The Sports Medicine
Tommy Boone, PhD,
MPH, FASEP, EPC
Professor and Chair
Department of Exercise Physiolgoy
College of St. Scholastica
Erin Rademacher, BA,
Department of Exercise Physiology
College of St. Scholastica
Decades of sports medicine
emphasis on the inherent value of diversity of thought and interaction
with a host of other professionals have brought us progressive alienation
from exercise physiology, from our fellow exercise physiologists, and from
ourselves. In seeking to recapture something of the spirit of the
early physical educator with an interest in the physiology of exercise,
this brief article proposes that the “sports medicine myth” lies at the
heart of our problems. It is probably a subject that most exercise
physiologists aren’t interested in thinking about. Nonetheless, it
is an important next step in the exploration of the most fundamental self-knowledge
– of who are we, where we come from, and our purpose as an emerging professional.
The message is simple. Exercise physiologists need answers about
themselves. Call it a philosophy of the emerging profession.
Call it what you will, but it is as important as the research that is published
and defined by exercise physiologists.
It has been easy to overlook
the fact that the roots of sports medicine are firmly embedded in the work
of physical educators who were among the earliest in transition to being
called exercise physiologists. How did it begin? In brief,
it was started with the notion that sports medicine would be the outlet
for research about sports, athletics, and exercise. The members understood
that it personified the spirit of academic thinking, research, and application
that was needed to better serve the public. The deliberations were
mostly centered on the presentation of the research, and most of the presenters
were academically declared physical educators. In its sheer simplicity,
everyone trusted the process.
Unless we periodically remind
ourselves of the function and nature of how organizations work, our tendency
is to believe that everything is as it should be. But, all organizations
aren’t working as they should and everything isn’t right. What should
have happened simply didn’t happen for a variety of reasons. What
is powerfully important is that sports medicine is not the same as exercise
physiology. For those who believe in sports medicine, their unquestioning
belief is disempowering. Indeed, the belief has disempowered exercise
physiologists to such an extent that they have now handed over responsibility
for what they are to a plethora of external influences. How did this
happen, and why is it continuing to happen? These are two very interesting
questions. Part of the answer to each lies with the sports medicine
The existence of exercise
physiology within sports medicine is based largely on the myth that sports
medicine promotes exercise physiology. The reality is that sports
medicine has not promoted and/or transformed exercise physiology from its
early definition with physical educators. Instead, sports medicine
is “the” agenda of sports medicine people, and its existence has served
powerful individuals and other groups of professionals for decades.
The empowering message that in essence drives sports medicine is incorporated
into its vision. By focusing our attention on the mission statement,
its sheer simplicity defines why exercise physiology has not (and cannot)
flourish as a profession within its house of members.
“The American College
of Sports Medicine promotes and integrates scientific research, education,
and practical applications of sports medicine and exercise science to maintain
and enhance physical performance, fitness, health, and quality of life.”
Again, it is worth repeating,
“sports medicine is not exercise physiology”. The sports medicine
myth of promoting exercise physiology simply isn’t correct. The purveyors
of the myth that built sports medicine on the backs of exercise physiologists
have benefited at the expense of young professionals in exercise physiology.
Prestige and power appear to be their rewards. Meantime, they have
done little to help exercise physiologists in the academic settings.
In fact, many academic exercise physiologists believe that the sports medicine
leaders didn’t consider the physical education/exercise physiology field
of study worth their time. They developed certifications that built
the sports medicine name, but failed miserably in getting involved at the
academic level. The deleterious effects of the certifications without
a direct academic link to physical education/exercise physiology are still
The reality, of course, is
that the myth continues to confound, confuse, and ultimately slow the process
of change from sports medicine to exercise physiology. The belief
that both can survive within the elbow-link of a “College” mentality simply
isn’t logical thinking. One will flourish. The other
will not. It is therefore inevitable that a number of different but
related emerging professions (like biomechanics, sports psychology, exercise
immunology, exercise nutrition, sports management, athletic training) have
created their own professional organizations. In fact, it doesn’t
take much time to locate the organizations on the Internet. A few
emerging professions even have several highly specific professional organizations
outside of the sports medicine context.
So, why is it a problem for
someone to disagree with the sports medicine process? In a world
of conflict, confusion, and effort towards making sense of life, disagreeing
with colleagues ought to be considered imperative if growth and new vision
are important. The privilege of disagreeing is just that, a privilege.
Daring to question anything is appropriate and necessary for an understanding
of life’s issues and concerns. The cloud of unknowing or simply not
knowing what is straight thinking is the problem. True knowledge
and understanding come from the study of things, including but certainly
not limited to sports medicine.
The reality is that the preoccupation
with the sports medicine myth kills any alternative thinking. Individuals
with the temperament and inclination to try something different are often
times unwilling to do so, as if there is some kind of universal truth.
They fear the consequences should the powerful sports medicine people decide
to put their foot down. Perhaps, it is as simple as a colleague in
a university setting who is a strong advocate of sports medicine with the
final vote on tenure of a colleague who thinks differently about exercise
physiology. The possibilities for doing harm and creating negative
effects are numerous. Where is our collective wisdom during these
times of increased communication, cell phones, satellite links, and the
In the broadest sense possible,
“we the people” didn’t advance to the collective maturity that defines
the United States by biting our tongue every time we wanted to say something
or disagreed with a friend or colleague. We have the right,
as individuals, to disagree on all kinds of matters. Clearly, there
are dozens of examples, including a woman’s right to an abortion, whether
drugs should be legalized, health care, hospital care, the death penalty,
and the value of a college education to talking on the cell phone while
driving a car. Discussions about these topics and others, including
the sports medicine myth are important and necessary to fully understand
the underlying issues.
The myth that sports medicine
can or should guide the development of the emerging profession is not realistic.
The sweltering masses of sports medicine members cannot solve the concerns
and issues of exercise physiologists. Unfortunately, concerns over
promotion, tenure, and position appear to have grown so excessive as to
push into the background what should be the exercise physiologists’ central
concern, the professionalization of exercise physiology. Yet, the
myth continues with the recently developed new sports medicine certification
for young professionals working in cardiac rehabilitation. The ACSM
Registry for Clinical Exercise Physiologists (2) is another
example of putting the cart before the horse (i.e., certification before
The sports medicine belief
has distracted the thinking of academic exercise physiologists. They
have placed too much faith in its leaders, and the belief has resulted
in a focus that isn’t about exercise physiology. Sports medicine
is too overdiversified to benefit the transition of exercise physiology
from a discipline to a profession. But, contained within their hard
work, the leaders of sports medicine are doing what they do best for their
organization. That is, they have not allowed themselves or their
followers to stretch the sports medicine “agenda” too thin in embracing
the concerns and issues of exercise physiologists. What they
can’t say for themselves is exactly what the American Society of Exercise
Physiologists (ASEP) can say and, that is, it exists as a professional
organization just for exercise physiologists. Simple as that.
In fact, read the ASEP Vision (3) for yourself.
1. To be recognized
as the leading professional organization of American scholars and practitioners
in the study and application of exercise physiology to fitness, health
promotion, rehabilitation, and sports training.
ASEP has a focus. It is
defined, and it has nothing to do with sports medicine. It is not
an organization of members who have membership with their own professional
organization. Instead, it is an organization about exercise physiology
and for exercise physiologists. The purpose of ASEP is not secondary
to gaining members at the expense of losing its direction. The need
to focus on the vision of any organization is widely recognized.
The ASEP vision is the driving force behind the methods and procedures
by which the goals and objectives are realized.
2. The Society is dedicated
to unifying all exercise physiologists in the United States and worldwide
to promote and support the study, practice, teaching, research, and development
of the exercise physiology profession.
3. Through proactive and
creative leadership, the Society empowers its members to serve the public
good by making an academically sound difference in the application of exercise
physiology concepts and insights.
The point is that producing
academically prepared exercise physiologists takes time and commitment.
Those responsible for the direction of the organization must be honest
and hard working. They must stand up for their beliefs and refuse,
where necessary and appropriate, to be a doormat for those who disagree
without respect for the ASEP perspective. Similarly, it is
the responsibility of the ASEP member to support the focus on long-range
planning instead of on short-term solutions. It is precisely this
thinking that has resulted in the development of the ASEP Board of Certification
and the Board of Accreditation that now sets the academic standards for
The unmistakable purpose
of ASEP is to unify exercise physiologists around the notion of smart credentials.
Colleagues who understand this point have made it clear that ASEP is solidly
in step with the right thinking. The “Exercise Physiologist Certified”
exam (4) is the first such examination for exercise physiologists.
The standards are high, and they promote the academic coursework considered
appropriate for an academically prepared exercise physiology professional.
The ASEP approved “Guidelines for Undergraduate Accreditation” (5)
provide standards for upgrading the content to begin the first-ever efforts
to standardize the exercise physiology curriculum. If you doubt this,
then look at the documents and determine for yourself the intent and seriousness
that went into the development of each.
Proponents of sports medicine
may argue otherwise, but it is futile to do so. The impact of ASEP’s
effort to make itself accountable has already been realized. Ironically,
several of the people who have taken the EPC exam asked, “Why wasn’t this
exam done years ago?” In defense of hundreds of academic exercise
physiologists who support sports medicine, it is clear that having the
PhD degree doesn’t automatically mean that a person is thinking straight.
Unfortunately, it is rather harsh to say, but most (including myself for
many years) simply had no idea what was meant by professionalism.
To most people, being a member of sports medicine was the thing to do.
No one questioned it and, certainly, no one considered a reason to fix
it. This mentality has driven sports medicine to the forefront while
failing to improve the concerns and issues of the non-PhD exercise physiologists
in the public sector.
While not understanding the
need to look for something better to retool and improve exercise physiology,
the politics of what exercise physiology ought to be were forgotten.
Proponents of sports medicine went to work designing certifications on
top of certifications, claiming that each was different from the other.
Educators who work in the certifications workshops appear to demonstrate
unswerving faith in the process. The hard truth is that the certifications
are generic, however challenging they may be. Without a direct link
to an academic setting and an approved core of courses (most notably in
the form of an academic degree), the certifications fall far short of the
mark in defining exercise physiology. They simply don’t define the
person as an exercise physiologist.
Those of us who have taught
in the workshops understand the work that goes on. Not just anyone
can pass the tests, but that in itself is an issue. For example,
what if a person were to study everything possible and then were allowed
to sit for, say a lawyer’s certification to pass the bar exam? Even
if the person were to pass the exam, the person cannot refer to him- or
herself as a lawyer without having attended law school. The same
is true for the medical field, and essentially all other professional fields
of work. So, the obvious question is, “Why would any organization
create a certification that sets the stage if not encourages the person
to believe that he/she is an exercise physiologist upon passing the exam?”
The answer is that no organization should.
Of course, the accountability
of sports medicine is built upon the notion that the certification is title
specific. That is, let us say that John passed the Health Fitness
and Instructor’s Certification and, therefore, is certified as a Health
Fitness Instructor.” Perhaps, what should also be stated with rigorous
clarity is that John is not an exercise physiologist upon passing the exam.
In other words, to be accountable for the exam and the candidates’ view
of the results is to acknowledge the responsible step of how the certification
may be used in the public sector.
It is pure irony that it
took a completely new professional organization of exercise physiologists
(vs. the sports medicine conglomerate) to understand the transformation
that was needed both in thinking about professionalism and in certification
accountability. The result of this thinking is recognized as comprehensive
and valuable. It exceeds “what is” and sets the stage for even better
things to come. At least now, exercise physiologists are sharing
the responsibility from within their shared professional setting, the ASEP.
It is internally consistent with the vision of the organization, and it
is truly accountable to the candidate both by title and credential.
If we now look back through
time from the current view of where we are, it would be virtually inconceivable
that exercise physiologists would repeat the same mistake. A further
sign of this thinking is the increase in membership in ASEP. The
wheels of new thinking and new possibilities are moving forward.
The way in which exercise physiologists go about developing the new exercise
physiology will always be influenced by the ever-present ASEP. This
fundamental change in perception has given rise to our inherent sense of
oneness. As exercise physiologists, we have the right to our own
professional organization, regardless of the fact that ACSM refuses to
acknowledge that ASEP exists. It is our right to set our certification
standards, to move towards accreditation, and explore possibilities within
ASEP and outside of ASEP to grow and prosper.
Discarding the illusion of
who we think we are within the context of sports medicine is important,
especially if it continues to promote the myth. However, it
is important to remember that the reality of coming into our own thinking
is not without difficulties. A change in perception of the kind consistent
with the ASEP Vision comes about only after significant un-learning has
occurred. In a real sense, we find our potential within the process
of transformation and the re-integration of our personality and our essence
into our earlier dreams and expectations for exercise physiology.
This new, transformed state of thinking and being differs from our formal
sports medicine connection. It will be the one thing that unites
all exercise physiologists.
To turn our back to ASEP
is to deny the reality of who we really are. This is why we have
within each of us a need to understand the following passage in the Gospel
of Thomas: ‘Jesus said, “If you bring forth what is within you, what you
bring forth will serve you. If you do not bring forth what is within
you, what you do not bring forth will destroy you.”’ (6)
The message contained in the passage applies to all exercise physiologists,
and it perhaps opens the way to understanding why ASEP is so important.
Put simply, it is time that all exercise physiologists are motivated collectively
and individually by what is right for exercise physiology rather than what
is good for sports medicine.
What is important is
that we must stop being add odds with the concerns and issues of all exercise
physiologists. The importance of being in the present moment is the
key to getting closer to who we want to be. Knowingly or not, all
exercise physiologists are involved in our own process of self-realization
and professionalism. Some of us may have “better” things to do than
get involved with ASEP. Others may yearn intensely for an opportunity
to help shape and define the transformation process, and still others who
have no desire either way. But, the story doesn’t stop here.
The message in this article applies to all of us.
College of Sports Medicine (2001). Mission Statement. http://www.acsm.org/
College of Sports Medicine (2001). Clinical Exercise Physiology. http://www.acsm.org/rcep.html
Society of Exercise Physiologists (2001). ASEP Vision. http://faculty.css.edu/tboone2/asep/vision.htm
Society of Exercise Physiologists (2001). Information for EPC Candidates:
A Guide. http://faculty.css.edu/tboone2/asep/EPCManual.html
Society of Exercise Physiologists (2001). Guidelines for the Accreditation
of Undergraduate Programs in Exercise Physiology. http://faculty.css.edu/tboone2/asep/accredit.htm
of Thomas 45:29-33, in The Nag Hammadi Library, New York, 1977, p 126.
Quoted in Pagels, Elaine, The Gnostic Gospels, Penguin Books, Harmondsworth,
1982, p 15.
©1997-2001 American Society of Exercise Physiologists. All Rights
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