Chrissie Slot journal: underperformance syndrome

Chrissie Slot and eight other cyclists are keeping rider journals for The British Continental in 2021. Chrissie only started cycling three years ago and this season was going to be her first year racing at the national level. In her fifth journal entry, Chrissie talks about her experiences with Underperformance Syndrome…

For this post, I thought I’d write about some news I received a few months ago. Before you get your hopes up, I haven’t been awarded anything! Well, unless you can ‘award’ someone a diagnosis…

To finally be given a label for the vicious cycle I was in came as quite a relief

Towards the end of May, I was diagnosed with a condition called ‘Underperformance Syndrome’ (UPS for short). It’s fair to say that up to that point, I’d had a pretty frustrating, stop-start year on the bike. So to finally be given a label for the vicious cycle I was in came as quite a relief.

So, what exactly is Underperformance Syndrome? It’s actually a re-defined version of Overtraining Syndrome. While the symptoms may be similar, UPS recognises that the primary reason for its onset often isn’t just ‘too much training’ or ‘too little recovery’. Instead, the cause may be multifactorial, with an accumulation of sporting and non-sporting factors contributing to it.

These factors could include poor nutrition, mental health issues, or perhaps returning to training too soon or intensely following a virus. Basically, the same outcome can be triggered by anything that adds stress to the body over a prolonged period of time. Since the whole body is affected, symptoms are widespread, with there being around 90 potential physiological and psychological symptoms a person may experience. Some of the symptoms I personally experienced were:

Poor quality sleep.
Performance plateau/decline.
“Heavy” leg muscles even at lower intensities.
Mood disturbances.
Prolonged general fatigue despite rest.
Elevated resting heart rate.
Increased perceived exertion.
Heart palpitations.
Frequent stomach upsets.

However, other common symptoms are:

Sore throat.
Recurrent infections.
Increased sweating.
Weight loss.
Loss of appetite
Loss of libido.
Loss of competitive drive.
Increased fall in blood pressure.

What I think triggered my own experience of UPS was my mindset. This past year, like many, my mental health suffered. However, I didn’t realise how reciprocally linked my physical symptoms were to my riding, so I continued training. Little did I know that by doing so, I was digging myself a deeper and deeper hole.

I’d find myself crying for no obvious reason, and I was barely sleeping. Functioning, let alone riding, became near impossible

At my worst, I was needing to ice my legs after rides, my heart would pound heavily long into the night, and walking upstairs made my legs scream with pain. I’d find myself crying for no obvious reason, and I was barely sleeping. Functioning, let alone riding, became near impossible.

I explained all of this to my local GP. She looked as bewildered as I did. See, to a non-athletic population, the symptoms I listed could point towards a whole host of different conditions. The easiest box to slot me in was chronic fatigue with mild depression, so I was handed a prescription for anti-depressants and sent on my way. The reality was though, neither of these diagnoses were correct; low mood was merely a by-product of a much broader issue.

A couple of months went by, and I still had more questions than answers. I couldn’t work out why I was still experiencing these symptoms, despite removing cycling from the picture. As all the unknowns continued to swirl around my head, I became increasingly desperate for answers. Luckily, a sports therapist I’d been to see had recommended a sports doctor in my local area, so I paid for a consultation with him.

I’m relieved to say, this really was a turning point. The doctor said to me, “I’ve seen many athletes just like you walk into my office, and they all get better”. We agreed on a plan of action consisting of a few months of complete rest (meaning no exercise except walking and yoga), some stress-reduction techniques, and he referred me to all the necessary places on the NHS to investigate my heart symptoms. It cost a lot, but I’m glad I went through with it.

Part of the reason this all dragged on for so long was because of the apprehension I felt about the expense of seeing a sports doctor. Although I was initially holding on for a referral through the NHS, unfortunately, this never came to fruition. In fairness, with the pandemic in full force, the timing of my illness probably wasn’t ideal! But on a more serious note, the challenge of getting referred to the NHS for sport-related issues does make me wonder, how many other athletes might there be who are struggling in silence?

I would urge anyone feeling tired for more than a couple of weeks for no obvious reason to seek help

Fortunately, however, UPS isn’t overly common. But since it’s best caught early, I would urge anyone feeling tired for more than a couple of weeks for no obvious reason to seek help; nip things in the bud, and keep an eye on any symptoms that persist, since a decline in performance is usually one of the last symptoms to show itself. It’s worth noting though, that tiredness can be a sign of many other things: mineral deficiencies, anaemia, an under-active thyroid, for example. And a regular blood test can rule most of these out.

Thankfully, my recovery has been really encouraging since my consultation. Of course, it hasn’t all been plain sailing, and the ‘no exercise’ part of the plan seemed torturous to begin with! But I was genuinely desperate to feel like myself again – to sleep properly, walk up a hill, eventually run or ride, that knowing I would be able to do those things again if I rested properly was all the motivation I needed. It’s also been a blessing in some ways; it’s forced me to figure out what else I enjoy beyond exercise.

Nowadays, my health is in a much better place. I’m back enjoying exercising, but in a more balanced way. My fatigue has lessened, and I’ve got no worrying heart symptoms. I still feel like I’ve got a bit of a mental scar from how much of a rut I got into with the training, which is to be expected. But I’m confident that one day soon, that child-like desire to ride a bike will come flooding back. And when that happens, I can’t wait to learn to love it all over again.