Exercise an old idea
- Deborah Minors
The idea that movement is medicine dates back to the Ancient Greeks in Olympia but warrants resuscitation in the 21st Century.
When the Ancient Greeks delivered the first Olympic Games in Olympia in 776 BCE, they showcased athletes in peak physical condition. The fact that these exclusively male athletes competed in the nude is further evidence of the Ancient Greeks’ celebration of the physical human form.
Although chariot-racing and the pankration – the ultimate fighting sport to the death – no longer feature in the modern Olympics, the Games have endured in pursuit of Citius, Altius, Fortius (Faster, Higher, Stronger).
In the 21st Century, while few of us are Olympic athletes, sport and exercise as medicine – and as a scientific and academic discipline – are now more than ever a critical component of a healthy and thriving lifestyle.
Demitri Constantinou, a Professor in the Department of Exercise Science and Sports Medicine at Wits says, “Many will immediately think that Sport and Exercise Medicine is a highly specific and specialised field of medicine looking after elite athletes, but it’s a lot more than that.”
At his inaugural lecture in September 2025, Constantinou, who himself is Greek, said, “We have to acknowledge the Ancient Greeks: Pythagoras was an athlete and the first to prescribe exercise for health. Plato considered physical activity as a sister art of medicine and popularised it. Aristoteles advised exercise for health and risk reduction and he linked cardiovascular physiology with health.”
Sports medicine heroics
Most people are familiar with the Hippocratic oath – the physicians’ pledge to practise medicine ethically. Constantinou says, “Hippocrates, a physician, is known as the father of medicine. He was the first practitioner of physical therapy.”
In the 5th Century BCE, Olympic athlete Iccus, who is considered the father of athletic nutrition, was one of the first to emphasise balancing diet and exercise, says Constantinou. Later, in 785-420 BCE, Herodotus used physical exercise and manipulations as tools for restoring health, while Crates took daily walks to improve diseases of his liver and spleen.
But it was Herodicus in the 5th Century BCE who first combined sports with medicine, pioneering sport and exercise medicine into what would become an academic and scientific discipline.
The field of Sport and Exercise Medicine (SEM) flourished. By the 19th Century, British physiologist Archibald Vivian Hill founded the disciplines of biophysics and operations research, sharing the Nobel Prize in Physiology and Medicine in 1922 for research into the production of heat and mechanical work in muscles.
A century later, in 1928, on Valentine’s Day, arguably fittingly heart-related, physicians from 11 countries founded the Association Internationale Médico-Sportive (AIMS) today known as FIMS, the International Federation of Sports Medicine.
Here in South Africa, a Wits University graduate in 1940, Cyril Wyndham (1916-1987) set up the famous Human Sciences Laboratory of Chamber of Mines Research Organisation. “He worked on physiological problems faced by miners and became the leading international expert on human thermal physiology,” says Constantinou. “By 1975, he had published over 250 papers on applied physiology.”
By the turn of the century, the BMJ Open Sport and Exercise Medicine Journal, which was established in 2015, highlighted the field of SEM in its call for papers. Five years later, in March 2020, the Health Professions Council of South Africa formally recognised SEM as a medical speciality in the country – and not a moment too soon ...
Pandemic of inactivity
According to the World Health Organization, inactivity (‘inexercise’) causes some five million deaths per year globally. “In South Africa, inactivity is even worse,” says Constantinou. “Even though we see a decline in communicable diseases, there’s an increase in non-communicable diseases and part of the problem is obesity. There has been a significant increase over the past three decades, particularly of black females – who are obese, not even overweight. And it starts early in life.”
Systemic inequality and the fact that obesity is “not seen as a public health priority, but should be” contribute to this “pandemic of inactivity”, along with a lack of awareness of what SEM is, says Constantinou, who chairs the FIMS Education Commission.
Stronger together
SEM has the potential to get South Africans moving and thriving. In June, Constantinou was a signatory to the 2025 Hamburg Declaration on Sport, Health and Human Performance. The declaration unites a powerful coalition of sports medicine, public health, academic, athlete-representatives, and policymaking organisations in a shared commitment to safeguard health, promote inclusivity and support sustainable human performance across all actors of sport and physical activity.
“Sport and Exercise Medicine is a catalyst for social change,” says Constantinou, who advocates for harnessing the power of sport, for example, the Springboks, to bring people together and promote physical exercise. “We cannot allow only those people with resources to be active.”
We need not all be Olympians but we can aspire to move more as individuals, families and in our communities in pursuit of Faster, Higher, Stronger – Together. This was how the Olympic motto was updated in 2021 to denote that we can only become stronger by standing (and moving) together, in solidarity.?
- Deborah Minors is Senior Communications Officer at Wits University and CURIOS.TY Co-Editor.
- This article first appeared in?CURIOS.TY,?a research magazine produced by?Wits Communications?and the?Research Office.
- Read more in the 20thissue, themed #Thrive, which explores what it truly means to flourish — across a lifespan, within communities, and on and with our planet.