In Part I of this series, I described my experience with developing overloaded muscles and the struggle I faced in finding my correct diagnosis. In this part of the series, I will explain what to look for and what to do if you may be suffering from the same fate.

Treatment, prevention signs and symptoms

The first and most important part in the treatment of overloaded muscles is to remove the stress that creates the vicious circle of overloading the muscles. The stress must be reduced to an amount that is well below the stress level that can be tolerated so that healing can be permitted. This applies to both overtraining and overloaded muscles. The training volume should be reduced, and the training must become smarter and have more variation. When it comes to the actual treatment of the tissue, the muscles can restore their functions by being treated by special sports massage and smart training (7). Before treatment is initiated, it is important that the right diagnosis is made. Is it general overtraining, overloaded muscles, a combination of both, or some other differential issue?

In the case of overloaded muscles, there are some clear symptoms and a certain history that fits this diagnosis, separating it from the others. An athlete with typical overloaded muscles will meet most of these findings (7):

  • The affected muscle stiffens fast, and when lactic acid first comes, it is almost impossible to get rid of even by decreasing the intensity.
  • The muscle is shorter and weaker, less elastic, and can involuntarily contract.
  • On palpation, the tissue isn't flexible across the fibers, and the muscle is hyper-tone in its initial phase. After two months or more, the muscle becomes hypo-tone or atonic.
  • The athlete may experience hypersensitivity and pain when the muscle is palpated, and during treatment, autonomic signs may appear.
  • When reading the training log of the athlete, there is little structure and periodization. Typically, the athlete hasn’t per se worked out too much, but there is too much high intensity or the low intensity sessions are too long in combination with insufficient variation. Often, the athlete hasn’t spent enough time building up training tolerance through aerobic training. This is often seen more in athletes who do sports involving static elements like downhill skiing and skating. This might be because when the muscle does static work or work that demands more than 70 percent of 1RM power, the blood supply gets impinged and the muscle has to work anaerobically.
  • The athletes has deteriorated motor skills.
  • The athletes has muscle spasms.
  • The athlete needs longer recovery times.
  • There isn't anything wrong with blood values.

Secondarily, some of these findings can distinguish the difference from pure overtraining:

  • An overtrained athlete often has staleness. While the progression of an athlete with overloaded muscles may also involve staleness, it is more typical to see a rapid loss of fitness. High intensity anaerobic training will go poorly, although in the low intensity trainings, the athlete can seem unaffected with the exception of lower performance.
  • Rest alone will cure pure overtraining usually within twelve weeks. However, twelve weeks of rest for the overloaded muscles will have done next to nothing to fix the dysfunction.
  • If you're lifting weights, you will struggle to get the pump in your muscles if you're overtrained.

The clinical findings can separate a dysfunctional overloaded muscle from a healthy muscle as well:

  • In the EMG, the hyperactivity in the affected muscles can be identified because it detects the involuntary contractures in the muscle.
  • With ultrasound, oedema can be detected, which shows that in the initial phase, there is more depth and fluid in the affected muscles.
  • DNA analysis can show that the affected muscles have significantly shorter “telomeres 3” than the healthy control group. This means that the satellite cells have gone through significantly more cellular cycles than in the unaffected muscles, indicating that more regeneration in the affected muscles has taken place (8).
  • The myosin and actin filaments that usually overlap, creating contractions in the muscles, have been overstretched. This might explain the weakness in the muscle.

Theory behind the treatment mechanisms

Massage will align the injured muscle fibers and create small micro-traumas in the muscles, initiating the healing process. Due to the chronic overload of the tissue and the formation of scar tissue, the muscle tissue needs mechanical stimuli to start the initial healing process after the chronic overload. In the same way that regular tendinitis turns chronic after three months, the body stops the healing process. It is that initial response of healing after an acute trauma that is created by the massage together with the fiber alignment. The difference here between general overtraining and overloaded muscles is that the muscles and body are overloaded in overtraining as well, but they will heal by themselves. Rest won’t cure overloaded muscles because they have a structural dysfunction that needs to be treated actively with the right type of training. Regular overtraining will, in most cases, be cured within twelve weeks of relaxation and/or moderate activity if there is sufficient nutrition and rest.

Normally, when your muscle goes through training and gets a micro-trauma, it will go through three stages—acute inflammation, tissue formation, and tissue remodeling. As explained above, massive signs of repair and remodeling is found in the overloaded muscle as well as short “telomeres 3” and a lot of regeneration.

When a muscle is damaged, the satellite cells can create new muscle fibers and heal the damaged muscle fibers, although the satellite cells depend on the macrophages and regeneration of the tissue can’t go on without them (2). However, in addition to the healing by satellite cells, scar tissue forms, which creates a dysfunction in the muscle and makes it more vulnerable to repeated injury. It is this reaction that starts the problem in an overloaded muscle. The healing process isn't given enough time, and due to the chronic overload, the injury keeps on occurring and a massive formation of scar tissue takes place. In addition, the satellite cells are trying to fix the damaged cells, but the formation of scar tissue is sabotaging the process. As a result, you never recover before this cycle begins again. However, research shows that some invasive techniques such as injections of Decorin can increase regeneration without the formation of scar tissue (3).

When this negative circle first starts, it's really prone to continue, as there are many secondary effects that keep it going. When scar tissue is formed, it can lead to hypoxia in the muscle as well as vasodilatation, swelling, and other factors that limit oxygen supply, which even increases the formation of scar tissue further. The muscle will switch to anaerobic metabolism earlier than normal due to the lack of blood supply. You won’t necessarily be able to see this in your heart rate, but locally, the muscle will switch to anaerobic metabolism, which again increases your recovery time.

The only good recipe for getting rid of overloaded muscles or a combination with overtraining is smart training, massage, rest, and good nutrition. This will take you back to the positive circle. Eventually, after three to twelve months, you can recover. After recovery, you must continue training smart so that you don’t get into the same overload cycle again, as you will be more prone to this because you have overloaded the muscles previously.

If you're an endurance athlete, the first step you need to take is to spend three to twelve months making a solid aerobic foundation (6). A foundation with easy training and eventually a high volume will increase your tolerance for harder training later. This applies to strength-related sports as well. Don't underestimate easy, high volume training with weights.

When it comes to prevention and signs and symptoms that you should be aware of, there are many things you can do. The best way to prevent overloaded muscles is to avoid harmful overloads. This can be done by having a training schedule that uses periodization and allows you to autoregulate. The need for individual training plans is important, especially within team sports where many athletes seem to be trained in the same fashion. It's crucial to have a combination of  variation and a coach who knows when to push you and when to back off.

Foam rollers, tennis balls, massages, good warm ups, and regular stretching are all effective and cheap tools. Tests for early diagnosis include the POMS questionnaire, MAF test, and an orthostatic test. Keep track and make note of your subjective mood and sleep quality and pay attention to early symptoms including dizziness, poor muscle control, deteriorated motor skills, hypersensitivity on muscle palpation, elevated heart rate (generally and during submaximal activity), easily provoked lactic acid in affected muscles, and poor results in maximal endurance effort training on high intensity compared to low intensity. In the end, the best prevention is to train smart with much variation and speed so that the muscles don’t get monotonous stimuli. Get enough rest and worry less in your life.

Training schedule

What should a training schedule look like, and how should you train to avoid overtraining and overloaded muscles? Regardless of whether your goal is increased strength or endurance, you need to cycle your training in micro and macro cycles. The four basic periods in one macro cycle are the preparation phase, base, realization phase, and peak. Your micro cycles will be cycles within the macro cycle, shifting between easy, medium, and hard sessions.

The preparation phase:

After the previous season, you've had some time off or at least less training for several weeks or maybe months. The first phase is then the preparation phase. It slowly gets you ready for a new season. This phase will have low intensity and low volume, including some easy technique trainings and meetings with your coach and team. Normally, this phase is rather short—maybe two to three weeks—before it fades into the base phase.

The base phase:

The base phase is typically done early in the season. This is the time to put in the hours. There is lots of volume, but it's low to medium intensity. The training in this cycle is the most general of the four phases and lasts for two to four months. If you participate in endurance sports like rowing, you can do cycling, running, swimming, rowing, cross-country, and skating. The main goal is to increase your tolerance for more heavy training and put down the foundation for the season to come. If your main goal is endurance, it isn’t much different. You'll do lots of sets at low intensity and plyometric exercises and put down some time for your cardio work. If your main goal is strength, your cardio should be done differently. Hours and hours of low intensity work won't benefit you as much as shorter intervals done in an explosive fashion.

Recourse/realization phase:

In this phase, your workout gets more specific toward your main goal. The volume goes slightly down and the intensity goes up. This period will last for one to two months. Keep in mind that within the macro phases, there are micro phases divided into easy days, medium days, and hard days. On top of that, you should always be able to autoregulate your training plan because no plan is perfectly scheduled for the entire season. Every macro phase should have a period where you allow complete rest for your body and make sure that it's completely recovered.

Peak phase:

The fourth and final phase is the peak phase, preparing you for competition. This phase has high intensity and low volume to ensure that you have enough rest so your body is completely recovered and can perform at your full potential. The trainings are short but very specific to your goal. If you’re racing in endurance sports, you will do short intervals at your race pace or above, but the distance will be much shorter than your race distance. In weight lifting, you will have submaximal lifts at a high intensity but a lower volume than in the previous phase.

In this phase, there are huge differences in duration. In some endurance sports, you have to pace your peak, meaning that you have to choose when during a long peak you want to perform the best. Some want to peak late in the season, meaning they will underperform and have done less intensive work pre-peak, but they will slowly get in better shape throughout the season. Others peak at the first race and will sooner or later be forced to have a dip in performance, planned or unplanned. You can’t peak for three months. If you want to have several peaks during a season, you will have to underperform or not perform at some point, as you will be forced to do less intensive trainings with more volume for a while before you can peak effectively again.

Post-season, this major cycle will start over again, but the content from season to season will change as you age and need to work on different aspects of your performance. Variation in training regimes must not be underestimated, especially in endurance sports. Many juniors are used to a very high level of high intensity training. This won’t be tolerated as well when you’re thirty years old, so with increasing age, there must be more volume with less intensity.

This is a general periodization of a season, but if you've been overtrained or had overloaded muscles, there are some things that you should have in mind when you set up your schedule. For the first couple of months, you should avoid any kind of anaerobic training, except maybe for low rep weight training at low to medium intensity. In the case of overloaded muscles, your cardio training should consist of (7):

  • UT1 aerobic training with a lot of variation and no static elements with a maximum duration of forty minutes and a heart rate between sixty and seventy percent
  • Short intervals below anaerobic threshold. Bear in mind that you shouldn’t only train your heart rate but also the sensation in your muscles (e.g. 5 X 10-second sprints), with a break lasting the time it takes you to walk back to the starting line. Take five-minute breaks between the series of 5 X 10. Keep in mind that you shouldn't feel any acid and your heart rate should drop to 120 beats per minute in the breaks between sets.
  • Short sprints of 30 meters or jump drills with short duration (Take breaks because you don’t want any lactate.)

As you progress, you can make the UT1 trainings a bit longer but not more intensive. Slowly incorporate short intervals with good breaks at a higher intensity (7).

The reason for training aerobic at such a low heart rate is that the energy is coming almost purely from fat, not from the stores of glycogen in the muscles. This shortens the recovery time and still gives you the benefits of aerobic training such as formation of capillaries, muscle economy, and the effectiveness of burning fat as energy. As your muscles start to tolerate higher intensity again, the training should include elements of high intensity because it has benefits that can’t be trained using pure aerobic training, such as cardiac output, anaerobic threshold, duration at anaerobic threshold, and the specificity of competition speed. During your first months of active training, you should regularly check your muscles and reflect on your training in cooperation with an experienced physical therapist.

Next time, I'll release the last and final part of this series where I'll show you tools and measures that you can use to track your progress and recovery.

Sources

1. Budgett R (1998)Fatigue and underperformance in athletes: the overtrining syndrome. British Journal of Sports Medicine. 32:107-10.

2. Lescaudron L, E Peltékian, J Fontaine-Pérus, D Paulin, M Zampieri, L Garcia and E Parrish. (1999). Blood borne macrophages are essential for the triggering of muscle re- generation following muscle transplant. Neuromuscul Disord 9:72–80.

3. Sato K, Y Li, W Foster, K Fukushima, N Badlani, N Adachi, A Usas, FH Fu and J Huard. (2003). Improve- ment of muscle healing through enhancement of muscle regeneration and prevention of fibrosis. Muscle Nerve 28:365–372.

4. Overtraining Effects on Hormonal and Autonomic Regulation in Young Cross-Country Skiers,' Medicine and Science in Sports and Exercise, vol. 26(5), p. S65, 1994

5. Asker E.Jeukendrup MSc  and Matthijs K.C. Hesselink MSc Department of Human Biology, University of Maastricht, The Netherlands

http://sportsexerciseengineering.com/2012/09/09/overtraining-what-do-lactate-curves-tell-us/

6. Dr. Phillip Maffetone (2010). The Big Book of Endurance Training and Racing.

7. Sandvand Omfjord C. Muskulære funn ved feiltrening (Hovedfagsoppgave i idrett). Norges idrettshøgskole: Oslo 2003

8. Collins M, Renault V, Grobler LA, St Clair Gibson A, Lambert MI, Derman EW, Butler-Browne GS, Noakes TD, Mouly V. Athletes with Exercise-Assosiated Fatigue Have Abnormally Short Muscle DNA Telomeres. Med Sci Sports Exerc 2003; 35(9): 1524-1528.