When South African trail runner Ryan Sandes won the North Face TransGranCanaria (a 125km race through the mid-altitude areas of Gran Canaria) at the start of the racing season in 2014, he was in the shape of his life. In the same year, he trained for South Africa’s Drakensberg Grand Traverse – a 209km Fastest Known Time (FKT) attempt – with adventurer and endurance athlete Ryno Griesel. Mileage is often hard to gauge with trail running, but the pair were training between 15 and 30 hours a week. Sandes also scored highly at the Ultra Trail World Tour. Then he decided to race the Ultra Trail Mount Fuji – which meant he would compete in a 24-hour event just two weeks after he’d run a record time of 41 hours and 49 minutes at the Drakensberg Grand Traverse. He thought that because the races were fairly slow-going, the distance wouldn’t take it out of him. But the truth is, running three or four ultra marathons in a year is asking a great deal. Even the body of an elite athlete can be pushed only so far. Soon, the cycle of too much racing, and not enough recovery, began to take its toll – in the most frightening of ways.
Feeling tense and anxious before a big race is only natural, but the stress Sandes felt before his next race, the Western States 100-miler (California, US) in June 2014, was much higher than he was used to. Usually he had a cast-iron stomach that nothing would affect, and good tolerance for high temperatures. But during this race, Sandes’ stomach didn’t feel right, and he felt like he was overheating. His legs felt heavy and then they seized up: it was as if – inexplicably – they had nothing left. Despite the effort he had made in training, Sandes only came fifth.
In December that year, tests revealed he had glandular fever. ‘Even so, I didn’t take it as seriously as I should have,’ he admits. ‘I backed off, but I thought I would bounce back after two or three months.’ It would take another nine months before Sandes committed to taking proper time off. He wasn’t a newbie runner any more. Trail running was his job and he felt he had to perform in order to keep it. His competitors were running two or three 100-mile races a year – and on top of that, another two or three 50-milers (80km). Some were logging 320km of training a week – and they were doing really well.
Maybe, Sandes thought, he hadn’t won Western States because he hadn’t trained hard enough. Maybe the answer was to train even harder. Or maybe he was so preoccupied with trying to hit impossible targets that he lost touch with his own body.
THE EARLY SYMPTOMS
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In preparation for the 2015 racing season, Sandes began high-intensity training, in an attempt to increase his engine’s power. But as soon as he stressed his system, he fell ill again. ‘I wasn’t full-on sick. I just didn’t have any energy,’ he recalls. ‘I’d take 10 days off to recover, but the moment I resumed training again, I felt tired.’ Sandes became so tired that he eventually found it difficult to get out of bed. He dropped out of a string of races in 2015: TransVulcania (La Palma, Canary Islands), Western States and finally the Ultra-Trail Du Mont-Blanc (UTMB).
There had to be a reason. There was: Sandes had developed overtraining syndrome (OTS) – a disorder that afflicts endurance runners. It is defined as a lasting decrease in athletic performance and changes in mood, which don’t resolve following a normal period of rest. And it’s not just elite athletes who are at risk. Granted, OTS is most likely to occur in overachievers, but it also affects the everyday athlete. Those who train in a group where the other runners are marginally better are perpetually training a little harder than they should. Others at risk include those who set unrealistic goals that they think they can achieve simply by training hard, and runners who carry on training despite external stressors, such as long working hours, relationship problems or sleep deprivation.
It took Sandes more than 12 months to recover. As he dealt with the consequences, he also had to accept that he’d made a big mistake. Thankfully, he was one of the lucky ones – he caught OTS in the early stages. There are others who don’t come back from it at all.
What is OTS? Professor Mike Lambert, who works in the Division of Exercise Science and Sports Medicine at the Sports Science Institute of South Africa, is especially interested in how the body responds to training.
‘OTS is a very advanced state and it happens when your body fails to adapt,’ he explains. Lambert asks us to imagine we are curled up on the sofa at home, relaxing with a good book. Our heart rate and breathing rate are low and our blood is circulating to our organs, and not really to our muscles that much. Basically, our bodies are regulated to the state we’re in now. Then, someone comes charging into the room screaming, and we’re given a big fright. Suddenly, our system is disturbed: our heart rate shoots up and our breathing rate increases. ‘From a biological perspective, our body interprets exercise as being just as stressful,’ explains Lambert.
(Related: Warning signs of overtraining syndrome)
‘After high-intensity training we’ve used up some muscle glycogen, lactate levels are high and our breathing rate and body temperature have increased. When you’re recovering after high-intensity training, all of those things need time to get back to normal again. If, on the other hand you get sick, train too much and don’t recover enough, or adopt poor eating habits, your body is unable to do that. The consequence is that your body loses the ability to regulate itself.’ This means that high levels of hormones such as cortisol – which is released in response to exercise stress – are circulating in your body, even when you’re not really stressed.
OTS is difficult to diagnose, for two reasons. The first is that symptoms are individual, and even within an individual they might change over time. Secondly, there are medical conditions with similar symptoms that could be misinterpreted as overtraining – not eating enough carbohydrates or protein, iron deficiency and allergies, for example. You have to be sure those aren’t causing the problem first.
THE FULL ONSET
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After he had been diagnosed with glandular fever, Sandes visited his family holiday home in Cape St Francis, South Africa, for three weeks, where there is an 8km trail called the Wildside. At first, even walking on it felt difficult. When he could finally run on the trail, it was as tough as running 100km. OTS had affected the part of the nervous system responsible for controlling Sandes’ heartbeat, and the hormones that increase heart rate blood pressure, breathing rate and mental alertness when he felt stressed. This meant that when Sandes was running at any speed, his heart rate was higher than usual for that speed.
‘Your perception of effort increases in tandem,’ explains Lambert. ‘So if Sandes was actually running at 4:35/km, he probably felt like he was running much faster.’ OTS affects the performance of other muscles, too. ‘Unless the energy you get from carbohydrates is replaced during a long-distance run, your muscles begin to fatigue, thus reducing your ability to produce force,’ Lambert wrote in the 1999 book Overload, Performance Incompetence and Regeneration in Sport.
And because your nervous system can’t control your bodily functions as effectively, your muscles lose their ability to produce lactate. ‘As long as the clearance of lactate is matched by its production, it becomes an important source of fuel,’ wrote Michael Hutchinson, author of Faster: The Obsession, Science and Luck Behind the World’s Fastest Cyclists. ‘In the later stages of a marathon – an event in which the effort is consistently quite high for hours – typically, half the energy supplied is done by lactate transporting energy from non-used muscles. Without that, you will fatigue more quickly.’ In addition, high-intensity exercise damages your muscles. And then, Lambert explains, ‘white blood cells promote inflammation and damaged muscle fibres are removed, after which the regeneration of new muscle fibres begins.’
If you run an ultra marathon, obviously your muscles will be sore. Usually, by the fifth day or so after, the pain starts to subside. But it takes at least four weeks for your muscles to regenerate after anything over marathon distance – which is why pain isn’t a good guide to your muscles’ state of recovery. If they aren’t given the chance to heal before your next training session, you may find you feel tired and that your performance has dropped.
In more severe cases, the new muscle fibres will atrophy (waste away), causing a loss in muscle mass. ‘Look at the muscles of an athlete suffering from an extreme case of OTS under a microscope, and they look like those of someone much older. By overtraining, you’re accelerating the ageing process,’ says Lambert.
Sandes kept getting sick because the excess cortisol circulating in his body was suppressing his immune system – his body was unable to produce enough white blood cells. Not only do white blood cells help your muscles to heal; they also help to fight infection. When Sandes had glandular fever in 2014, his immune system was so ravaged that his white blood cell count dropped by more than half. ‘Glucose (from carbohydrates) fuels the immune system. If your circulating glucose is low, then your immune system basically runs out of energy. That means it can’t do its job properly. The result is that you lose your ability to resist colds and become more susceptible to allergies,’ says Lambert, who gets a fever blister the moment his immune system is suppressed.
‘In athletes suffering from OTS, serotonin [the happy hormone] isn’t manufactured at the same rate,’ says Lambert. Though this has yet to be proven conclusively, the theory has been around since the 1980s. Researcher William Morgan published a study on athletes who, during periods of vigorous training, reported increased negative moods (tension, depression, anger, fatigue and confusion) and a decrease in enthusiasm. This may explain why Sandes felt grumpy. ‘I don’t know how much that had to do with the frustration of constantly having to drop out of races, but I definitely experienced a lot of low moments,’ he says. ‘In the lead-up to UTMB, I was trying to force my training and it wasn’t as exciting or enjoyable as it should have been.’
‘It can take years to recover from the symptoms of OTS, and return to the level you were at before,’ says Lambert. ‘It all depends on what caused it: it takes a long time to come back from a hard race in which heat and exhaustion were defining factors; but less time if your OTS was caused by poor nutrition. It’s all about removing the cause. If it’s nutrition, for example, you need to fix your diet.’
Sandes had to take a break from training and racing. ‘As soon as I accepted that, my white blood cell count bounced back. It could just be coincidence, but I believe being in a happy headspace aids recovery, and trying to force it delays that process.’ Sandes has learned from his experience and has made considerable adjustments to his training. These days, he tries to do smaller blocks of training and his recovery periods are longer. But given the amount of time it took for him to recover, there’s no doubt prevention would have been better than this cure.
(Related: How to recover from overtraining syndrome)
Does Sandes regret 2014? Not entirely. OTS might have been even harder to accept had it not come off the back of a successful racing season. But he does acknowledge that he failed his system by coupling hard races with inadequate recovery. ‘There are times when I’m not sure if I’ve truly recovered,’ he says. ‘I achieved lots of consistent results in 2016, but no big wins. I don’t know if that’s because I’m getting older or if OTS has taken something away.’
Sandes has been competing in ultras for nearly 10 years. A lot of the guys who are new to the scene are doing exceptionally high mileage. Sandes doesn’t follow suit, because he’s knows he can’t sustain it. What does Sandes’ story teach us? That rest should be taken just as seriously as training. Regardless of what causes OTS, the consequences of ignoring it can be huge.
KNOW YOUR OTS
Do this simple self-check
Psychological markers such as anxiety and loss of vigour tend to manifest earliest.
Ultra-marathon legend Bruce Fordyce called this sudden drop in performance ‘the plods’. He took it as a sign to back off.
Changes in sleeping habits.
Increased occurrence of injury.
High susceptibility to cold and infection.
HOW TO AVOID OVERTRAINING
Follow these guidelines to stay healthy
1/ Apply the 10 per cent rule. This means that you should never increase your weekly mileage by more than 10 per cent over the previous week.
2/ Periodise your training. Treat every fourth week as a recovery week; reduce your time training by 10-50 per cent of your peak week.
3/ Recover effectively. Never follow a high-intensity session or a long run with another. Either rest, or run at an easy pace.
4/ Listen to your body. Don’t try to run through tiredness or sickness.