How to Avoid Overtraining Syndrome and RED-S

By Dr Catherine Spencer-Smith, Physician in Sports and Exercise Medicine at London Bridge Hospital and The Wellington Hospital. 

Around this time of year is when a lot of people in the UK give up their New Year’s fitness resolutions. It’s a tale as old as time. After the excesses of the festive season, many of us hurtle headfirst into promises of a monastic lifestyle; vowing to run a Marathon, swim the Channel or tackle a Tough Mudder before Spring arrives. 

But going too hard, too fast can do much more harm than good. Whilst I firmly believe that exercise should be incorporated into everyone’s lifestyle where possible, it must be implemented in a way that is enjoyable, practical and healthy for the individual. It’s not only possible, but incredibly easy, to do yourself a significant injury by pushing yourself through too much training.

Enter the dreaded ‘Overtraining Syndrome’ and ‘Relative Energy Deficiency in Sport’ (RED-S). Overtraining Syndrome describes what happens to your body if you push through too much exercise and do not get enough rest and RED-S is when you’re under-fuelling for your sport. Many think these conditions only affect elite athletes, but it is actually regularly found in normal people like you and I who have taken up a new exercise regime. It’s particularly common in runners who attempt to increase their distance or speed too quickly. When Overtraining Syndrome strikes, you might find yourself feeling moody, fatigued, struggling to sleep even though you’re tired and your muscles might feel extra sore. When RED-S happens, your body isn’t getting enough calories to support all the additional exercise that’s happening, so bodily functions such as the menstrual cycle, bone strength and immunological functioning suffer as your metabolic rate literally changes. 

The symptoms of RED-S can include missed periods, a drop in libido, or recurrent coughs and colds. Because RED-S can also lead to reduced bone mineral density, it can also lead to the increased risk of stress fractures.

Firstly, you must be realistic about your calorific intake and make sure you get enough nutrients to fuel your new routine. January is often the month where we find people calorie restricting, trying new diets such as the vegan diet and increasing their amount of exercise. This is all fine in theory if it is carried out responsibly. However, often people malnourish their bodies by trying all these things at once. It’s something people don’t like to hear, but you must be increasing your calorie intake if you’re increasing the amount of energy your body uses. Rest is equally as important as nourishment, so try to get plenty of sleep. If you’re new to exercise it’s sensible to alternate the days on which you train. This allows your body to get a much-needed break. I would recommend starting by exercising three days a week initially and increasing this slowly over time if desired. 

One sign that you may be slipping into overtraining is an increase in your resting heart rate first thing in the morning. If this keeps going up a little day by day, it’s an early sign to rest up. If you have a smart watch, it’s really easy to track this if it has a pulse rate detector, or you could of course count the pulse at your wrist over one minute. Before embarking on your new fitness regime, I would recommend visiting a Physiotherapist as they will be able to spot any small errors in your movement or weaknesses in your body.  Spotting these and getting professional advice prior to starting a new form of exercise will help prevent potential further damage. Avoid the curse of Overtraining Syndrome and RED-S. Instead, set yourself up for success instead of failure by setting realistic goals and remember to care for your body by taking time to recover.