Overtraining: The Female Athlete Triad

Live Fit | Overtraining: the Female Athlete TriadWhat is The Female Athlete Triad?

In brief: A damaging combination of overtraining and under eating.

Exercise is Good for You

It is common knowledge that exercise offers many benefits such as increased strength and endurance of skeletal muscles and the cardiovascular system. Exercise has also been shown to improve self-esteem, self-confidence, self-discipline, and to build character.

However, too much exercise can easily turn into overtraining, which will diminish the benefits and cause serious life-long ailments such as osteoporosis, arthritis and autoimmune diseases. For women, a group of disorders may materialize that are collectively known as the Female Athlete Triad.

Too Much of a Good Thing

This triad of ailments is caused by a combination of overtraining and under eating. This disorder results in three major problems for women: 1) disordered eating, 2) osteoporosis (loss of bone strength), and 3) amenorrhea (loss of menstrual cycle). Men can also suffer from similar disorders with the exception of the latter.

The Cause

These problems are caused by a strong desire to conform to standards of either appearance or performance, oftentimes unrealistic. This may cause the person to become obsessive/compulsive about exercise (in any form) or eat in an unhealthy manner (eating far too few calories and/or purging).

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How to Recognize Overtraining

Overtraining is, quite simply, training to an excessive degree to the point that a person experiences stress and physical trauma faster than the body can repair the damage. This definition is subjective and so is the line between proper training and overtraining. Because of this subjectivity, it is often not recognized by the athlete. It is far easier for someone who is close to the athlete to recognize the signs and symptoms of Female Athlete Triad, which has the unfortunate acronym of FAT. However, since exercise is generally thought to be positive, it may be difficult to know when a person is harming themselves instead of strengthening or improving.

Signs and Symptoms

Signs of overtraining, and FAT, will be exhibited in varying degrees depending on the extremity at which the person trains. Some of the most obvious signs are stress fractures and other over-use injuries. Less obvious signs include: Simple fatigue, prolonged weakness, chronic soreness, loss of body weight, insomnia, anorexia, depression, disordered eating, flu-like symptoms, frequent minor infections, under performance, excessive fatigue, amenorrhea, osteoporosis, or obsessive/compulsive behavior with exercise.

Eating Disorders, or Disordered Eating May Accompany Overtraining

Disordered eating is not the same as an eating disorder. Disordered eating can occur when there is a preoccupation with food and body weight. Recognizable signs include:

  • Expressed concern about being fat,
  • Frequently eating alone,
  • The use of laxatives,
  • Trips to the restroom during or immediately following a meal,
  • Increased criticism of self and
  • Continual drinking of no-calorie beverages.

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Overtraining can cause serious, life-threatening and life-long problems. Leslie Heywood, the author of Pretty Good for a Girl: An Athlete’s Story is still suffering the symptoms of overtraining and the Female Athlete Triad, which began for her more 30 years ago.

Permanent Damage

Heywood was a track and field star in high school and college and was driven to be as tough as her male counterparts. She wanted to be the best, to be noticed, so she pushed herself to extremes nearly everyday, pushing herself until she was in pain.  Eventually it caught up with her – her immune system began attacking her body. She was 18 and had the joints of a 50 year old. She still suffers from vertigo, fevers and joints so stiff she has to lie in bed, sometimes for days.

Push Through the Pain

In college, she had a stress fracture in her foot and severe hip and shoulder pain from running. Unfortunately for her body, the pains went away when she ran. The signs that her body wanted her to slow down may have appeared obvious to some people, but she didn’t see, or didn’t want to see, what she was doing to herself. Her entire being and self-worth was dependent on winning competitions, at being the best, at being admired and looked at in awe. Her scholarship was dependent on her performance in these competitions. Her appearance was dependent on her intense physical activity to keep her slim. Without it she would get fat, she thought, and that was not acceptable. In addition, her coaches were pushing painkillers and cortisone to keep her in the races.

Did Not Respect Advice

Heywood did not realize or care what harm she was doing to her body. Her mother told her repeatedly that she is “not a machine, not a steamroller,” but Heywood shrugged it off because she didn’t value her mother’s opinion. Some of her teammates and roommates told her she should take it easy, but she knew that winners always go to extreme measures to win, and that the people telling her this were not winners. Being extreme is what sets them apart from the rest of the world. If winning were easy, everyone would do it. American society encourages this attitude. Heywood said in a phone interview with this author that she bought into these social pressures:Live Fit | Pretty Good for a Girl

The idea that “success” means outward achievements like winning athletic contests, getting academic degrees, getting good jobs, having money to buy stuff. You should be willing to, consumer culture preaches, sacrifice anything and everything to this “success”:  the natural environment and the health of the planet, your family, your relationships, any sense of community, free time, your own hobbies and interests. Nothing is important but the accumulation of stuff, and “success” as the dominant culture defines it (2002).



By the time she entered college she was at her worst, getting up at 4 in the morning to run 15 miles and do 1500 crunches before breakfast (which consisted of one piece of toast with a teaspoon of jam and a cup of hot tea, no milk), she would then run at track practice and again later that day and evening. The rest of the time she ate very little, vomited much of the food she did eat, and took laxatives.

Killing Herself

Heywood finally slowed down, but only when her family physician told her she would die if she did not stop competing and training as hard as she was. This was a hard blow; she had to find something to occupy her time and keep her body from becoming fat. She began teaching aerobics 5 times a day and eventually got into power lifting, which she still competes in, though only occasionally. It took her many years to rein back and change her concept of success.


Heywood is an extreme example of overtraining. There were many factors contributing to her exercise addiction and disordered eating, but the results were that she was overtraining and causing permanent damage to her body. It has been thirty years since she was in high school; she has only recently conquered most of her issues with self (including body image), competition, relationships and success. It has not been easy for her and she still suffers many of the physical problems that began so many years ago. However, on the positive side, she believes that her book has helped enlighten others to these issues and saved people from repeating her mistakes.

Is It Worth It?

American society encourages success at all cost, but this should really be examined closely before one does irreparable damage to one’s body. Everyday athletes – professional on down – are permanently injuring themselves for a game or sport. Some of these injuries will greatly affect their quality of life. Are a few years of competition really worth a lifetime of pain and impairment?


To avoid overtraining, the athlete must listen to his or her body. What does it need? Listen to coaches, friends, parents; they may see what the athlete does not. Train smart; use all the tools, technology and information available to improve performance and nutrition. Take advantage of physical therapists, personal trainers and athletic trainers — they are all professionals in the field of improving the operation of the human body. It’s true a winner must work harder and be willing to go the extra distance, but there is no reason that person must permanently damage his or her body to be the best. Condition the body for sustainable activity and for good health.

 You Can Be a Winner Without Damaging Your Body

It is possible to excel in competition without damaging the body. It is a good idea to check yourself now and then to see if everything is functioning normally. There are also some signs and symptoms that will indicate if you are pushing it too hard without enough rest or nutrition to sustain the effort.

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 Signs and Symptoms of Overtraining:

  •  Elevated Resting Heart Rate
  • Stress fractures
  • Over-use injuries
  • Illness, or flu-like symptoms
  • Frequent infection
  • Disordered eating
  • Constant fatigue
  • Prolonged weakness
  • Chronic soreness
  • Loss of body weight
  • Insomnia
  • Anorexia
  • Depression
  • Under-performance
  • Obsessive/compulsive behavior with exercise


Heywood, L. (2000). Pretty good for a girl: an athlete’s story. Minneapolis: University of Minnesota Press.

Heywood, L. (April, 2002). [e-mail].  Binghamton, New York

For more information:

Regarding Autoimmune Disease:

  • National Resource on Health –   http://www.niaid.nih.gov/publications/autoimmune/autoimmune.htm
  • American Autoimmune Related Diseases Association, Inc. – http://www.aarda.org/
  • iVillage – http://www.ivillage.com/topics/health/0,10707,166079,00.html

 Female Athlete Triad:

  • The Physician and Sportsmedicine –     http://www.physsportsmed.com/issues/1996/07_96/smith.htm
  • American Family Physician – http://www.aafp.org/afp/20000601/3357.html
  • NebFacts – http://www.ianr.unl.edu/pubs/foods/nf361.htm


  • SportsMed Web – http://www.rice.edu/~jenky/sports/overtraining.html
  • Sports Medicine – http://sportsmedicine.about.com/library/weekly/aa040600.htm

Leslie Heywood:



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