Training and overload: adaptation and failure in the musculoskeletal system

The musculoskeletal system is extremely adaptable, but finding the correct balance between maximizing a training response and avoiding overtraining can be difficult. Overtraining is manifest by a number of symptoms which can be physiological and psychological in nature. The present review addresses the specificity of training in relation to the musculotendinous system. Training and exercise can also result in maladaptation due to exposure to a stimulus too frequently or a stimulus that involves forces that are beyond the capability of the musculotendinous system. Overtraining can occur because of musculoskeletal imbalances, poor muscular coordination, inadequate skill, inappropriate training, fatigue and incomplete rehabilitation from a previous injury. Athletes can present with various signs and symptoms of musculotendinous injuries that are a direct result of overtraining; these are discussed in association with preliminary treatment and rehabilitation of overuse and overtraining injuries.