Best Defense

Thomas E. Ricks' daily take on national security.

What if it isn’t PTS, but rather OTS?

What if it is not PTSD?



By Stacy Bare
Best Defense wilderness columnist

What if it is not PTSD?


By Stacy Bare
Best Defense wilderness columnist

What if it is not PTSD?

In the summer of 2015, Outside magazine ran an in depth article on ultra-runners and endurance athletes suffering from Over Training Syndrome, or OTS. A quote in the article from David Nieman, a former vice president of the American College of Sports Medicine and a professor of health and exercise science at Appalachian State University, resonated in my mind as I replaced OTS with PTSD (post-traumatic stress disorder).

OTS is one of the scariest things I’ve ever seen in my 30 plus years of working with athletes… to watch someone go from that degree of proficiency to a shell of their former self is unbelievably painful and frustrating.

I came home from war and no one in the military or later the VA Health Care system, thought to see if I might have OTS. Any challenges I had were assumed to be mental health related, unfortunately, and often incorrectly synonymous with PTSD — and somehow divorced from my physical body. I had no visible wounds. And yet, there I was a shell of my former self performing far below past standards of physical and mental excellence. The VA response was to send me to Cognitive Behavioral Therapy (CBT) or Prolonged Exposure Therapy (PET). I declined both options and was later told my PTSD was not related to my time in Iraq.

What if I didn’t even have PTSD?

I thought about my routine for a good portion of my time in Iraq: wake up, eat food from the lowest bidder with questionable nutritional content, put on 80 pounds of gear and walk around in sweltering heat. Every now and again, sprint as fast as I can for about fifty yards or so. Navigate additional obstacles, smash down doors, run up and down stairs and perform a series of squats and combat rolls.

Dehydration was a routine issue I often countered by too much hydration which I now realized flushed my body of needed nutrients. At the end of the day, I came home to base, ate a handful of supplements and if I had the time and energy, I’d lift my face off until I went to bed for a few shitty hours of sleep to repeat it all the next day.

I am not a professor of exercise science but if there’s an easy recipe to get OTS, I think patrols in the Army may be it.

In January of this year my thoughts on service members and veterans having OTS or suffering similar challenges as top flight athletes was reinforced when I read that Ryan Hall, one of the top marathoner’s in the United States decided to quit running. The New York Times article that covered his retirement did not use the term Over Training Syndrome. However, from what I read in the Outside article, it seemed there was a close parallel. Mr. Hall, in speaking about his decision to retire said:

I’ve explored every issue to get back to the level I’ve been at, and my body is not responding. I realized that it was time to stop striving, to finally be satisfied and decide, ‘Mission accomplished.’

How many service members feel the same way Mr. Hall does, but because of a commitment to service, to country, or to being in the middle of a contract, don’t have the luxury of saying ‘mission accomplished’? And those individuals keep pushing on, deployment after deployment, year after year.

The article goes on to note that one of Hall’s challenges was with his testosterone levels, saying that:

Testosterone is vital for optimum athletic performance, but that hormone’s levels can drop over time with extreme training, similar to how some female runners or gymnasts experience decreased estrogen levels.

The requirements of a lot of military service should rightfully be paralleled to optimum athletic performance and yet, we have failed to make the comparison at a broad level. Worse, we have failed to physically prepare many of our service members at all, throwing them into marathons while only training them, often poorly, for a two mile run.

I don’t write any of this to minimize the very difficult reality of PTSD in returning service members and veterans. Rather that we’re only going to continue to fail our veterans if we assume any and all challenges are always PTSD related — and worse, that PTSD does not have a physical component to it.

Furthermore, if OTS is really impacting our community in ways I believe it is, what else are we missing and what other communities, like exercise science, can contribute to veteran well-being?

Stacy Bare is a 2014 National Geographic Adventurer of the Year. He received a Bronze Star for Merit for his service in Baghdad in 2006-07 and as Director of Sierra Club Outdoors co-founded the Great Outdoors Lab with Dr. Dacher Keltner at UC-Berkeley.

Image credit: Luc-Olivier Merson/Wikimedia Commons

Thomas E. Ricks covered the U.S. military from 1991 to 2008 for the Wall Street Journal and then the Washington Post. He can be reached at Twitter: @tomricks1

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