Overtraining Athletes—and a 2-Minute Test to Detect It

Overtraining is more than physical. Photo by Yuris Alhumaydy on Unsplash

Want to be competitive at the national level? You’ll need to complete a staggering amount of training to get there. As training volumes continue to rise in a race to be the best, coaches must also be hyper-aware of their athletes’ response to that volume. Too much training too quickly can lead to Overtraining Syndrome (OTS), a chronic condition in which continued training actually makes the athlete slower instead of faster. It can sideline rowers for weeks or months and even make them more prone to illness and injury. Not a good outcome to keep your team healthy.

A traditional approach to detecting overtraining involves monitoring the training load of an athlete based on their workout sessions. Coaches assign a “training load score” to each workout session based on the volume of work (e.g. number of kilometers or total time) combined with the desired intensity (e.g. steady state, AT). Some programs go even further to measure the internal cost of the work (“stress”) by incorporating an athlete’s heart rate data (e.g. TrainingPeaks’ Training Stress Score).

There are some challenges with monitoring load and stress as a signal for overtraining.

  1. Not all athletes respond the same way to the same training load. Even if they are equipped to handle the same amount of training load, they may feel the cost of that training (the training stress) differently.
  2. Measuring stress is labor-intensive and can be cost-prohibitive, as it requires heart rate monitors for every athlete and effective heart rate max testing.

What else can you do? Since the 1980s, researchers and scientists have used surveys about an athlete’s state of mind to understand what kinds of thoughts and feelings are most beneficial for peak performance in sport. While we’re still refining our answer to that question, we can still use these same surveys to detect signs of overtraining earlier and more cheaply than other physiological tests. In this post, we’ll explore how you can use the Profile of Mood States (POMS) questionnaire to detect signs of overtraining in your team.

The Profile of Mood States (POMS) Questionnaire

The POMS questionnaire consists of 65 questions, each of which asks participants to rate how much they identify with a certain word right now or in the past week. You rate each word on a scale of 0 (Not at All) – 4 (Extremely). Examples of these words: “peeved,” “shaky,” “on edge,” “energetic,” “uneasy,” “rebellious.”

Each word is associated with exactly one mood markers:

  1. Depression
  2. Anger
  3. Fatigue
  4. Confusion
  5. Tension
  6. Vigor (liveliness, having energy)

When you finish the questionnaire, your scores for each word are added up and grouped for each mood marker.

Grant, et al. examined the difference in responses between a group of athletes diagnosed by a physician with Overtraining Syndrome and a group who were not overtrained. This is what they found:

Pay attention to the shapes of the Overtrained vs. Not Overtrained lines. The absolute scores are not important.

Their conclusions:

  1. Athletes at risk for overtraining or already overtrained tend to show significantly higher than average scores in fatigue and anger and lower than average scores in vigor.
  2. Athletes who are not overtrained demonstrate an “iceberg” profile with their answers, where the “tip” of the iceberg is in vigor and moods like anger and fatigue are very low.

You can try the full POMS survey here.

POMS for Young Adults (POMS-A)

Besides being over 50 years old and designed originally for psychiatric patients, POMS has some additional problems:

  1. It’s 65 questions long. That’s longer than some standardized tests, which make it undesirable to ask your athletes to do multiple times.
  2. It was originally designed for people over 18 and as a result uses language not immediately familiar to teenagers, like “bushed.”
  3. Some words/phrases are ambiguous. For example, does “ready to fight” literally mean ready to fight, or does it mean ready to compete?

So in 1999, Terry et al. set out to develop a shorter version of POMS that could yield similar results that teenagers could also understand. They succeeded in creating a 24-question version which has the same measuring power as the original version.

You could do this in 2 minutes. (Terry et al. Development and validation of a mood measure for adolescents. 1999)

 

Limitations

Despite all the research done around POMS and its shorter variants, it has one big problem:

There is no digital question list or clear protocol to interpret results.

All I could find for POMS-A was the picture I inserted above, directly from the original research.

The original 65-question POMS is online, but it’s excessive for most situations. Its owner, Multi-Health Systems (MHS), also believes it is obsolete compared to shorter variants (which they also sell).

Furthermore, there is no clear protocol on how to interpret results from the survey. For example, you can look for the iceberg profile. But it’s not clear what you should do with an athlete who doesn’t have an iceberg. If they show high scores in anger and fatigue and low scores in vigor, then it might be indicative of overtraining syndrome. However, it’s not clear how high is “high” and how low is “low.”

Fortunately, we can overcome these challenges.

No Digital Question List

  1. Here’s a Google Form you can copy to run with your team. It asks for your athlete’s name and their answers to the 24 questions.
  2. Open your results from the form in the accompanying spreadsheet.
  3. Open this spreadsheet and copy the Result Interpretation tab to your new spreadsheet from step #2.

You should now be able to gather results and meaningfully view your athletes’ profile data.

No Clear Protocol

With any research results, it’s important to recognize that the graphs and results we see represent averages across the whole group. We don’t see how individuals contribute to that average.

This means that although the research by Grant, et al. above showed a stark contrast between overtrained and non-overtrained athletes, some athletes might not clearly fit into either camp.

These lines represent averages of overtrained and non-overtrained athletes. The individual athlete lines might be more ambiguous.

It’s the same reason why the 220 – age formula for max heart rate works well for some people but not others. On average, it works well.

The solution is change your strategy. Instead of relying on one survey to tell you what you need to know, treat these responses as checkpoints throughout the year and do this instead:

  1. Send out the first survey when your team is fresh and just starting the season. This will helps you establish a baseline for each athlete.
  2. Then resend out the survey periodically throughout the season, especially during stressful times. I recommend at least once midway through each season (fall, winter, spring).

Look for big changes relative to each athlete’s baseline. If you have an athlete who starts the year with high vigor and low on the other states, but then increases sharply in depression mid-year, then it’s worth following up with them to talk about what’s going on. Similarly, if you have an athlete who starts the year with no state much higher than the other, and mid-year you see vigor shoots up, that’s also a good chance to check in to see what’s going well, so you can reinforce it!

Summary

The POMS questionnaire is a research-driven tool to detect signs of overtraining in athletes before they show other physiological or immunological signs. Despite the plethora of research, there are few tools available to actually administer the survey, so I’ve provided an example in the “No Digital Question List” section. For best results, look for big changes in an athlete’s profile over time, as opposed to trying to interpret one survey result.

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