovering and keep up the fight.

  28. astroyam

    Thanks for sharing Geoff.

    I wonder, in the same way that blood doping allows athletes to train absurd amounts without overtraining, could blood doping, as a medical practice, pull someone out of an overtraining rut back to normal?

    Just an idea…

    1. Joe

      That's a great idea. It sounds "dirty," but in this case we are talking about a person's ability to feel normal again, I don't see a problem with that (if it is medically safe). I have health issues that I wish that blood doping could resolve, and would do so in a heartbeat.

      1. MonkeyBoy

        i am curious how either one of you believe that increasing the number of red blood cells in his bloodstream would help with his overtraining syndrome.

  29. Mic

    It's pretty amazing how situation after situation is difficult to diagnosis but when it happens there is a duh momment.

    My mother in law recently had fainting spells, and they thought it was the heart medications. Finally she was at work away from her hospital and at lunch. She felt faint to her co-worker took her to a different hospital and Doctor.

    She needed a pace maker. Duh.

    Also, I would advise Jornaling. Write it down. A friend was journaling at the advice of a Neurologist and through that her Husband figured that she was getting this crushing Migraines after she ate Chinese food.

    One last, I had gastritis once. It couldn't move. Morphine and an IV got me back on my feet. This was due to Ibu on an empty stomach after Over Training.

  30. Jason

    Geoff.. THANK YOU for this! From the outside it does sound like symptoms driven by overtraining. From the outside it seems like Tony K runs too much and that's why he's constantly fighting injury.

    From the inside its tough to accept an I scheduled day off (or even a day of less than ten miles) no matter how little sleep I've gotten or how bad I feel.

    We all want to see you back Geoff… Hope recovery continues!

    1. Luke Garten

      I am amazed at how guys like Tony K and others can put in over 200 miles a week, and at altitude. Some people are just gifted I guess.

    1. KenZ

      Ben, now that he might have it, is HRV even remotely helpful, since he has no baseline numbers? Are you finding your HRV useful, or more as a biohacking curiosity?

      1. Ben Greenfield

        HRV can be helpful because he will be able to KNOW when his body is ready for hard training again, based on when his HRV gets back above 90. HRV is one of the things I do EVERY DAY without fail. Literally, I roll over in bed in the morning, grab my HRV and take it. Every day. It's that valuable of a training parameter to me.

  31. Tamm Lee

    Like anything else it can be addicting. I had this problem, sort of, with biking for awhile. Not that it was hurting me physically but it consumed all my time every day. Had to finally see the big picture and get some balance.

  32. Justin McMillan

    Geoff, thank for your honesty and willingness to leave yourself vulnerable. I know that you will help a lot of people by writing about this. I hope that you continue to recover and eventually regain full strength. If you desire it, I also hope that one day you can return to the fulfilling running life that you so obviously love. Stay strong!

  33. Ben Nephew

    Hi Geoff,

    Thanks for sharing. I'd be interested in any test results that were consistently outside the typical ranges. I'm guessing that a big part of your questioning of overtraining syndrome is the non-specific nature of the diagnosis. It's almost like the doctor stopping at just saying you have a foot injury when you have a stress fracture.

    I study the effects of stress in smaller mammals at work, and some of my research is focused on vasopressin. What often happens following exposure to chronic stress is that the hormones that mediate the endocrine stress response will change. Instead of CRH to stimulate cortisol release, vasopressin (AVP), or antidiuretic hormone levels will increase in respone to a downregulation of CRH. Vasopressin is great because it is resistant to cortisol induced negative feedback. Well, it's great if you want and/or really need to respond to a stressor for an extended period of time.

    Have you had a dexamethasone suppression test to look for issues with your HPA axis (possibly referred to in your comment about poor adrenal function)?

    Vasopressin is obviously important in water retention and diuresis, but it also has independently roles in blood pressure regulation and mood (anxiety and depression), and body temp.

    I don't think we really know the long term effects of longer races on the body, especially with respect to the individual variability in responses. It is possible that there are many runners out there unknowingly increasing their chances of all sort of disorders. A good example is depression. Exercise and running is an effective and safe treatment for depresssion, but excessive training or racing is likely to do more harm than good.

    For anyone interested in a great book on stress, read, "Why zebras don't get ulcers," by Robert Sapolsky. It'll make you think about the potential effects of stress in both your running and life in general.

  34. Val

    Very good article. Like your statement of overtraining as an hypotetical condition. It is certainly no 100% proven, but not many things are and statements like your are great eye openers. Thanks for sharing this and all the best in your recovery.

  35. Tash

    Thanks for sharing this story. I've hit stage 2 on a number of occassions but wasn't even aware that there could be a stage 3. Thank you for the warning. I hope you recover quickly – all the best.

  36. the "other&quot

    Hi Geoff,

    I have never been much of a training log guy, but were you able to kind of track the arc (or path) that created this issue for you? I know this is a very open and vague question since there are countless variables (miles, elevation gain, exertion levels, conditions, races run, etc.) that could be considered in all of this… but any insight would be helpful and appreciated. Just wondering if there was a path that you could see looking back that might be learned from in terms of a broad perspective that us common folk out here in "Ultra Land" could learn from.

    Also: Thank you for your open and candid account of this experience as you move through it. As noted by others above, most top shelf athletes hide their weaknesses and injuries away. My favorite professional sport is a hotbed for this! (Football – Go Bears!)

    Sending you positive vibes from outside of Chicago, Geoff.

    1. geoff

      I have kept a training log for most of the past 4 or 5 years. I certainly increased my training load over that time, but mostly between 2008 to 2010 and then it kind of leveled off for 2011 and 2012. Honestly I don't think that too much training has been my problem, but rather too much racing and too much legitimate time off from racing. I've been fortunate enough to be virtually injury free for my entire ultra running career. this was great at the time, but it allowed me to race pretty much every month or two for 5+ years. my training volume has typically only averaged ~80 miles a week, and hardly ever more than 100-110. the longest week of training i've ever done was about 135 miles. granted a lot of this is very tough mileage with a ton of vertical so in terms of hours my volume was sometimes quite high. even based on hours though, i almost never sustain over 20 hours a week for more than a few consecutive weeks. If i am in fact dealing with "overtraining" it would likely be more accurate to call it "overracing" as i think that's where the real stress on my body was coming from. not only was i racing 10-15 times per year for several years in a row, but i was running nearly every one of these races to win them. in a typical year i would maybe run 1 or 2 truly casual races and the rest of them, even if i called them a "training race" i was still pushing myself really damn hard. I was determined to win every race (even if i didn't realize it at the time), not because i felt like i needed to prove anything to anyone, or because i'm hyper competitive, but because i knew i had the ability to do so. racing is fun no matter how hard you run, but in my mind it's a lot more fun when you push yourself really hard, and even a little more fun when pushing yourself leads to a win. i would go into so many races thinking i was just going to do an easy training race and then half way through end up running to try to win as much as ever. I pretty much did this month in and month out for 5 years. i'm not saying it wasn't worth it, but certainly i'm paying the price now.

  37. Duane VanderGriend

    Geoff,

    Thanks so much for giving us details. I have been wondering what was happening with you ever since you started mentioning it in your writing. I hope that you can return to the joy of running.

  38. Jamey Bilyeu

    Another very good read is "A step beyond: A definitive guide to ultra running", edited by Don Allison. Check out the sections about a runners Endocrine system (page194). It may be that It's WAY worse than just overtraining..
    . All the best to you man.

  39. geoff

    Ben, this was all stuff i looked into initially with my sports doc. and nothing seemed to be too out of whack (except for my cortisol levels) ADH was normal as was ACTH. Might take a closer look at Vasopressin stuff again though, as this has been one thing that has remained in the back of my mind as a possibility because my water retention function seems to still be fairly out of whack at times. Have not done a dexamethasone suppression test. might be worth it, although i've kind of come to the point of just being sick of continuing to look for stuff when nothing seems to be there. things that have been consistently out of whack have been cortisol (both high and low), most nuerotransmitters, vit, D (seems fairly low even when i supplement a lot), total IGa, and then there have been some other things a bit out of whack but not as much so: total protein, ferritin, several amino acids.

    1. Ben Nephew

      Were you ever referred to an endocrinologist? I can understand your exhaustion in terms of searching for answers. Decent research on common running injuries is hard enough to find, and we are talking about a very small population that attracts very little research. Trying to identify issues with hormone levels can be often be difficult, it may require repeated sampling with some sort of manipulation. Good comparison might be stress tests that pick up heart issues that don't show up in a checkup, or glucose tolerence tests that identify hypoglycemia when your basal levels are fine most of the time. The dex test might be good in terms of both a more specific diagnosis and possibly to help stabilize your HPA activity. Something similar to smacking the TV to clear up the picture. Either way, you may have a bit of a rough acute response to the test, depending on what exactly is going on.

  40. Tyler

    Geoff – I have good friend who has had nearly identical symptoms. After four negative tests, she eventually demanded a Western Blot test on advice from a friend and tested positive for Lyme Disease. Might be worth the test if you haven't already done it.

  41. MD

    Diuresis following endurance events is possibly due to the state of ketosis brought about by fat metabolism that is required for long distance events. Ketones are filtered by the kidney and act as an osmotic diuretic preventing fluid reabsorption from the renal system and more likely produced when fat metabolism dominates at the expense of carbohydrate metabolism, which becomes dominant depending on your diet and length of runs.

    1. Ben Nephew

      It always worries me when a researcher sounds like a used car saleman. People need to read the literature carefully. The relevant points are explained here:

      http://www.runnersworld.com/health/too-much-runni

      All you really need to do is look at the graph that he presents from the Lancet study. Do you see a U shaped curve?

      Well, what about the cardiovascular physiology studies O'Keefe cites? Even if the data are reliable, this potential adverse effect of strenuous excercise had no impact on the increasing benefits in longevity of running up to 2 hours a day in the Lancet study of 400,000 people.

        1. Ben Nephew

          I actually do have concerns about the effect of longer ultras, but the argument that O'Keefe is making has no support. The concerns I have are more related to the dangerous combination of obsessiveness and running that can be relatively common in ultrarunning, but I doubt that this issue is something that can be addressed with a generalized mileage or pace guideline. It's a individual issue concerned with running specific decision making.

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