Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation

Background: Overtraining Syndrome (OTS) is a condition resulting from excessive physical activity without adequate recovery, predominantly affecting elite athletes and military personnel. While overreaching can be a temporary state, non-functional overreaching may progress to chronic OTS. This revie...

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Main Authors: Ondrej Fiala, Michaela Hanzlova, Lenka Borska, Zdenek Fiala, Drahomira Holmannova
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-07-01
Series:Sports Medicine and Health Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666337625000174
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author Ondrej Fiala
Michaela Hanzlova
Lenka Borska
Zdenek Fiala
Drahomira Holmannova
author_facet Ondrej Fiala
Michaela Hanzlova
Lenka Borska
Zdenek Fiala
Drahomira Holmannova
author_sort Ondrej Fiala
collection DOAJ
description Background: Overtraining Syndrome (OTS) is a condition resulting from excessive physical activity without adequate recovery, predominantly affecting elite athletes and military personnel. While overreaching can be a temporary state, non-functional overreaching may progress to chronic OTS. This review explores various hypotheses regarding the pathogenesis of OTS, including glycogen depletion, dysregulated cytokine response, oxidative stress, and alterations in the autonomic nervous system function. It also highlights the systemic impact of OTS on multiple organ systems, immune function, and overall health, linking the condition to chronic inflammation and an increased disease susceptibility. Additionally, it addresses the role of the gut microbiome in health modulation through physical activity. Methods: This narrative review was conducted through a structured search of peer-reviewed journal articles in databases such as PubMed, Web of Science, and Google Scholar, focusing on studies involving human participants and published in English. Results: OTS has systemic effects on multiple organ systems, immune function, and overall health, leading to chronic inflammation and increased disease susceptibility. Athletes with OTS exhibit higher morbidity rates, influenced by factors such as sleep deprivation and stress. The review also emphasizes the role of the gut microbiome as a significant modulator of health through physical activity. Conclusion: Balanced training and recovery are crucial for preventing OTS and maintaining optimal health and quality of life in physically active individuals. Understanding the complex pathophysiology of OTS is essential for developing effective prevention and treatment strategies.
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spelling doaj-art-08f02ea3f7034628b77a0def744ffc172025-08-20T02:16:02ZengKeAi Communications Co., Ltd.Sports Medicine and Health Science2666-33762025-07-017423724810.1016/j.smhs.2025.01.006Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestationOndrej Fiala0Michaela Hanzlova1Lenka Borska2Zdenek Fiala3Drahomira Holmannova4Department of Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech RepublicCorresponding author.; Department of Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech RepublicDepartment of Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech RepublicDepartment of Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech RepublicDepartment of Preventive Medicine, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03, Hradec Kralove, Czech RepublicBackground: Overtraining Syndrome (OTS) is a condition resulting from excessive physical activity without adequate recovery, predominantly affecting elite athletes and military personnel. While overreaching can be a temporary state, non-functional overreaching may progress to chronic OTS. This review explores various hypotheses regarding the pathogenesis of OTS, including glycogen depletion, dysregulated cytokine response, oxidative stress, and alterations in the autonomic nervous system function. It also highlights the systemic impact of OTS on multiple organ systems, immune function, and overall health, linking the condition to chronic inflammation and an increased disease susceptibility. Additionally, it addresses the role of the gut microbiome in health modulation through physical activity. Methods: This narrative review was conducted through a structured search of peer-reviewed journal articles in databases such as PubMed, Web of Science, and Google Scholar, focusing on studies involving human participants and published in English. Results: OTS has systemic effects on multiple organ systems, immune function, and overall health, leading to chronic inflammation and increased disease susceptibility. Athletes with OTS exhibit higher morbidity rates, influenced by factors such as sleep deprivation and stress. The review also emphasizes the role of the gut microbiome as a significant modulator of health through physical activity. Conclusion: Balanced training and recovery are crucial for preventing OTS and maintaining optimal health and quality of life in physically active individuals. Understanding the complex pathophysiology of OTS is essential for developing effective prevention and treatment strategies.http://www.sciencedirect.com/science/article/pii/S2666337625000174Overtraining syndromeOverreachingTrainingPerformanceExhaustionInadequate recovery
spellingShingle Ondrej Fiala
Michaela Hanzlova
Lenka Borska
Zdenek Fiala
Drahomira Holmannova
Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
Sports Medicine and Health Science
Overtraining syndrome
Overreaching
Training
Performance
Exhaustion
Inadequate recovery
title Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
title_full Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
title_fullStr Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
title_full_unstemmed Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
title_short Beyond physical exhaustion: Understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
title_sort beyond physical exhaustion understanding overtraining syndrome through the lens of molecular mechanisms and clinical manifestation
topic Overtraining syndrome
Overreaching
Training
Performance
Exhaustion
Inadequate recovery
url http://www.sciencedirect.com/science/article/pii/S2666337625000174
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