Year: 2026 | Month: January-March | Volume: 11 | Issue: 1 | Pages: 108-117
DOI: https://doi.org/10.52403/ijshr.20260112
Physiotherapeutic Management of Cardiopulmonary Implications in Overtraining Syndrome: A Comprehensive Review
Jaspreet Kaur1, Gitanjali Sikka2, Deepak3
1MPT Cardiopulmonary, College of Physiotherapy, Pt. B.D. Sharma, University of Health Sciences, Rohtak, Haryana, India
2MPT Cardiopulmonary, PhD, Associate Professor, College of Physiotherapy, Pt. B.D. Sharma, University of Health Sciences, Rohtak, Haryana, India
3MPT Cardiopulmonary, College of Physiotherapy, Pt. B.D. Sharma, University of Health Sciences, Rohtak, Haryana, India
Corresponding Author: Jaspreet Kaur
ABSTRACT
Background: Overtraining syndrome (OTS) is a complex, multisystem condition characterized by persistent performance decline, mood disturbances, and prolonged recovery despite adequate rest. It results from an imbalance between training load, recovery, and additional stressors, leading to autonomic, cardiovascular, respiratory, inflammatory, and neuroendocrine dysfunctions. Given the increasing prevalence of OTS among athletes, particularly in endurance sports, effective multidisciplinary management strategies are essential.
Objective: This review aims to synthesize current evidence on the role of physiotherapy in the management of cardiopulmonary impairments associated with overtraining syndrome and to evaluate the effectiveness of physiotherapeutic interventions in restoring physiological function and athletic performance.
Methods: A narrative review of existing literature was conducted focusing on cardiopulmonary, autonomic, and systemic consequences of OTS and physiotherapy-based rehabilitation strategies, including heart rate variability–guided training, graded exercise prescription, respiratory muscle training, recovery optimization, and holistic lifestyle interventions.
Results: Evidence suggests that physiotherapy interventions improve autonomic regulation, cardiovascular efficiency, and respiratory function in athletes with OTS. Strategies such as HRV monitoring, individualized aerobic and resistance training, inspiratory muscle training, and recovery-focused modalities were associated with reduced physiological stress, enhanced exercise tolerance, and improved recovery capacity. Additionally, physiotherapy-supported recovery strategies contributed to reduced systemic inflammation and improved overall well-being.
Conclusion: Physiotherapy is central to the management of overtraining syndrome by improving cardiopulmonary function and restoring autonomic and systemic balance. An individualized, monitoring-guided approach supports safe return to sport, reduces recurrence, and protects long-term athlete health, while further high-quality longitudinal research is needed to develop standardized, evidence-based rehabilitation protocols.
Keywords: Overtraining syndrome, Physiotherapy, Cardiopulmonary dysfunction, Heart rate variability, Athletic performance, Recovery strategies