Olympian swimmer Simone Manuel revealed this month that she was diagnosed with overtraining syndrome after suffering from poor performance, fatigue and depression. Overtraining syndrome is an important and often under-recognized problem in athletes. It can start in youth sports and progress up to the highest level of competition.

An athlete’s body is like a machine, and without enough rest between workouts or fuel from nutritional support, the machine can be strained and start to break down.

Overtraining syndrome occurs when the body starts to break down from prolonged overuse, leading to physical and emotional symptoms. It has sometimes been referred to as “burnout” and has led some athletes to change sports, or drop down in levels of competition, or even retire from sports.

After sustained amounts of high-level training, injuries start to occur more frequently or take longer than normal to recover because of repetitive pounding on the bones, or overuse of the muscles or tendons. Athletes with overtraining syndrome can also experience increased cortisol levels (one of the body’s main stress hormones), which can affect heart rate, blood pressure, and muscle strength. Overtraining can also cause hormonal changes that might lead to irritability, depression or anxiety.

While overtraining is more common in endurance sports, it can happen in any sport. Specializing in one sport year-round is a significant risk factor for the condition.

The best treatment for overtraining is to take a break — and not just for a few days. Most sports medicine physicians will recommend two months off, if not more, to give the athlete’s body time to recover. If properly recognized and treated, most athletes can recover fully and return to sports at the same level. However, if the diagnosis is delayed too long, an athlete could develop injuries severe enough that might prevent a full return.

What can a concerned parent or coach do to help an overtrained athlete? Look out for these signs in young athletes:

  • Repetitive injuries.

  • Decreased or changed mood.

  • Decreased enjoyment in the sport/activity.

Affected athletes often find that they no longer feel the same joy from participating in a sport that they used to be very passionate about. Parents should have conversations with their children to determine whether they still enjoy their sport.

If you are concerned that you or an athlete you know might have overtraining syndrome, talk to a primary-care physician or seek out a non-operative sports medicine physician.

I hope Simone Manuel’s openness to talk about how she has been affected by overtraining syndrome will help increase awareness and education about the condition.

Bradley J. Smith is a sports medicine physician at Rothman Orthopaedics.