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Episode 43: Case Study: Overtraining Syndrome And Chronic Fatigue During Marathon Training

In this episode, I share a case study from one of my listeners who is struggling with over-training syndrome (OTS) and chronic fatigue during marathon training. Additionally, I share how you can prevent over-training and identify possible symptoms and causes before you fall victim to it.

Matan Korrub writes:

Hey Steve,


First off I want to let you know how much I enjoy your podcast. I listed to a few different running podcast, but yours is one of my favorite. You seem to be experienced and knowledgeable, and your podcast is very informative. One thing that distinguishes your podcast from others is that you stress personal attention. You’re regularly asking listeners to reach out to you with questions.


So here’s mine:

I have had a history with what seems to be overtraining. I started running in 2006. By 2008 I was running ~50 miles/week and regularly doing long runs of 15-20 miles. I had a half marathon PR of 1:35, and a 5k PR of 19:02. In September 2008 I started feeling exhausted during my runs. It was an extreme fatigue. After 5 minutes of running I felt completely drained of all energy. The exhaustion got so bad that I became unable to run, and stopped running completely.


It was 8 months before I had the energy to run again. I was able to run, but SLOWLY and I was very out of shape. But I built it back up, and slowly crept back into the 40-50 mile/week range. However, after a few months the same fatigue issues returned, and once again I was forced to take more time off.


For the next 4 years a pattern ensued where I would take time off, get back into running, build my mileage back up, and then the fatigue would return. This became unbearably frustrating. I was also concerned that I had some type of health issue causing this fatigue. I went to an internal medicine doctor who ran every exam imaginable. Everything came back normal.


A sports medicine doctor suggested that the fatigue issues may be the result of overtraining. We decided to make some drastic adjustments to my training. I was given a walk/run program and did a very gradual buildup.


I’m now running 25 miles/week, and feeling great! I’m taking 2 full days off each week, and I’m really focusing on rest/recovery. I’m also doing some quality workouts (lactate threshold runs and intervals), whereas in the past I was doing 100% slow/easy runs and just focusing on volume.


I ran a 10k a few weeks ago at 6:39 pace. I’m getting close to the PR shape I was in during 2008. However, my goal is the marathon. So the question I’ve been asking myself is what kind of mileage I will need for the marathon.


I’m very concerned about the fatigue issues returning. As a result I’ve been very conservative with my mileage. I don’t want to come close to approaching that ledge. But I still want to run the best marathon possible (and one day qualify for Boston). I’m looking for some guidance on how to train intelligently and keep me from having any further overtraining episodes.


After some follow-up questions about diet, hours per sleep, and his ramp up schedule, days off, etc. I offer several tips or improvements that can possibly help.  The main ones include:

  • It was determined that Matan was running 6-7 days per week and running 40-50+ miles per week, week in and week out.  Additionally, each long run ranged from 14-18 miles and he was doing this each and every week.One recommendation is to periodize training and build up mileage, followed by periods of ramping down (after the marathon).  Keeping sustained miles week after week for months is not only necessary but can lead to overtraining syndrome.  It is OK (and recommended) that he continue to build up to those levels, but only as needed to peak just prior to race day along with a 2-3 week taper phase.
  • It was recommended that Matan add a couple more rest days each week.  Focusing on rest and recovery to rebuild glycogen stores and repair/build muscle should help prevent overtraining and prevent excessive fatigue.
  • It was recommended that he make sure that the appropriate levels of blood testing and metabolic testing is done.  Fatigue and chronic over-training to this level is rare and there could be medical reasons behind it. He mentioned that he had seen an internal medicine doctor and had lots of test ran all with normal results, but one thing he should check is thyroid and vitamin B-12 deficiencies which have been known to have symptoms that are similar to over-training syndrome.

I offer several tips in order to avoid over-training and how to recognize when you may be training too much.  Do you have tips for Matan? Anything that you can think of that may help?  I am curious as to what  tips and suggestions you can offer. Feel free to like our community Facebook page and submit your question or comment there, or in the comments section below.

Finally, if you enjoyed this podcast, would you consider leaving 5* feedback and comments on my iTunes page? Your feedback is absolutely critical to the continued success of this show.

Happy Running!

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Steve is a RRCA and USA Track and Field certified running coach and club director for Run Fit Running Club in Central Ohio. He is the host of the Start Running Podcast and Marathon Training Podcast which can be found in iTunes.

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  1. Arindam

    I started running for relaxation 2 years ago. I found running helps me to have clarity of thoughts. Just started training half marathon. Will run half marathon in Jan’14.

  2. By Steve Carmichael
    By Steve Carmichael12-31-2013

    Arindam, Good luck on your half marathon next month!

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