Exercise Medicine is Ancient History

Three runners. Side B of an Attic black-figured Panathenaic prize amphora” by Marie-Lan Nguyen is licensed under CC by 2.5.

Exercise is Medicine® (EIM) is a global health initiative that was launched by the American College of Sports Medicine in 2007. The goal of EIM is to encourage health care providers to incorporate physical activity into their patients’ treatment plans. Susruta would have said, “It’s about time.”

According to research by Charles Tipton from the University of Arizona, Susruta is the first physician in recorded history to use exercise as medicine for his patients. Susruta lived about 2600 years ago in the Indus Valley. He recommended to his patients that they exercise every day, but at half of their capacity – to do otherwise could be fatal.

Hua T’O, a Chinese physician and surgeon who lived during the East Han Dynasty about 2000 years ago, had similar physical activity recommendations as Susruta. According to Tipton’s research, Hua T’O believed that:

The body needs exercise only it must not be to the point of exhaustion for exercise expels the bad air in the system promotes free circulation of the blood and prevent sickness.

Hua T’O recommended exercises that mimicked the behaviours of animals to his patients.

It is well known that the ancient Greeks enjoyed their sports, but the first philosopher-scientist to promote daily exercise for health was Pythagoras around 2500 years ago. Yes, it’s the same guy with the theorem that haunted us all in geometry. Tipton found that Pythagoras advocated a daily routine of “long walks, running, wrestling, discus throwing, and boxing” to bring the body back into harmony and maintain a healthy state.

Around the same time in history as Pythagoras, Herodicus, considered to be the father of sports medicine, stressed the importance of exercise as therapy. However, Tipton points out that Hippocrates (a former student of Herodicus) and Plato criticized Herodicus for prescribing overly strenuous exercises to his patients. Imagine how that would feel if Hippocrates – the same Hippocrates who created the oath that current medical doctors take – and Plato were your critics. Still, Hippocrates did believe in the therapeutic effects of exercise.

Tipton’s research identified writings by Hippocrates stating that “eating alone will not keep a man well, he must also take exercise” and “. . . food and exercise, while possessing opposite qualities, yet work together to produce health.” Furthermore, Tipton suggests that Hippocrates was the first physician in history to provide a written record for exercise prescription. His detailed writings described a walking program for a patient with consumption (tuberculosis).

Moving away from Greece in time and space, Tipton shifts his focus to the Roman Empire around 1900 years ago and the physician Claudius Galenus or Galen. Galen believed exercise would thin the body, strengthen muscles, and increase flesh (Tipton speculates this might mean muscle mass) and blood volume. Tipton’s research showed that Galen prescribed exercises for weak patients or patients suffering “with arthritis, depression, dropsy, epilepsy, gout, tuberculosis, and vertigo.” His favourite exercises to prescribe were games involving a small ball. Galen’s use of exercise in medicine influenced medical practices in Arabic and European countries for 1400 years.

It appears that our ancestors knew long ago what our current medical establishments have just begun to relearn: exercise is medicine. The facts speak for themselves.

Rodney Steadman 23 February 2015

Works Cited

Tipton, C (2014). The history of “Exercise Is Medicine” in ancient civilizations. AJP: Advances in Physiology Education, 38 (2), 109-117 DOI: 10.1152/advan.00136.2013

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