Maximizing performance and the prevention of injuries in competitive athletes.

Training athletes to achieve their personal best is an arduous task. The art of coaching athletes toward world-class performances is a blend of science and psychologic motivation. Competitive athletes train 20 to 40 hours per week and push the physiologic limits of the human body. In the past, applying training loads was a best-guess estimate made by the coach and/or athlete. Every athlete is different, and his or her day-to-day exercise and nonexercise stressors vary greatly. Psychophysiologic disturbances precipitated by overtraining can lead to exponential changes in an athlete's ability to tolerate training loads. Musculoskeletal injuries, neuroendocrine irregularities, immune system suppression, and psychologic problems plague athletes and coaches as they attempt to set world records. This paper provides a framework for physicians, athletes, and coaches to better understand the complexities of training, with hopes of preventing overuse problems.