Tracing the Evolution of Sports Medicine

This article first appeared in the November 1983 issue of AB.

 

Sometime in the early 1970s, Americans began to turn on to exercise. I don’t believe anyone can tell us exactly when it happened or exactly why it happened; and that’s okay, for it really doesn’t matter. What matters is that it did happen and that it happened spontaneously.

The exercise movement is a perfect example of grass roots Americana. No one organized the movement, no commercial entity conjured up the movement for profit. In fact, most of the establishment, especially the American medical community, initially ignored or distantly observed the movement. Because of this non-intervention, participatory exercise thrived. Led by the jogging community, exercise and fitness became a new way of life; not a fad but a trend.

 

A Trend, Not a Fad

The proof that exercise is a trend and not a fad can be found in the psyche of the jogger. The rewards in the form of emotional highs are achieved as a result of intense commitment. Every jogger knows that each run is valuable only if he or she breaks a sweat. In fact, it is the commonality of sweat that serves as a bond among all joggers. It is the element of sweat which makes it so difficult for commercial enterprises to capitalize insincerely on the interests of the jogger.

Don’t get me wrong, exercise and fitness in this country is big business and many will make large profits; but the involvement of commercial enterprise must be sincere or it will be rejected. The surest sign that the jogging trend has run amuck will be when people become concerned about what they look like when they are running.

Right now, attire is not important. The only necessary investment is a good pair of running shoes. Clothes don’t matter, cut-offs, shorts and t-shirts (often obtained from running events) are all that is needed. This is an important point. Joggers and runners are sincere athletes. It matters more to them what they do than what they look like when they are doing it.

The apparel industry is trying hard to market fashionable (expensive) running attire. From my observation, few joggers invest in such clothing, except possibly as leisure wear to be worn after strenuous activity. The often-noted statistics that one out of every three pairs of shoes sold is a running shoe does not mean that one out of three people run. It may simply mean that one out of three people want to look like they run. A spin-off of the commitment to exercise fitness may very well be a more casual dress style for work and play.

 

Medicine Finally Gets Involved with Sports

One of the last bastions of the establishment to embrace the fitness movement was the American medical community. With the exception of a few thousand physicians who belonged to sports medicine organizations such as: The American College of Sports Medicine, The American Medical Joggers Association, The American Orthopedic Academy for Sports Medicine, and the American Podiatric Society for Sports Medicine, most of the physician community did not know how to tap into the movement. They did, however, know that it was essential that they become involved, for their patients began to demand a new kind of service and understanding.

 

Exercisers Seek New Medical Services

The individual who has made a commitment to fitness has become a consumer of medical services and no longer a victim. The individual who is fit is interested in staying fit. when sidelined by an injury the exercising individual seeks the information, care or assistance that can help him or her return to his or her desired pattern of activity. The exercising individual seeks a new kind of medical practitioner, one that treats the person and not just the disease or injury.

Out of fear of being left behind, the medical community has responded, and in as sincere a way as possible. Physicians themselves have become more fit. Hospitals and clinics have opened sports medicine sections. Insurance companies offer favorable rates to people who practice healthy lifestyles. Sports medicine clinics have become so prevalent that they are too numerous to list. The response by the medical community has been appropriate and has severed to reinforce the new trend.

But what of the future? Where will the interest in sports and exercise lead us? What role will medicine play? Just what the heck is sports medicine anyway and how is it different from traditional medicine?

Back in the winter of 1980, when American hearts and hopes were captivated by the Winter Olympics in Lake Placid, a young male speed skater accomplished the impossible. Eric Heiden from Madison, Wisconsin won five gold medals and suddenly was the darling of the media. During one of the many interviews he graciously gave, he was asked, “What next? What will you do after the Olympics?” Heiden’s response was that he was thinking of going to Sweden to study sports medicine. Immediately, the switchboard at the American College of Sports Medicine lit up. Callers wanted to know more about sports medicine and how they could get involved.

 

What is Sports Medicine?

Depending on who you ask, “What is sports medicine,” you may get one of several definitions. Let me offer a definition which attempts to embrace all the various perspectives. I know that for some the definition will fall short because it fails to emphasize their perspective. But this definition is intended to be generic, and of value to the non-involved person.

Sports medicine is a perspective, much easier to describe than to define. It involves sports but is not limited to organized athletics. It involves health but is not limited to medical supervision. Essentially, it is an understanding of the health implications of human beings engaged in activity.

 

Not Limited Just to Physicians

Sports medicine is a branch of medicine that is not limited to physicians. It is administered and identified under different approaches such as: orthopedic surgery, athletic medicine, kinesiology, cardiovascular rehabilitation, nutrition, biomechanics, and more. It cuts across almost all areas of medical specialization.

The interdisciplinary nature or sports medicine is its strength. The educator, the researcher, the trainer, and the medical practitioner are all integral participants. Their respective expertise makes sports medicine a unique specialty that takes a holistic approach toward health.

Sports medicine has been viewed by many as that branch of medical services which makes it possible for: 1) competitive and recreational athletes to attain greater levels of performance in their particular sport of exercise; 2) injured athletes to receive proper treatment and rehabilitation in order to return to their particular sport or exercise; and 3) deconditioned as well as chronically or degeneratively ill persons to undergo exercise rehabilitation leading to significant improvement in functional capacity and daily living.

 

Holistic Approach Toward Health

Essentially, sports medicine is a combination of holistic and preventative medicine. Sports medicine is concerned with the optimum functional capacity of the individual. It recognizes that to function optimally the body must be understood as an integration of moving parts.

Prevention of injuries and achievement of optimum capacity is accomplished through proper training and nutrition. The focus of treatment and rehabilitation is as much on the person as it is on the injury.

Sports medicine is an active participant in the exercise movement, not just its handmaiden. Because it pervades all of sport, it is not possible to talk about the future of sports without talking about the future of sports medicine.

 

What’s in Store for the Future?

Crystal ball-gazing is not my forte, but I have been in a position for the past several years to observe the events that will be shaping the new directions in sports medicine. Let me offer my thoughts on what to look for during the next five years in just a few areas touched by sports medicine.

 

1. Drugs, Alcohol and Sports

There is no greater problem in sports today than the abuse of drugs and alcohol. This abuse tears at the very fabric of what sport is supposed to be all about.

The fiasco in Caracas during this year’s Pan American games is just the tip of the iceberg. The abuse of alcohol and drugs is prevalent in nearly all sports and the alibi that sports is a microcosm of society will simply not wash. Drugs that are designed to enhance performance have to place in sport.

The spirit of the Olympic movement requires that the athlete perform to the best of his or her ability without the use of artificial aids. To take drugs to enhance performance is a violation of the spirit of the Olympic movement.

 

Drug Testing Will Not Control the Problem

The health dangers of drug use and excessive alcohol ingestion are well known. The athletes already know what the dangers are but they continue to ignore them. No amount of preaching will make a difference. Drug testing is an unfortunate and necessary evil, but it will not control the problem either.

The only way abuse will stop is when the athletes themselves decide to stop it. When the athlete’s grapevine says stop the abuse, it will stop. Athletes must adopt the motto of Pogo: “We have seen the enemy and it is us.”

Alcohol abuse is a different problem. It is an illness that can affect the performance of athletes. Alcohol abuse is also prevalent in society, but its effect on performance is less alarming. Absenteeism or inferior performance by a sausage stuffer will not raise an eyebrow. But if a third baseman muffs a play because he has an alcohol problem, it will be a headline on the sports page.

One answer to this problem is for professional and collegiate athletic programs to engage the services of professionals who offer employee assistance programs. One of these professionals, Heitzinger and Associates, has pioneered a method tailored to athletes. Their Athlete Assistance Program will be a model for others who emulate such programs in the future.

 

2. Proliferation of Sports Medicine Societies

By my count, there are close to 100 professional and medical societies involved in one of the many aspects of sports medicine. And that number continues to grow. This growth is understandable because of the multidisciplinary nature of sports medicine. There are advantages as well as disadvantages to such proliferation. On the plus side, specialized societies allow each discipline the opportunity to more fully develop their perspective. However, such proliferation also results in duplication of effort, lack of communication and the inability to concentrate adequate resources on difficult problems.

In the near future, I see the formation of a permanent inter-organizational council serving as a conduit of information among the several societies and organizations. Plans are already underway through the cooperation of several societies to conduct a Sports Medicine Congress and Exposition in August of 1985. This Congress would bring together all societies under the same roof for the first time. The purpose of the Congress is to present and debate the latest state-of-the-art information in many of the specialty areas of sports medicine.

 

3. The Industrial Athlete

A new term will be emerging in the near future, as the Industrial Athlete joins ranks along with the Elite Athlete, the High-Performance Athlete, and the Recreational Athlete.

Lately, the quality of the American worker has been challenged as foreign products that are less expensive and better-built flood the market. Certainly, part of the problem rests with the condition of our antiquated factories, but a larger problem rests with the performance and productivity of our workers. The lessons learned through sports medicine research which have been used by athletes are also applicable to the industrial setting.

There is a direct correlation between fitness and functional capacity. Industry would be wise to consider investing in employee fitness programs, whether they be in-house or purchased. Increased employee fitness will have two beneficial results; an increase in functional capacity as well as a reduction in accidents and illness.

Let’s face it, most of our people are breaking down because of underuse. Employee days lost because of cardiovascular disease, alcoholism, low back pain, as well as through accidents and other preventable illnesses are significant and result in higher and higher production costs.

America is in competition and the best-trained athlete does the best in competition. It’s time for industry leaders to realize that the worker’s an athlete whose performance is directly related to his level of fitness. It’s time for sports medicine and industry leaders to collectively devise the mechanisms which will lead to the development of better fit, more productive, happier employees.

 

4. The Cosmetic Side of Fitness

Many commercial fitness centers are engaged in the sale of the wrong product. They are selling sex and glamour. Their advertisements often feature beautiful actresses and actors who seem to imply that the road to beauty and stardom is through their fitness center.

They will continue to attract the customers who are looking for the quick fix. But fitness requires a lifelong commitment, whose end result is a happier, healthier individual. Being fit will improve your sense of being and your appearance but it will not change the shape of your nose or the curve of your lip.

The commercial fitness centers do have a place and the time will come soon when they stop insulting their potential customers. The better ones will realize that there is a vast audience out there of intelligent consumers. The product they want is an honest one, they do not want to be sold the cosmetic side of fitness.

 

5. Competitive Youth Sports

It has been said, and I would agree, that competitive youth sports may be one of our most sophisticated forms of child abuse. I am not condemning or attacking all youth sports, but I am concerned with too much competition at too early an age. The problem rests primarily with the parents and the adults and it is time that we consider letting our kids be children again.

Recently, an American little league team from Georgia won the little league championship before 40,000 spectators. Can you imagine the pressure on those kids? Not only were they involved in international competition (the team they defeated was from the Dominican Republic) but they had to listen to the chants of, “U.S.A, U.S.A!”

Most of us have never competed before 480 people, much less 40,000. It is a small wonder that college seniors experience burn-out. By the time a young athlete gets to college he may already have been competing for 10 years.

The problem is the emphasis on winning. When kids play on their own, they play to win, but when the game is over, it’s over. Often, when parents and other adults get involved—even though they mean well—the emphasis on winning is blown way out of proportion. Vince Lombardi’s famous quotation: “Winning isn’t everything, it’s the only thing” in many cases typifies the problem.

It is this over-emphasis on winning that leads to abuse, and the child is often the victim.

 

“Kids Play for Championship of World”

When left along kids play fair. When they choose up sides they choose fair sides, for the important thing to them is the game and not how badly they beat their opponent. When kids play on their own, every game is for the championship of the world and they have something to look forward to and to dream about. When kids are involved in competitive leagues, the everyday fantasy of playing for the championship of the world is lost.

Leagues are here to stay and so is the competition, but we reap what we sow. I would not be surprised to find that the athletes in the collegiate and professional ranks who rely on alcohol and drugs are doing so as a release from tension or as a form of fantasizing

The solution is not to dismantle the leagues but to educate the parents and coaches so that children can be kids again.

 

6. The Female Athlete

The last, but certainly not the least, subject I wish to present deals with the emergence of the female athlete in America. Not that long ago, women’s sports were treated as a second-class citizen and relatively few women participated. But women’s athletics is on the rise. In fact, it is growing at a much faster pace than is men’s athletics.

More and more changes are on the horizon. The 1984 Olympics will feature a women’s marathon. This, I feel, will be a showcase event that will further spark the growth of women’s athletics.

A new society has recently been formed which is concerned with research on physically active women. This society, Melpomene, is named after the first woman marathoner, a Greek, in the 1896 Olympics. Sports medicine clinics designed to serve female athletes are on the drawing board in a number of locations.

Why is this significant? Because athletics may be the great equalizer that helps to liberate both sexes. Women’s athletics has already destroyed on myth. It used to be said that “horses sweat, men perspire and women glow.” We now understand that it is okay for a woman to perspire and that no loss of femininity results.

I started this article by talking about the commonality of sweat that bonds all joggers. It is that same commonality of sweat shared equally by men and women that will finally free us all. 

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