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EXPLAINER: What is overtraining syndrome in sports?

Simone Manuel is seen before the women's 100 freestyle during wave 2 of the U.S. Olympic Swim Trials on Thursday, June 17, 2021, in Omaha, Neb. (AP Photo/Charlie Neibergall) (ASSOCIATED PRESS)

Olympic champion Simone Manuel stunningly failed to advance out of the semifinals in the 100-meter freestyle at the U.S. swimming trials. Then she revealed why: The 24-year-old sprinter was diagnosed with overtraining syndrome.

Manuel said she'd never heard of it. Her mother searched online to find information about the myriad symptoms Manuel was experiencing. She first felt off in January and by March “my body completely crashed,” she said.

“Just walking up the stairs to the pool, I was gassed,” Manuel said.

The first Black woman to win an individual swimming gold medal at the Olympics noticed her times were getting slower. She initially tried to modify her training. When that didn’t ease her symptoms, she completely stopped for three weeks. But for elite-level swimmers whose training requires them to be in the water daily, it was disastrous.

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WHAT IS OVERTRAINING SYNDROME?

It's an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability. Also known as burnout, it is thought to be the result of the physical and emotional stress of training. Anyone can develop the condition, but it's more common in athletes under 30 who participate in activities that involve repetitive impact. It's not life-threatening and usually doesn't cause permanent damage if you seek appropriate treatment.

WHAT ARE THE SYMPTOMS?

Fatigue, depression, decreased performance, slower or faster than normal heart rate, loss of motivation, insomnia, irritability, agitation, weight loss, sore muscles and anxiety. Pain can begin consistently after a certain time, distance or intensity of exercise, and progressively worsen as exercise continues. Pain can become less intense or stop within a short time of stopping the exercise.

WHAT ARE THE RISK FACTORS?

Age. The kind of exercise you do, especially repetitive impact activities like running and swimming. Working out too intensely or too frequently.

HOW IS IT DIAGNOSED?

It is a clinical diagnosis, which is made on the basis of medical signs and reported symptoms rather than diagnostic tests. Much remains to be learned about OTS.

HOW IS IT TREATED?

OTS may respond to nonsurgical treatment and modifying activity. Taking an extended break, as Manuel did, can relieve symptoms, but relief is usually only temporary. Once exercise is resumed, symptoms can return.

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More AP Olympic coverage: https://www.apnews.com/OlympicGames and https://twitter.com/AP_Sports