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swimwiththebeat 4 minutes ago [-]
I definitely experienced this in training for my marathon and half Ironman (which I had stupidly signed up for in consecutive months). I didn't follow my training plan properly and tried to cram all the volume in the last month or two and it didn't end well. I was able to make it through the half Ironman through pure adrenaline, but I laid in bed for the following two weeks and barely moved. I had no motivation to do anything whatsoever.
It turns out that I was deficient in plenty of vitamins: D, B12, iron. I'm sure these were all symptoms of OTS. I didn't feel the same in any of my workouts until maybe 4 months later. Even then, it took very gradual build-up after those 4 months to get back to where I was. Taking vitamin supplements helped, sure, but the true cure was just ramping down the exercise a lot and getting proper sleep over months.
I empathize with these athletes because exercise is addicting; it feels almost morally wrong to take days off. There's also always someone better than you. But as I got older, I realized that recovery is just as important (if not, more important) than the actual work. In fact, that's where all the gains are made.
I found a few helpful pointers with structuring my workouts now is to:
* Increase training volume <10% W/W. It gives your body time to adapt and also helps with preventing injury.
* Mixing in recovery weeks is also really helpful with helping your body adapt.
* There's no way around doing a lot of volume when training for endurance events, but keeping your HR lower the whole time is a good way to make sure you don't overtrain and can show up the next day.
kzrdude 3 hours ago [-]
Nils van der Poel was* a long distance speed skater who set impressive records and wrote about his training regime. His book is https://www.howtoskate.se/. He trained ambitiously for 3 years, won Olympic gold medals and retired! He followed a very analytically minded path and avoided overtraining.
For those interested in the topic, this book is an amazing and extremely scientific read. Scott was a world cup nordic skier and mountaineer. I am a nobody but got to train with him before my first ultra and it was eye opening. I would upload every workout and if my HR zone was too high he would text me and say "Slow down! I don't care if you're walking at a snails pace."
Note that in the only reasonably-close-to-contemporary story of the run, the marathon run itself came at the end of a multi-day run from Marathon to Sparta and back, about a 300 mile round trip. The marathon run was just the last 26.2.
6LLvveMx2koXfwn 29 minutes ago [-]
I thought the (1).2 was added so that the first modern marathon at the London Olympics (1908) could finish in front of the King? Before that the 'marathon' was 25 miles. And the 300 mile round trip is at least partially replicated in the modern Spartathlon [1]
I wonder if this is due to a lower rate of coaching. I don’t have a ton of first hand knowledge but most other endurance sports the athletes usually come up through well organized teams. Maybe the lack of organization (which is great for other reasons) leads to less coaching and therefore missing someone to tell you to rest and recover before you go over the edge.
drakonka 3 hours ago [-]
The article addresses this:
> That’s not to say that athletes in other sports aren’t working hard. They are. But they typically do so within a team environment or under the direction of a professional coach, providing them with well-established frameworks for success. Even though ultrarunning has grown, there’s still little infrastructure to support its competitors. Sponsorships mean full-time careers, but that rarely includes coaching.
anibal-sanchez 35 minutes ago [-]
Most pro athletes have coaches. The real problem is that nobody understands chronic fatigue. In the best case, after the high season, the athlete takes "holidays" with a couple of months of lower-load training, hoping that it will be enough to cope with years of high-load training.
For instance, nobody knows how each body adapts to a high-carb/high-tech diet over a decade of training. They just hope for the best.
For sure, amateurs shouldn't be doing the same.
wollowollo 2 hours ago [-]
If you want to try your hand at powerlifting as an amateur, there's plenty of programs and templates with different styles of periodization that will have you doing micro- and meso-cycles of effort running up to a competition (or just testing your maxes in the gym).
I'd figure similar programs exist for traditional athletics. I guess much of the issue is the boundary between amateur and pro; most casual lifters in the gym have no hopes or business trying to compete in bodybuilding, powerlifting or strongman.
guerby 2 hours ago [-]
Tim Noakes is cited in the article for his 1987 book "The Lore of Running", I wonder if people following its 2021 "Real Meal Revolution" about keto would be subject to the very same OTS or not in the long run.
nradov 1 hours ago [-]
It's impossible to do really high intensity endurance training on a ketogenic diet. You won't have the energy to execute the fast interval workouts necessary to increase your race pace. So in that sense it will prevent OTS, but it will also be impossible to compete at an elite level (except maybe for longer ultramarathon events where speed isn't as important).
drakonka 3 hours ago [-]
The description of it as well as one of the theories on the cause make me think of burnout:
> Kreher and others believe that the mind plays an equally important role. Because your central nervous system influences your brain as well as your physiology, he theorizes that true overtraining syndrome is triggered by a combination of psychological and physical stress.
> “That’s the multi-system nature of the condition,” Kreher says. “The interaction of the mind and body is incredibly influential.” To finish a 100-mile race requires a psychological thrashing, and some runners have described a kind of post-race depression. As they try to rally to train for the next goal, perhaps beating themselves up for their prior performance, that mental stress, in addition to the physical depletion, could bring on OTS.
bhouston 2 hours ago [-]
I wonder if gut changes could arise as a result of endurance training and then that affects the mind? This seems to be an understudied area. They are just apparently looking into gut changes with regards to endurance training:
It’s become common over recent decades for endurance athletes to consume gels etc during events.
Maybe those gels are themselves bad for you somehow (they are basically pure sugar), but also if you don’t eat while running and just eat a normal diet of 3 square meals a day then that naturally limits how much you can train.
Modern endurance athletes override the normal human digestion process by eating in a way that our ancestors wouldn’t have been able to do, therefore allowing them to train and race harder.
But to what end?
liendolucas 2 hours ago [-]
Interestingly the same that can happen to the mind. I can't recall the source of the article but it mentioned a mathematician working so hard on a problem for a long time that at some point he could no longer use his brain power to continue doing moderately difficult level math.
I don't particularly find surprising that someone pushing so hard can end up this way, we aren't limitless in our abilities after all.
bell-cot 4 hours ago [-]
I'm not in this space, on either the athlete or the biomedical side - but it sounds like a "more is better" running mindset and mythos is colliding with the biological realities of human bodies which either (1) Were not carefully designed for this kind of duty cycle, or (2) Have accumulated quite a few deleterious mutations in the generations since that design, resulting in frequent operational failures at well below the hoped-for spec.
Might anyone know if indigenous groups such as the https://en.wikipedia.org/wiki/Rar%C3%A1muri - where extreme distance running seems part of their traditional culture - have been studied in this regard?
pif 3 hours ago [-]
> They are renowned for their form of prayer that involves running for extended periods of time.
Mark me as atheist!
keybored 59 minutes ago [-]
I haven’t read OP, but there are enough people in our culture with a monomaniac tendency who only need an obsession to go overboard all unsupervised. So they might start running a little, of course slow to start because they physically can’t take it, but after a point they might not notice that adding more and more activity volume can’t just be done forever just based on your gut, dayfeel, and no pain no gain. Or someone reads about meditation and starts doing hour-long meditations, then soon retreats. Then their mind gets hit with an uncomfortable and disturbing realization while their minds are figuratively in a bad and structurally weak yoga pose. But why didn’t the meditation book warn about this? The meditation book aimed at people who successfully will do it for twenty minutes a day and will have 90% no long-term follow through.
globular-toast 33 minutes ago [-]
Wasn't this kinda inevitable? When I was little a marathon was considered a monumental athletic performance achieved by few. Nowadays it's like everyone who has ever put a pair of trainers on has "run" a marathon (completed would be more accurate, because many people walk a significant part of it). Yeah, I know, I know, gatekeeping is not cool etc. etc.
Meanwhile, the world record marathon time must be reaching its irreducible minimum.
It seems to me like more and more people are now pushing distance to set themselves apart from everyone else. If you say "I ran a 2:30 marathon", most people won't know if it's impressive or not. If you say "I ran 10 marathons, backwards, while juggling 10 pineapples" suddenly people are interested.
3 hours ago [-]
Noaidi 54 minutes ago [-]
From the article:
“He’d waffle between jittery agitation, as though he’d just had seven cups of coffee, and a fatigue so profound that he could hardly get off the living room couch.”
“I was convinced I’d come down with some severe condition that was going to kill me,” he says. For the next two years, Roes’s life became a series of waiting rooms and tests: blood work, brain scans, heart screenings. “I was having severe fevers and extreme phases where I would go into such a brain fog, I thought I might black out,” he says. The tests yielded no definitive diagnosis.
—
I have lived this myself. I’m not an ultra runner but many of these symptoms These runners have I have without ever being into exercise. And it runs in my family. They keep finding little weird things in my test results, but it’s never anything that leads to a diagnosis or affect. They label me with a psychological disorder only.
I’m inclined to think that both my issue and these runners issues has to do with how they handle oxidative stress and the damage that can do to the neurological system. We know these runners are fueled by a sort of addiction to the running. And that’s going to involve dopamine. But since you have to metabolize dopamine using monoamine oxidize enzymes, you’re going to create hydrogen peroxide, and oxidative stressor, as a product. In my opinion to understand, neurological disorders, you need to understand how oxidative stress damages the neurons and the immune system.
And it seems by even just thinking about this I was right I just googled over training and oxidative stress and came up with this paper
So I’m assuming the people this affects probably have some mild genetic issue that makes them a little bit worse at handling oxidative stress of some sort. This could be with glutathione peroxide or catalyze or any of the nutrients needed for us to absorb the cofactors that enable us to get rid of oxidative stress.
tsimionescu 21 minutes ago [-]
There are so many things going on at the same time in the body of someone pushing themselves so far beyond human limits that it seems extremely unlikely you'd find a single neat cause for this. The bottom line is that they're destroying their bodies for athletic achievement, and most likely one too many things are pushed beyond a limit. The cure, or at least prevention, for them is simple - they should just stop doing this to themselves.
The fact that the vague array of symptoms matches your own possibly genetic symptoms doesn't mean much, most likely. Perhaps there are some similar biological mechanisms behind at least some of it, but perhaps not.
nradov 14 minutes ago [-]
Oxidative stress could be a factor in some cases but connecting that to dopamine metabolism seems like a real stretch.
Noaidi 4 minutes ago [-]
A real stretch you say? Meaning that it’s something that they definitely would not study at all?
When training is effective or the athletes are not exhausted, the decrease of the excretion rate--with the exception of dopamine--is more likely to be lower (noradrenaline, adrenaline). Generalization of these results requires further expansion of the experimental basis.
catigula 1 hours ago [-]
I'm super interested in what drug or gene therapy we don't know about is causing this.
eulgro 3 hours ago [-]
> he inhaled a peanut butter and jelly sandwich at the kitchen table
Well that can't help for sure.
ck2 40 minutes ago [-]
OTS and long-covid are remarkably similar
once the body/brain/CNS starts treating cytokines produced by exercise (and illness) as a pathogen instead of doing stress adaptations, you will become perpetually ill and unable to exceed aerobic threshold (or lactate threshold) without PEM
and there's no escape, no amount of rest will cure it, there's no supplement or drug that will reprogram your mitochondria at that point
and right now all research is effectively dead for long-covid, forget OTS which will never happen
I don't see why it's so mysterious, fatigue accumulates until something tips you over the limit
goda90 3 hours ago [-]
Do we know the biological mechanism to cause OTS, though? That would open up avenues for treatment and more precise prevention besides "rest more" (not that that's a bad preventative).
bbayles 37 minutes ago [-]
A lot of it is anorexia by another name. There is a subspecies that involves compulsive exercise. Doing lots of athletics without proper nourishment is a good recipe for low performance and injury.
raverbashing 2 hours ago [-]
Yes, a lot of them. Non exaustive list:
- bone microfractures
- nervous system depletion
- tendon "microlesions" (not so sure about this term though)
- immune system blunting due to stress
- raised cortisol levels
- (possible) nutritional deficiencies given the increased exertion (or just metabolic bottlenecks)
inigyou 3 hours ago [-]
What's fatigue? Is there a fatigue molecule?
rzzzt 2 hours ago [-]
Lactic acid?
perrygeo 15 minutes ago [-]
Nope. Lactate and lactic acids are by-products of fatigue, not causal agents. Far from being toxic, elite athletes are even intentionally ingesting lactate as fuel these days.
nradov 10 minutes ago [-]
Correct. Related to that, accumulation of free hydrogen ions is associated with acute fatigue (although not necessarily related to chronic conditions like OTS). This is why some endurance athletes are now taking sodium bicarbonate supplements.
raverbashing 2 hours ago [-]
I'd say ask ChatGPT because the list is loooong
andrewstuart 2 hours ago [-]
It’s well known ultra training destroys your heart.
In any sport.
They tested the blood of marathon runners and found heart attack markers in many of them because the heart muscle is being damaged and healing and scarring and hardening the muscle leaving young ultra trainers with the heart of an 80 year old.
Additionally recent studies have shown high duration/volumes of cardio increases plaque buildup in the arteries.
"Indeed, many studies have shown a relationship between endurance sports and higher volumes of coronary calcified plaque as determined by computed tomography."
Paywalled articles are allowed on HN, but if you pass the URL to archive.is and then post the link here, you can get a few karma points for free.
bell-cot 4 hours ago [-]
Not if you're security conscious enough to default-block js.
robin_reala 3 hours ago [-]
…or hit the reader button.
avalys 51 minutes ago [-]
> A thin-faced, introspective Montanan, Wolfe had recently quit his job as an assistant U.S. attorney in Helena to concentrate on running for the North Face’s global athletic team.
Well yeah, that seems more important. /s
Article is faintly ludicrous.
Extreme endurance exercise is bad for your body. Medicine has understood this for years. Marathon runners, cyclists and swimmers have one of the highest incidences of atrial fibrillation once they pass age 60. If you took a blood test right after running a marathon, doctors would think you’re having a heart attack.
> Back in Montana he started running 25, sometimes 30 hours a week, fasting to drop any extra weight off his already thin frame and beating himself up in the margins of his training logs.
> Skaggs told me after Hardrock, he took a single day off, then started training for a marathon. “Stupid-hard running,” he says, “and the symptoms just kept getting worse and worse.”
This article is about people who are damaging their bodies through extreme, unnatural exercise - and then they are surprised that they’ve damaged their bodies. This publication is blithely unaware of how ridiculous this sounds. Like reading a Reddit thread of coke addicts earnestly cheering each other on to consume more and more coke, then being disappointed when their nose disintegrates.
I suppose it’s scientifically interesting that we don’t know the cause down to the biomolecular level. But that’s not surprising either. Other than genetic disorders that can be traced to a single faulty protein, or those caused by some external causative agent like a toxin or a virus, we don’t really know the root cause of that many diseases.
pipes 2 hours ago [-]
Click bait title.
smcg 35 minutes ago [-]
This seems like it should be obvious that it should happen. The human body was not designed for ultra-marathons. At a certain point the body shuts down out of self-preservation, because the mind is exhausting it too much.
It turns out that I was deficient in plenty of vitamins: D, B12, iron. I'm sure these were all symptoms of OTS. I didn't feel the same in any of my workouts until maybe 4 months later. Even then, it took very gradual build-up after those 4 months to get back to where I was. Taking vitamin supplements helped, sure, but the true cure was just ramping down the exercise a lot and getting proper sleep over months.
I empathize with these athletes because exercise is addicting; it feels almost morally wrong to take days off. There's also always someone better than you. But as I got older, I realized that recovery is just as important (if not, more important) than the actual work. In fact, that's where all the gains are made.
I found a few helpful pointers with structuring my workouts now is to:
* Increase training volume <10% W/W. It gives your body time to adapt and also helps with preventing injury.
* Mixing in recovery weeks is also really helpful with helping your body adapt.
* There's no way around doing a lot of volume when training for endurance events, but keeping your HR lower the whole time is a good way to make sure you don't overtrain and can show up the next day.
See also brief overview article about him:
https://runningmagazine.ca/sections/training/olympic-speed-s...
(*) He changed his name since, to a more common name, so using past tense seemed humorously appropriate.
https://uphillathlete.com/product/training-for-the-uphill-at...
https://en.wikipedia.org/wiki/Pheidippides
1. https://www.spartathlon.gr/en/home/
> That’s not to say that athletes in other sports aren’t working hard. They are. But they typically do so within a team environment or under the direction of a professional coach, providing them with well-established frameworks for success. Even though ultrarunning has grown, there’s still little infrastructure to support its competitors. Sponsorships mean full-time careers, but that rarely includes coaching.
For instance, nobody knows how each body adapts to a high-carb/high-tech diet over a decade of training. They just hope for the best.
For sure, amateurs shouldn't be doing the same.
I'd figure similar programs exist for traditional athletics. I guess much of the issue is the boundary between amateur and pro; most casual lifters in the gym have no hopes or business trying to compete in bodybuilding, powerlifting or strongman.
> Kreher and others believe that the mind plays an equally important role. Because your central nervous system influences your brain as well as your physiology, he theorizes that true overtraining syndrome is triggered by a combination of psychological and physical stress.
> “That’s the multi-system nature of the condition,” Kreher says. “The interaction of the mind and body is incredibly influential.” To finish a 100-mile race requires a psychological thrashing, and some runners have described a kind of post-race depression. As they try to rally to train for the next goal, perhaps beating themselves up for their prior performance, that mental stress, in addition to the physical depletion, could bring on OTS.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12116556/
Maybe those gels are themselves bad for you somehow (they are basically pure sugar), but also if you don’t eat while running and just eat a normal diet of 3 square meals a day then that naturally limits how much you can train.
Modern endurance athletes override the normal human digestion process by eating in a way that our ancestors wouldn’t have been able to do, therefore allowing them to train and race harder.
But to what end?
I don't particularly find surprising that someone pushing so hard can end up this way, we aren't limitless in our abilities after all.
Might anyone know if indigenous groups such as the https://en.wikipedia.org/wiki/Rar%C3%A1muri - where extreme distance running seems part of their traditional culture - have been studied in this regard?
Mark me as atheist!
Meanwhile, the world record marathon time must be reaching its irreducible minimum.
It seems to me like more and more people are now pushing distance to set themselves apart from everyone else. If you say "I ran a 2:30 marathon", most people won't know if it's impressive or not. If you say "I ran 10 marathons, backwards, while juggling 10 pineapples" suddenly people are interested.
“He’d waffle between jittery agitation, as though he’d just had seven cups of coffee, and a fatigue so profound that he could hardly get off the living room couch.”
“I was convinced I’d come down with some severe condition that was going to kill me,” he says. For the next two years, Roes’s life became a series of waiting rooms and tests: blood work, brain scans, heart screenings. “I was having severe fevers and extreme phases where I would go into such a brain fog, I thought I might black out,” he says. The tests yielded no definitive diagnosis.
—
I have lived this myself. I’m not an ultra runner but many of these symptoms These runners have I have without ever being into exercise. And it runs in my family. They keep finding little weird things in my test results, but it’s never anything that leads to a diagnosis or affect. They label me with a psychological disorder only.
I’m inclined to think that both my issue and these runners issues has to do with how they handle oxidative stress and the damage that can do to the neurological system. We know these runners are fueled by a sort of addiction to the running. And that’s going to involve dopamine. But since you have to metabolize dopamine using monoamine oxidize enzymes, you’re going to create hydrogen peroxide, and oxidative stressor, as a product. In my opinion to understand, neurological disorders, you need to understand how oxidative stress damages the neurons and the immune system.
And it seems by even just thinking about this I was right I just googled over training and oxidative stress and came up with this paper
https://pmc.ncbi.nlm.nih.gov/articles/PMC3435910/
The four theories of the disorder from the same magazine, which includes oxidated distress as one of them
https://www.outsideonline.com/health/training-performance/ov...
So I’m assuming the people this affects probably have some mild genetic issue that makes them a little bit worse at handling oxidative stress of some sort. This could be with glutathione peroxide or catalyze or any of the nutrients needed for us to absorb the cofactors that enable us to get rid of oxidative stress.
The fact that the vague array of symptoms matches your own possibly genetic symptoms doesn't mean much, most likely. Perhaps there are some similar biological mechanisms behind at least some of it, but perhaps not.
https://pubmed.ncbi.nlm.nih.gov/1601559/
When training is effective or the athletes are not exhausted, the decrease of the excretion rate--with the exception of dopamine--is more likely to be lower (noradrenaline, adrenaline). Generalization of these results requires further expansion of the experimental basis.
Well that can't help for sure.
once the body/brain/CNS starts treating cytokines produced by exercise (and illness) as a pathogen instead of doing stress adaptations, you will become perpetually ill and unable to exceed aerobic threshold (or lactate threshold) without PEM
and there's no escape, no amount of rest will cure it, there's no supplement or drug that will reprogram your mitochondria at that point
and right now all research is effectively dead for long-covid, forget OTS which will never happen
* https://imgur.com/a/OzP83pd
* https://i.imgur.com/v6BnoJG.png
* https://i.imgur.com/VpEwjp0.png
"Overtraining syndrome"
I don't see why it's so mysterious, fatigue accumulates until something tips you over the limit
- bone microfractures
- nervous system depletion
- tendon "microlesions" (not so sure about this term though)
- immune system blunting due to stress
- raised cortisol levels
- (possible) nutritional deficiencies given the increased exertion (or just metabolic bottlenecks)
In any sport.
They tested the blood of marathon runners and found heart attack markers in many of them because the heart muscle is being damaged and healing and scarring and hardening the muscle leaving young ultra trainers with the heart of an 80 year old.
The best modern advice is don’t overtrain.
https://youtu.be/Y6U728AZnV0
"Indeed, many studies have shown a relationship between endurance sports and higher volumes of coronary calcified plaque as determined by computed tomography."
https://pmc.ncbi.nlm.nih.gov/articles/PMC11395881/
Well yeah, that seems more important. /s
Article is faintly ludicrous.
Extreme endurance exercise is bad for your body. Medicine has understood this for years. Marathon runners, cyclists and swimmers have one of the highest incidences of atrial fibrillation once they pass age 60. If you took a blood test right after running a marathon, doctors would think you’re having a heart attack.
> Back in Montana he started running 25, sometimes 30 hours a week, fasting to drop any extra weight off his already thin frame and beating himself up in the margins of his training logs.
> Skaggs told me after Hardrock, he took a single day off, then started training for a marathon. “Stupid-hard running,” he says, “and the symptoms just kept getting worse and worse.”
This article is about people who are damaging their bodies through extreme, unnatural exercise - and then they are surprised that they’ve damaged their bodies. This publication is blithely unaware of how ridiculous this sounds. Like reading a Reddit thread of coke addicts earnestly cheering each other on to consume more and more coke, then being disappointed when their nose disintegrates.
I suppose it’s scientifically interesting that we don’t know the cause down to the biomolecular level. But that’s not surprising either. Other than genetic disorders that can be traced to a single faulty protein, or those caused by some external causative agent like a toxin or a virus, we don’t really know the root cause of that many diseases.