ABSTRACT
Early iterations of sports medicine are as old as medicine itself. The Ancient Greek physician Herodicus has been described as the father of sports medicine (Georgoulis et al. 2007). His most notable pupil, Hippocrates (460-370 bc), argued that exercise contributed to the balancing of the four humours: blood; phlegm; black bile; and yellow bile. Galen (ad 130-200) included rest/motion (exercise) amongst the ‘six things nonnatural’ which, in moderation, would optimize good health (the others being air, diet, sleep/awake, excretions/retentions and passions of the mind). Conversely both he and Hippocrates were critical of the immoderate lifestyle of elite athletes (Dunn et al. 2007). Although the humoral theory of medicine was superseded by new medical paradigms in the intervening millennia, the restriction of sports medicine to prophylactic measures essentially remained static until the late nineteenth century because, quite simply, there were few known effective cures. Exercise was advocated for the treatment of a number of specific ailments – e.g. gout, consumption – but the prescription for injuries incurred during sport was simply to rest (Berryman 2010). The range of sport, medicine and health intersections identified during the nineteenth century defies the evidence for the efficacy of exercise. Prominent themes include the role of sport and exercise in: the development of manliness and morality; countering physical deterioration as a consequence of urbanization; improving the health of factory workers and, at times of conflict and war, the wider population; and in relation to eugenics and social Darwinism (including race issues) (Welshman 1998). In addition, there are detailed accounts of the relationship between medicine and the restriction of sport and exercise opportunities for females due to fears of the negative impact on health in general, and childbearing in particular (e.g. Lenskyj 1986; Park 2015; Vertinsky 1990). Ultimately however, these accounts serve to reinforce our understanding of the sporthealth ideology rather than explore sports medicine more broadly. As Cronin (2007: 24) points out, this literature ‘has concentrated not so much on sports medicine as a practice that treats injury, but more on the broad
development of ideas that linked health and well-being to the pursuit of physical activity’. As noted in Chapter 1, the accepted sociological interpretation of the development of sports medicine is that it has been driven by performance concerns; that by the end of the twentieth century, physiology had ‘been put in the service of sport’ (Hoberman 1992: 74). Yet in examining the specialism in relation to the professional traits discussed in Chapter 2, we see that the medicalization of sport has been far less smooth or unilinear than this narrative depicts. There has been international variation in terms of intra-and inter-professional conflicts and in the deployment of essentially contradictory jurisdictional claims. At times, doctors have striven for greater social influence through medical and state recognition, and at times they have been cajoled into action by sporting authorities. Consequently, the focus of this chapter is the institutional manifestation of sports medicine; that is, its emergence as a ‘profession’, and the relationship between this professional group and medicalization processes. It provides a cross-cultural comparison of attempts to embark on ‘professional projects’, explores the internal and external conflicts which in various contexts were counter to the development of the specialism, and identifies the reluctant imperialism (de Swaan 1989) evident in relation to certain issues. It concludes by focusing on the ‘professionalization’ of British sports medicine, a case which both exemplifies the changing social conceptions of health discussed in Chapter 2 and is most central to the subsequent analysis. The value of this focus can be clarified through a brief review of what has now become the orthodox historical account of the development of sports medicine.
