Kibler W B, Chandler T J, Stracener E S
Exerc Sport Sci Rev. 1992;20:99-126.
Overtraining places a demand on the musculoskeletal system that may lead to damage to the musculoskeletal system, as well as to clinical, functional, and biomechanical adaptations that may be detrimental to sport performance. The types of injuries identified range from overt, which are obvious injuries that will usually prevent athletic performance for some period of time, to the subclinical, which decrease performance, but may be seldom recognized. These injuries apparently may be avoided or lessened in severity by a combination of several methods. A thorough preparticipation evaluation is important to detect subtle adaptations in strength and flexibility that can result from overtraining and may increase the athlete's chances of injury. A good sport-specific conditioning program is necessary to give the athlete a strong musculoskeletal base on which to build athletic skills and to decrease the risk of overtraining adaptation. In many sports, prehabilitation exercises can be performed for those musculoskeletal areas that are under high stress in a particular sport. Also, a maintenance conditioning program that extends through the season may be important to maintain fitness throughout the season. Following proper principles of conditioning, including specificity, recovery, and progression, are important. A complete and accurate diagnosis of the injuries that do occur is necessary so that proper treatment may follow. This can be facilitated by understanding the types of clinical presentations of injuries, and the different anatomical and functional alterations that may be acting to cause or to continue the clinical presentation. By following these general guidelines, safe participation in sporting activities as well as performance will be enhanced. The exact point where "training" becomes "overtraining" is difficult to define, especially prospectively. An exciting area of sports medicine research will be to define the anatomic parameters and exercise doses that will cause overtraining, and to devise fitness examinations and training programs that will allow maximal performance with minimal overload risk. At the present time, retrospective studies do indicate that adaptations occur in muscles, tendons, and bones in response to high training loads, and these particular adaptations are not beneficial to performance and may be associated with increased injury risk. Since the optimal exercise dose is not known, provision for evaluation of these adaptations and prehabilitation of all noninjured areas or proper rehabilitation of all injured areas will best prepare the musculoskeletal system for training.
过度训练对肌肉骨骼系统造成负担，可能导致该系统受损，以及产生一些临床、功能和生物力学方面的适应性变化，而这些变化可能对运动表现不利。已确认的损伤类型范围广泛，从明显的、通常会在一段时间内妨碍运动表现的显性损伤，到虽会降低表现但很少被察觉的亚临床损伤。通过多种方法相结合，这些损伤显然可以避免或减轻其严重程度。全面的赛前评估对于检测因过度训练可能导致的力量和柔韧性方面的细微适应性变化很重要，这些变化可能会增加运动员受伤的几率。一个良好的针对特定运动项目的体能训练计划是必要的，以便为运动员提供一个强健的肌肉骨骼基础，在此基础上发展运动技能，并降低过度训练适应性的风险。在许多运动项目中，可以针对特定运动中承受高压力的肌肉骨骼区域进行预防性康复训练。此外，贯穿整个赛季的维持性体能训练计划对于在整个赛季保持体能可能也很重要。遵循适当的体能训练原则，包括特异性、恢复和渐进性，是很重要的。对确实发生的损伤进行完整准确的诊断是必要的，以便后续进行适当的治疗。了解损伤的临床症状类型以及可能导致或延续临床表现的不同解剖和功能改变，有助于实现这一点。遵循这些一般指导原则，将提高在体育活动中的安全参与度以及运动表现。“训练”何时变成“过度训练”的确切界限很难界定，尤其是前瞻性地界定。运动医学研究中一个令人兴奋的领域将是确定会导致过度训练的解剖学参数和运动剂量，并设计体能检查和训练计划，以实现最大程度的表现，同时将过载风险降至最低。目前，回顾性研究确实表明，肌肉、肌腱和骨骼会因高训练负荷而发生适应性变化，而这些特定的适应性变化对表现并无益处，且可能与受伤风险增加有关。由于最佳运动剂量尚不清楚，对这些适应性变化进行评估以及对所有未受伤区域进行预防性康复或对所有受伤区域进行适当康复，将能最好地让肌肉骨骼系统为训练做好准备。
