I'd been treating Allison off and on over the last two years for a series of problems, including Hip pain, back pain, and plantar fasciitis (foot pain). Lately she'd been getting injured more frequently, and complaining that she was having trouble sticking to her training schedule.



Here's how she described her problem:

"I feel like crap. I'm tired a lot and pretty grouchy at work. I'm training for Chicago (the Chicago Marathon) and it's not going well. And my stomach's been bothering me. I know you do adrenal testing, and I wanted to see if I could do that. My race is in two weeks, so can we do it after that?"

I agreed. Allison got through her race, but she was not happy with her time. She said she didn't feel like herself and was absolutely exhausted for three days after the race. She came to pick up her test kit, and she looked drained.

"Why don't you take a few weeks off from training until we can see what's going on with you?" I suggested.

Allison agreed. I gave her the Functional Adrenal Stress Profile test kit, to see what was going on with her adrenals. I also had her complete a Metabolic Assessment Profile, to see if she was digesting proteins properly and to see if excessive exercise had caused any cell damage.

Allison's test results showed that she had really run herself into the ground. Her lab tests indicated:

* Her adrenals were in Stage 2 burnout.

* She was intolerant of gluten.

* She wasn't digesting protein adequately.

* Her body was under some stress from free radicals.

When I discussed Allison's test results with her, she asked a question that a lot of athletes like to ask, "Can't you just tell me which supplements to take?"

Unfortunately there's a mindset today that goes something like this: "Have a problem? Take a pill." While this may work in certain severe situations, the truth is that health problems and sports performance problems are rarely caused by a lack of pills; either prescription or supplement.

So, in Allison's case, the answer was a flat no.

"Look Allison, we need to get a handle on your diet, on your training schedule, on your sleep and recovery, and then we can talk about which supplements you should take. In cases like yours, there are no quick fixes, and I can tell you from experience that these problems will keep getting worse."

I told her she need to work with me for 6 months so we could really get her back on track. She agreed and signed up for a 6 Month Personal Program.

After she took the Starting Point assessment home with her and faxed it back to me, it was easy to see that Allison had several things working against her.

* She was over training. Distance athletes tend to train too much, for too many races without enough off time. Allison was no different. She ran in 4 (!) marathons this year, and did a few sprint triathlons. She was planning on doing a half Ironman next year.

* Allison was drastically over-consuming gluten grains, and carbs in general. The high-carb diet is still very popular among distance athletes. Allison was eating a lot of pasta and cereals, and was also using way too much protein powder.

* Allison was experiencing quite a few digestive problems as well. Her diet included a lot of processed foods, and not enough cooking with whole foods.

* She wasn't sleeping enough. Allison stayed up fairly late, and got up early to run. She was averaging around 6-7 hours a night.

* Allison was having problems with a low sex drive. This is common, especially in women athletes who are training too much. She had been married for about a year and half, and having children was in her plans.

So Allison over-training, lack of sleep, and gluten consumption had drained her adrenals. We had to get control of that problem first, then we had to look at her digestion.

The first thing I made her do was take a full month off from running. Yes, a full month. I even forbid her from running in the Turkey Trot. Here's why: A lot of runners are addicted to running. They'll keep running through almost anything. When someone starts developing some of the problems that Allison was experiencing, it's critical that she takes the time to heal. She wasn't allowed to ski until December.

While the rest in and of itself would help Allison tremendously, taking a month off would let her sleep later. Sleep is crucial for adrenal gland recovery.

That was all we worked on in month one. I'm not going to lie: At first Allison revolted. But after I explained that letting her adrenals recover now would pay off next year and told her that the adrenal fatigue was the reason she was feeling so badly during her runs, she agreed.

During that first month, we met every week. Allison spent about a week in runner's withdrawal. She had to fight the urge to put in 10 or 12 miles every single day. But she survived. She quickly started sleeping later, and getting about 9 hours of sleep each night. I had told her that month 2 would focus on getting off of the gluten, but she took herself off right away. She wanted a big project to focus her attention while she wasn't running.

We also started her on a supplement program.

After her month off from running, I let Allison start again. She agreed to keep her distances down to 3-5 miles three times a week. Twice a week she did a kettlebell training circuit at home, for no more than 30 minutes. If she went skiing, that replaced a day of running for that week.

After the first month, Allison was doing well. Her digestive problems still bothered her, so I had her see her doctor about it. The doctor had her do a stool test, and it turned out that Allison had an infection in her intestines. Her doctor prescribed antibiotics, and the problems improved in a few weeks (this was an instance when 'Have a problem? Take this pill' worked).

At 3 months, we had Allison repeat the Adrenal Stress Profile, and it was much better. She had stuck to her program and really been a great patient.

After about 4 months, Allison was doing really well. She was done with her supplement program. Her sex drive was back to normal, she was staying off of gluten, and she was getting ready to start training for her first marathon of the season. But then something happened. Take a guess...

Sometime in the 5th month of her program, Allison told me that she and her husband were expecting their first child. She'd be getting a long break from marathon training.

Allison's case of athletic fatigue is very common, particularly in women who are involved in distance sports. (Guys have problems with Athletic Fatigue, too, but the symptoms are different.) It's critical to take enough time to recover, eat right, and train sensibly.