Overtraining: making a difficult diagnosis and implementing targeted treatment.

Overtraining syndrome is a serious problem marked by decreased performance, increased fatigue, persistent muscle soreness, mood disturbances, and feeling 'burnt out' or 'stale.' The diagnosis of overtraining is usually complicated, there are no exact diagnostic criteria, and physicians must rule out other diseases before the diagnosis can be made. An orthostatic challenge shows promise as a diagnostic tool, but the subjective feelings of the patient remain one of the most reliable early warning signs. Prevention is still the best treatment, and certain subjective and objective parameters can be used by athletes and their trainers to prevent overtraining. Further studies are needed to find a reliable diagnostic test and determine if proposed aids to speed recovery will be effective.