4. ‘) t ; !4 j4 j$wiffi .:: L There
physical 1 from However, functioning, issues exercise, remainder central exercise, to and (1) differences, (3) different can BODY There SPORT, of communist striking as broad century developed athieticism motion The that understanding societies to to have exercise a such outline
Sport, are is consensus ideology examine object physiological linking and about activity Britain, sport patterns EXERCISE sport on a probably of very in as which in societies large for, health. maintenance or the have the and the of terms and this and sport linking the little this and some book, that in the Victorian of relationship and linked to
health some health. beneficial ideology few health of developing social way and AND chapter, examine health. birthplace ‘sport and perspective has the of is expanding sport ideas in of to sport in of the More rather exercise relations been THE from public try democratic is is the the which Almost consequences which which and between critically good physiological its
and with to and specifically, health of ETHOS key written different a near develop and health schools literature with distinctly associated many for exercise health, are in developed all issues physical ideology has universal some the you’. of and as of good has about OF impacts a schoolchildren modern (Mangan, widely this widely typically for both properly totalitarian the in consequences on can respects sociological a THE with health. long health; activity literature societies, the objects the acceptance the physical help and which accepted HEALTHY sports, sport relationships history. sociological been relationship relationship 1981), sets What uncritically to (2) and of societies, sport and has has the in and perspective. control this concerned to an of idea cardiovascular across while is In capitalist long been exercise; scene examine ‘moral’, and these chapter ideology particularly nineteenth that approach there accepted between between between the exercise obesity. been written a for social range sport with pro The are: was and and is the the an of a area the example, 12 express for the education Board exercise
Virtually ‘the schoolchildren fit. healthy sport stressed medalist today’s
Health, noted and while Health
Health tion associated
in to active Sporting fashion,
benefits
concern Irish there involvement Change participation
an and 30
1994),
Such
Such elementary its
. children
School
the Sport
of . health authoritative minutes
semi-official
Authority
is the .
Young of
Department
that concern
are
The lifestyle
In
purpose
health-promoting society’ when views are of Education
health
a
while by
Education, note of
Sebastian in statements the
across all Center Nation
and addition,
for
report
‘major
with the
regular Child,
sport. associated
Allied
Ireland,
and in those
English and of
in of
that
they
have the in
today; school health
the to Nation schools’. for
benefits
(foreword
them,
physical of (1997:
regular
all
moderate for sport
fitness
(1997: Active?
physical from
health
health
the
health report when
involved
adults improving Dunbar
Surgeon Authority,
and did of Coe:
most
levels been
regularly
a Disease
are
Sports
a
curriculum
with
Education annual
strategic 92 and
(1992)
sport study
an
2—4) moderate
physical
of
3),
Throughout
physical message
activity’, ‘Sport
benefits
endorsed children,
policy
not
publications and are
of
from
of
educators.
to per
independent
physical
activity
physical health
points
National
General’s Council, in
Irish schoolchildren,
Control
Mottram, has
and for
well
made
even the
report confined
1992)
similarly cent
sport;
is plan
the framework
the
activity.
in
to education
suggested
(1997), exercise medical, exercise.’
and seems
is established’ an society to
82
life-enhancing over
reference on the agreed
activity’
American
be widely
Sports
activity
what Colquhoun
drawn
and
in of the
recommended integral
per
Fitness
to
report, the
in
most
gained early 1988).
team
to noted
its many
the
to
More inter-war
quote
cent,
at the it
Britain. document
has
it
physical
strategy
that
Council
(1998) known Britain. Not was
that
up
is calls be
(1997: Chief the
and twentieth to
for
days
(Smith
part Department Survey
Physical
while
a years a
in
College
noted agreed
recently,
the by
well
the introduced it
number surprisingly,
lack number and
‘the
young is the
Ireland
the
was has In
Medical of of the and
period, one importance
document and
6). (1995:
that
In
the in former goes
and Kirk
‘well
known
of health
that idea a (Sports
the 1988,
that
also
century,
Sport In
Activity a accepted
of which important
Targeting healthy
hygiene same
general
people. the
of
adults
of variety through Jacobson,
on
the
(1987:
week rehearsed’
Sports of
128) there they that
drawn
The health as
Officer
health
Health Olympic
to benefits
The Section
the
United
Health by
organisation
Council is England,
a
of
suggest
it
should
felt and noted
sport lifestyle Health
frequently subject
fitness provision (Wimbusl by
of In
‘is 100),
idea
children.
‘had
physical
increase Nation’ Medicin attentiol
to
benefits
Sportin.
benefit
British
fit
officia] of
Educa
1988). seriou simila
Heah
State healtl
of
of
in keep
gold
that
and that
and
the for
the
anc talc
tht
an
in
of
th th
at it in tivity d :ise r ritegral to :ise.’ )er reed is )orts idren, •erence )f :he e olquhoun port, most [erican he ty ‘ork y. idely commended ‘), awn ical, ation gained sted vity’ itness
lat enhancing lished’ in
to 1988).
its team noted
many early
the
More
at it to document
quote the
cent,
it Britain. inter-war has
strategy
Britain. (1998)
physical
that
that Council up Not is (1997: known the calls
was
days
for
be
Chief
Physical
and
(Smith to
Survey twentieth Department
while part in
College a a
noted years
by
recently, agreed
lack
number the
number the well
it
‘the surprisingly, Ireland young
the introduced
is and
of has the
the
In
was of 6).
that document
and Medical
one In
goes
importance period, the (1995:
and
in
former ‘well
and
of
the that health
Kirk
(Sports known
a 1988, also
idea Activity In Sport
that
of
a Targeting
century,
which
general accepted same important
healthy adults people.
the
through of
hygiene on
of the
Jacobson, variety week
rehearsed’
Sports
there
of
drawn
(1987:
they 128)
health that
health
to Health The
as
benefits Officer Section Olympic
United
The
Health
organisation, the England,
Council
by
is
suggest should
and a
(Wimbush, fitness of
felt
lifestyle it noted
In ‘is frequently sport
Health
of by subject
provision
Medicine increased
idea
attention
children. 100),
Nation’s
Sporting
benefits, physical ‘had
to
benefits
Educa serious
official Health similar
fit British
1988), States,
of health
of
of
in
keep
gold
take
that
that that
and and and and
the the the the for
an its
of in in
‘significant (US amount Canada, Canada examinatiot health
developed ment in ation-bui1ding on maintain functions many Elsewhere, Bolshevik regular
but following by placed medical This when
sport,
relatively health 111). during from
late to were
because She and female
functions participation and
Such
developing
However, hygiene
which
Department
their Sheila
effective
nineteenth-century
policy, of consequently restricted argues
benefits
taking he such
chronically
and views
‘on
is
(Donnelly
of participation
a much
health.
work, sport,
health.
health
of
called of
very world. discussion
to
the Revolution
Fletcher
recently physical health as
and
the
build
Riordan
states menstruation
state-run of —
which
that,
it educate
societies part are
requiring
of
victory
of
means
in widespread,
need and might not and
sporting Canadian health;
must
upon of
Patricia
.
physical
Riordan,
the
not
cycling, up
.
and
in
benefits
‘Not sport have weak
Health the
(1987:
safe-guard only national dates come
activity
to paper
the
nineteenth vigorous
take
people in
be limited of (1981:
the sport of
in frequently
Harvey,
public’s indeed,
prescribed promote
Britain, justified
opportunities’ infrequently,
Vertinsky improving physical
noted
the
people’s for comes October
and activity.
from
swimming, Chinese data had
to first
for
prepared
and 145)
the can
in
integration
on
communists
in the
to
be
18)
had example,
a the modernising exercise,
that Riordan place’,
had
view
1950, attitude 1996)
Human hygiene,
writes:
capitalist century, most, has under the strong national be
place
consequences applied
exercise
health’
and/or
1917, health people
has
(1990:
only
health
although
similarly
practice for
obtained
similarly that
golf
medically
was
and noted
(ibid.,
considerable
if
‘The the
effect
pointed
towards which (1986: Health has
but
Services,
finite
nutrition
the
women
delimited of
sports, in to sport not (Clumpner
to Sport,
39), societies, and
standards as
he
endorsed
aegis societies,
pointed mothers, also
widespread China that
of
‘promote
women
the new p.
‘one
goes identified upon
all, noted
by hockey in was mental
291)
viewing
which
Canada is
1).
defined
health
female ideology for
out expand
the were
describing
of good 1996:
Soviet
days
and — including on
levels
in
the often
or
stress
the out
argues by rapidly
relatively
that
the most and
that
infants as
that,
to
1949,
physical sport in
and
to
actively
exercise’.
medical and
female
several for Mao and
exercise effects
of
notion that notions
10),
well point
public
of Government
the health
seen
women’s Pendleton, countries
linking
to
on
comprehensive
the health that physical
physical
ideology
following the Active
and
can emphasis
and promote
governments late
a
in argued the
as
physiological as
out inexpensive it
discouraged that culture significant
week’, profession’s
situation health moderate
June
‘of
and
ministry’.
of a
can Similarly, have
children’. develop men, sport
nineteenth damaging
has
channel that
Living
growing
all in
optimal women
activity
energy
sport.’
1981: have that
1952
and
saw
the was only 13
the for and
and the
in and
for, ‘in
in who, century
sport over-indulgence 14 THE (S. It the 1987).
cise frequently
countries of physical importance
activity tion
and suggests, (1991:
earlier, the Canada physical re-emergence Britain.
tion school these health-related the suggest, what perhaps to subject. presents are of
is
This
Colquhoun
However,
more draw
Crawford,
‘fitness
health-based
introduction
prevalence are Sport perhaps
often
of curriculum
in profession
IDEOLOGY
has
might they
5) is,
physical was
1899,
a
has
health-promoting,
in
and
However,
conscious
have
upon educators’ a
education new
in
effectively similarly
is
has
considered of
and
conflated
very industry’
achieving
met
had hope however,
the
indicated
course,
not the
Coiquhoun
be argued
written
of
health
and influenced issues,
health
the 1987),
of
partial
in
developed with
education in
USA.
an
surprising health
guides
of
added physical
will
heart
athletics.
prestige Kirk OF
of been
teaching
Kirk
physical
association
views
not
which have
the
marketing
that consciousness
resistance
more
including and
the
of
since
by Canada
‘HEALTHISM’ be and
matters
a disease (1987)
in
concepts
documented the
an
and
this women relatively
(1991)
generally new
maintaining
the
a
of
education marks though world,
‘academic’ associated
distorted that
several
have The they ‘explosion’
health-related education more
fact
their
re-orientation
Colquhoun
burgeoning
role
have a
from
with (Lenskyj,
and
to those
their
resistance
has
growing
directly
were
a
of
promoted that have
it
professional
occupy for
secure
low
in countries,
supported
new
the
view identified
might
fitness, eugenists
health
suggested
for
(HBPE)
society with
involved
subjects,
physical services.
in
AND
health.
in
many
of been
status
spiralling
moment
danger
nineteenth-century
affect
the of
societal
1987)
interest
and
have
to
a
number
medicine be
issues,
and
health
the
of
place recent
the
VICTIM-BLAMING
at
women’s
primary
of
the physical especially
is
noted such several
In
education,
in
have
‘intellectual’
physical
that mission
Perhaps
every
large’
causes
suggested of
medicine
their
and not
in
role
what
interest idea this
costs
from
of
an
neutering
and
as developments
of
both
this
that
been
and
unproblematic, central
processes
America subject
Dr
schoolchild (1989: explosion
school
context,
that
professional
of
full
of
education
is
of the
beauty
and
education
Britain,
emerging
of
science
Arabella the
such
health
in
which, sometimes
more
reaching
regular
medical
participation
that
sport
physical
health rather
basis
in New
themselves
importance
417). production
curriculum
vis-d-vis
people
the
as
which,
Coiquhoun (Vertinsky,
than
‘the
and
which, to
as
Australia, and
in
Zealand
in Kenealy a teachers,
for
physical
ideology care.
towards matters,
produc
back
provide we
greater
articles
educa school
means
illness.
called
happy recent
many
for exer
have
what
their
they
saw
by
To
in
he
to
of in in
it I
Sport, health and ideology 15 ugenists such as Dr Arabella Kenealy raWing uP0 R. Crawford’s (1980) concept of ‘healthism’, Colquhoun in danger of neutering themselvesby argues that HBPE is premised upon and helps to disseminate the idea that ance to women’s full participation in our health is largely under our own control. More specifically,he argues for nineteenth-century New Zealand that ‘by focusing on individual lifestyle as the major determinant of an :yj, 1987) and America (Vertinsky, individual’s health, health based physical education (HBPE) conforms to the practices of conventional health education and has therefore been severelyrestricted in its potential for emancipation, social justice, equality and social change. Indeed, the political issues which accompany HBPE AND VICTIM-BLAMING have not yet been fully exposed’ (1991: 6). The ideology of healthism, it is argued, serves to focus attention on indi involved in what is sometimes called vidual responsibility for our own health and, simultaneously, to divert ported the idea that sport and exer attention away from wider social processes — for example, poverty, un iight be noted that such people have employment,industrial pollution, or the poor quality or lack of accessibility mess, health and beauty as a means of health services — which may be associated with high levels of illness. By services. Perhaps of rather greater thus shifting responsibility for health away from manufacturers, govern tly affect every schoolchild in many ments and other powerful groups, the ideology of healthism diverts been recent developments in school attention away from the key issues in the politics of health. As R. Crawford noted the role of regular physical (1980: 368) has noted, it perpetuates the misleading — or, at best, greatly health. In this context, Colquhoun oversimplified— idea that we can, as individuals, control our own existence. of interest from the physical educa Moreover, our assumed ability individually to control our lives gradually ated issues, an explosion which, he becomes transformed into a moral imperative to do so for, suggests Lingnumber of professional articles R. Crawford (1984), we live in an era of a new health consciousnesswhere intries, especially Britain, Australia, to be unhealthy has come to signify individual moral laxity. Thus slimness signifiesnot only good health but also self-discipline and moral respons physical education, which, as we saw ibility, whereas fatness, in contrast, signifies idleness, emotional weakness ealth and medicine reaching back to and moral turpitude. In this sense our bodies, whether slim or obese, signify in the primary school curriculum in not merely our health status for they also become, quite literally, the un have suggested that ‘the recent embodiment of moral propriety or laxity. Within this context, those who upy a place of central importance in fall ill are increasingly likely to be seen not as unfortunate and innocent vic v moment in both the production of tims of processes beyond their control but, rather, as people who, through fessional mission and in the produc their moral laxity and lack of self-discipline, have ‘brought it on them ociety at large’ (1989: 417). selves’. The Victorian differentiation between the ‘deserving’ and the entified several processes which, they ‘undeserving’poor is, in some respects, in the process of being replicated in ation of physical education towards the differentiation between the ‘deserving’and ‘undeserving’sick. Lngsocietal interest in health matters, spiralling costs of medical care. To many physical education teachers, SPORT AND HEALTH: COMMERCIAL LINKS status of their subject vis-d-viswhat mbjects, have been more than happy One area which casts doubt on the assumed close relationship between vith medicine and science to provide sport and the promotion of healthy life-stylesis that of sports sponsorship ire and ‘intellectual’ basis for their and, in particular, the widespread sponsorship of sport by the manufac turers of two of the most widely used drugs in the western world: alcohol iggested that this emerging ideology and tobacco. In relation to the former, concern has been expressed about E-{BPE)is not unproblematic, for it sponsorship of sport by breweries. Dealy (1990), for example, has drawn w of the causes of health and illness. attention to the health problems associated with alcohol abuse and with 16 Sport and health the widespread practice of under-age drinking in the United States and has expressed concern at the close relationship between the National Collegiate Athletic Association (NCAA) and the breweries. It is, however, the relationship between sport and the tobacco industry which has been the cause of greatest concern. Taylor (1985) has pointed out that from the 1970s, business sponsorship of sport grew rapidly in Britain with the tobacco companies being by far the biggest spenders. Sports sponsorship, he notes, has been a relatively cheap and highly cost- effectivemeans of advertising for the tobacco companies, not least because in Britain it has enabled them to circumvent the 1965 ban on the advertising of cigarettes on television, for cigarette manufacturers have continued to reach large television audiences via the televised coverage of such popular sporting events as the Embassy Snooker World Championships, Benson and Hedges Cricket and the Silk Cut Rugby League Challenge Cup. Sponsorship of sporting events by tobacco companies has for many years been widespread; sports which have been sponsored by tobacco companies in Britain include motor-racing, power-boat racing, cricket, speedway, snooker, darts, bowls, horse-racing, tennis, rugby union, rugby league, basketball, badminton, show-jumping, motor-cycling and table tennis. Sponsorship of sporting events by tobacco companies is, of course, not confined to Britain. In 1982 Dr Thomas Dadour introduced into the Western Australian parliament a Billto ban all forms of cigarette advertis ing and promotion. The Bill was narrowly defeated. Had it been passed, one of the first casualties would have been the advertising at the Australia vs. England test match, which was sponsored by Benson and Hedges who had been the Australian Cricket Board’s main sponsor for more than ten years. The following year, the state Government of Western Australia intro duced another Bill similar to Dr Dadour’s. This Bill was also defeated following intensive lobbying by, amongst others, those associated with the cigarette-sponsored sports under threat (Taylor, 1985: 48—9).In a perhaps even more revealing incident in 1995, the highly successful Swedish yacht Nicorette, which is sponsored by a company which manufactures products designed to help people give up smoking, was banned from the Cape to Rio race, which is sponsored by the tobacco giant Rothmans. The captain of the Nicorette protested against the decision (which was reversed some two weeks later) by saying that ‘Rothmans is scared of his boat and the healthy lifestyle it seeks to promote’. Given the close relationship which is often claimed between sport and healthy life-styles,many people may find it more than a little incongruous that the organisers of a sporting event should not only accept sponsorship from a cigarette manufacturer but that they should also ban an entry sponsored by a manufacturer of products which are explicitly designed to help people give up smoking (The Times, 14 September 1995; Guardian, 27 September 1995). The widespread sponsorship of sporting events by tobacco companies would not, at least in the context of the present argument, be of any Sport, health and ideology 17 rinking in the United States and has significance were it not for the fact that, by the early 1980s, cigarette hip between the National Collegiate smokingwas estimated to be responsible for more than 300,000 premature rewerieS. deaths a year in the United States, and nearly half a million deaths a year een sport and the tobacco industry in Europe. The US Surgeon General has described cigarette smoking as :oncern. Taylor (1985) has pointed ‘the chief, single, avoidable cause of death in our society, and the most onsorship of sport grew rapidly in important public health issue of our time’, while in Britain the Royal being by far the biggest spenders. College of Physicians, in their report Smoking and Health Now, referred a relatively cheap and highly cost to the annual death rate caused by cigarette smoking as ‘the present holo )bacco companies, not least because caust’ (Taylor, 1985: xiv, xvii). More recently the British Government, in vent the 1965 ban on the advertising its consultation paper Our Healthier Nation (1998: 20), has pointed out :e manufacturers have continued to that smoking ‘isthe biggest cause of early deaths in England. It is estimated televised coverage of such popular to account for nearly a fifth of all deaths each year — 120,000 lives in the ker World Championships, Benson United Kingdom cut short or taken by tobacco.’ Without labouring the Ut Rugby League Challenge Cup. point, one might reasonably suggest that the ideology which associates acco companies has for many years sports with healthy life-styles sits uneasily with the widespread accept en sponsored by tobacco companies ance of sports sponsorship by breweries and, even more so, by tobacco 7er-boat racing, cricket, speedway, companies. tennis, rugby union, rugby league, There are, however, clear signs that the relationship between sporting motor-cycling and table tennis. organisations and the tobacco companies will, at least in Britain, have to obacco companies is, of course, not change in the next few years. Within three weeks of the Labour Party’s omas Dadour introduced into the general election victory in May 1997, the new Health Secretary in the ) ban all forms of cigarette advertis incoming Labour Government announced that the Government intended owly defeated. Had it been passed, to legislateto ban the sponsorship of sports events by tobacco companies. been the advertising at the Australia It is interesting to note that, rather than reporting this decision as good )nsored by Benson and Hedges who news in terms of health policy, some papers chose to report it as bad news l’s main sponsor for more than ten for sport: The Times, for example (20 May 1997) reported the story on its ‘ernment of Western Australia intro- front page under the headline ‘Cigarette adverts ban could kill top British dour’s. This Bill was also defeated sports events’, and it began its report by saying that ‘Top sports events gst others, those associated with the could be forced out of Britain or left impoverished if a Government pledge (Taylor, 1985: 48—9).In a perhaps to outlaw the sponsorship of sport by cigarette manufacturers goes ahead’. the highly successful Swedish yacht The Government had originally proposed that all sponsorship of sporting npany which manufactures products events would be required to end by the year 2003, but it subsequently dng, was banned from the Cape to decided that Formula One motor-racing should be given an extra three >baccogiant Rothmans. The captain years — until 2006 — to find alternative sponsors. The draft legislation, decision (which was reversed some which was announced in June 1999, also gave a similar extension to the imans is scared of his boat and the snooker world championship, organised by the World Professional Billiards 3iven the close relationship which is and Snooker Association (The Times, 18 June 1999). :hylife-styles,many people may find the organisers of a sporting event )m a cigarette manufacturer but that EXERCISEAND HEALTH )red by a manufacturer of products people give up smoking (The Times, There is now a substantial body of data from both epidemiologicaland clin tember 1995). ical studies which indicates that moderate, rhythmic and regular exercise )rting events by tobacco companies has a significant and beneficial impact on health. In Britain, the Royal )f the present argument, be of any Collegeof Physicians of London (1991: 28) concluded that: —U
1- II
j.
18 the
• •
• • • •
•
regular cardiovascular Studies al.,
depression (two Department association together, and health The tion can statistics pressure, pharmacological indicates Similarly, men lar the whelming.
More
It
At
lower reduced and
possible better maintenance decreased health controlled benefits
anxiety.
There psychological ing, value tive
Sport
exercise
1986;
Authority might
health-based
health carried expect British
whose
first
benefits
non-insulin-dependent
exercise
jogging, recently,
in in
levels
control in
that is
for benefits indicate and
and
one glance,
prevention Blair North
be
risk
(Stephens, protection
substantial Donnelly
for the
lives from
between
out
Medical
to
are
levels
of
the
hypertension,
noted
death
health
of
it
disease in
of
very
management
of
those
live is
in
of dancing
et
the
Health between
are of
the health. noted
Britain.
method
first all-cause America
of studies
decades
associated
arguments developing
Canada
that
healthy
al., of
obesity;
Health
similar
rates
that
regular
more
about
studies
physical Association,
and moderate
with of against
1988).
time, and
evidence
1989),
that
men
or
Regular
and
some
coronary
like
among
one-third
of
sedentary. Harvey
mortality; of and
point
from bones
Education
swimming to
fifteen
existing
hyperlipidaemia,
physical
in what
of
regular
with
lowering
those with
The
some diabetes coronary
American
in Human
those
while
of
the
activity
two
obesity
depression that
cancer
men
to exercise
favour
these and
reduced
has
report United
for
(1996:
disease
years
in cited only
cancers;
and
regular
identified similar
diseases, activity
exercise
a
the
whose
Authority
possible
is
mellitus;
example,
been
and
blood Services, review health
heart
and
of
one-half
beneficial
research,
above
moderately
of
United
less
of appears
States
5)
combined
and
and mortality
diabetes.
aerobic
conclusions,
learnt
sport
lower as
the
work
have mild disease,
‘is pressure’
benefits
above particularly
than
prevention of
anxiety;
follows:
might
osteoporosis
(1996:
(Paffenbarger
States),
has
US
potentially
1996)
lower
four
to
to
and
depression
or
and
noted,
about
levels
exercise
men
from
Surgeon
by
be
noted sites
general
high
stroke,
leisure
seem
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Sport, health and ideology 19 gular aerobic exercisesuch as walk- that the ‘numerous, almost miraculous claims for the benefits of physical is beneficialto general physical and activitylead one to wonder why it has not been patented by an innovative ;ise appears to be particularly effec company’, but, more seriously, they go on to point out that the wide ease and osteoporosis and of some spread nature of these claims should serve as a warning against their too and diabetes. easy and uncritical acceptance, and that the context of the claims needs to be examined carefully. In this context, there are some important provisos Authority (1996: 1) has summarised to be borne in mind when considering studies on the relationship between ctivity as follows: exercise and health. The first is that these studies do not suggest that all exercise is beneficial; rather, they indicate that exercise of a particular kind, amount and intensity has a beneficialimpact on health. The Nation’s r heart disease, stroke, hypertension Health (Smith and Jacobson, 1988: 126), for example, refers quite specifi mellitus; callyto the beneficial effects of what it calls ‘moderate, rhythmic and regu lar exercise’,which it goes on to define as exercise such as that involved in cers; brisk walking, running or swimming for 20—30minutes about three times don and anxiety; each week. The British Medical Association (1992: 14) similarly suggested possible prevention of osteoporosis; that the ‘recommended amount of exercise from a health perspective is seases, particularly for those with about twenty to thirty minutes of moderate exercise three times a week’. It emia, mild depression and chronic noted that the exercise that is most frequently suggested is brisk walking, and added that the level of activity which produces significant health bene fits ‘is related to the initial level of fitness: for the middle-aged sedentary nilar conclusions, and suggest that individual, this may correspond to walking, cycling slowly or gentle swim iced mortality from all causes, from ming’ (1992: 14). The precise activity which is considered to constitute of combined sites (Paffenbarger et ‘adequate’ exercise varies from one study to another, but activities men review of four population surveys tioned in this context include ‘energetic getting about’ and manual work he United States), suggests a positive around the house and garden (Morris et al., 1980), dancing (BMA, 1992) and lower levels of anxiety and and regular climbing of stairs (Paffenbarger et a!., 1986), while the US rt of the US Surgeon General (US Surgeon General (US Department of Health and Human Services, 1996) Services, 1996) claimed to bring recommends as examples of moderate activity washing and waxing a car, been learnt about physical activity washing windows, gardening and raking leaves. i research, and produced a list of It is important to emphasise, therefore, that what these studies have docu mtified above by the Health Educa mented is a beneficialeffecton health of ‘moderate’,or even gentle, forms of exercise; as Morris et al. noted, the activities which were defined in their health benefits are very substantial. study as constituting adequate exercise were ‘by no means extreme’, and example, has noted that insurance they added, of the 17,944 men who took part in their study, that ‘our men y moderately high blood pressure are no athletes’ (1980: 1210). The British Medical Association similarly rs less than men with low blood noted that several studies, and ‘particularly those from North America, :ercise ‘is potentially a major non- have suggested that only rather low levels of activity are necessary to blood pressure’ (BMA, 1992: 18). confer some degree of protection against heart disease both in terms of :edStates (Paffenbarger et al., 1986) the intensity of effort and of the total amount of exercise taken’ (BMA, vhosework or leisure involves regu 1992: 19). I one-half lower than those among This is an important point to note for, quite clearly, one cannot assume that the health benefits associated with moderate exercise will simply be d above might seem to indicate that duplicated — still less can one assume that they will be increased — by r of sport and exercise are over- exercisewhich is more frequent, of longer duration and of greater intensity, 6: 5) have noted, tongue-in-cheek, for exercise of this kind, as we shall see later, may generate substantial 20 Sport and health health ‘costs’in terms of additional stresses or injuries (for example, those associated with ‘overuse’). In short, to suggest that a 30-minute gentle swim three times a week is good for one’s health does not mean that run ning 70 miles a week as a means of preparing for running marathons is good for one’s health in an equally simple or unproblematic way. Indeed, it might be noted that one of the American studies, which found that death rates generally went down as levels of physical activity increased, also found a reversed trend at the highest levelsof physical activity. The authors note that this result may have been associated with methodological difficul ties in the study, though they also recognise that it may reflect ‘actual increased hazards associated with vigorous activities’ (Paffenbarger et a!., 1986: 606). It might also be noted that one study in New Zealand (Sullivan et a!., 1994) — significantly, it was a study of competitive athletes, many of whom were ranked in the top 10 per cent nationally in their age group and might therefore be expected to have engaged in relatively intensive training — found a strong positive association between exercise and a large number of symptoms, including anxiety related to competition, stitches, lightheadedness, muscle cramps, wheezing, chest pressure, spots in front of eyes, retching and incontinence of urine and stool, while it was negatively associated with only a few symptoms, including headaches, abdominal bloating, sneezing and depression The second proviso concerning the studies cited above is that most relate primarily to physical activity or to exercise, rather than specificallyto sport. Although sport and exercise are overlapping categories, there are nevertheless important differences between them, and these differences have important implications for their health consequences. It is to these issues that we now turn.
EXERCISE AND SPORT
Most sociological definitions of sport include the element of physical exertion as an essential component (Edwards, 1973; Guttmann, 1978; McPherson et a!., 1989). However, if all sport necessarilyinvolvesphysical exercise, it is not the case that all physical exercise involves sport, for what is usually considered a further necessary component of sport — the competi tive element — is frequently more or less absent from many forms of physical exercise. Moreover, since sport is inherently competitive, it must involve more than one person, for while one can exercise alone, one cannot play sport alone, since one needs an opponent. This relativelyobvious difference between sport and exercise has important implications for their potentially very different health consequences. As we have seen, most of the studies cited earlier were concerned with the health consequences of ‘moderate, rhythmic and regular’ exercise. One Sport, health and ideology 21
:ressesor injuries (for example, those important difference between sport and exercise is that non-competitive to suggest that a 30-minute gentle exercise involves a rather different pattern of social relations than does one’s health does not mean that run- sport and, associated with this, the former is much more likely than is the preparing for running marathons is latter to involve physical movements of a rhythmic nature and, of critical imple or unproblematic way. Indeed, importance, the intensity of the exercise is likely to be, to a much higher rican studies, which found that death degreethan in the case of sport, under the control of the individual partici of physical activity increased, also pant. Consider, for example, the situation of a person who regularly takes evelsof physical activity. The authors a brisk walk, or goes jogging or swimming, as a means of ‘keeping fit’, or ociated with methodological difficul perhaps as a means of weight control. When such activities are undertaken recognise that it may reflect ‘actual alone, as they frequently are, the precise nature of the physical movement — ;orous activities’ (Paffenbarger et a!., that is, the action of walking, jogging or swimming — as well as both the t one study in New Zealand (Sullivan duration and the intensity of the exercise, are to a high degree under the cudyof competitive athletes, many of control of the individual involved in the exercise. Thus, for example, a r cent nationally in their age group person jogging or swimming alone can determine for how long to continue have engaged in relatively intensive the exercise, and at what pace. Where exercise of this kind is undertaken ciation between exercise and a large in a small group of perhaps two or three friends, as is also conmion, the iety related to competition, stitches, duration and intensity of the exercise are likely to involve a level of activity ezing, chest pressure, ‘spots in front agreed upon by all participants and with which all participants are reason of urine and stool, while it was ably comfortable. It is important to note that this is not the situation in the w symptoms, including headaches, case of sport. ression. As we noted earlier, sport cannot be played alone for it must involve two 3tudiescited above is that most relate or more opposing players. This, together with the fact that sport involves exercise, rather than specifically to not only co-operation but also, and in a highly institutionalised form, com ire overlapping categories, there are petition, means that sport, and particularly team sport, is usually a con etween them, and these differences siderably more complex social activity than is non-competitive exercise. health consequences. It is to these Consider, for example, a game of soccer or rugby or American football. The game involves a complex interweaving of the actions of a substantial number of players, together with the relationships between players and match officials,club coaches and many others, including, at the elite level, large numbers of fans. Even if we considerably oversimplify the situation by confining our analysis solely to the interactions between the players, rt include the element of physical it is clear that we are dealing here with a social phenomenon of some (Edwards, 1973; Guttmann, 1978; complexity. Elias and Dunning (1986: 193) drew upon the example of all sport necessarily involves physical Association Football (soccer)to illustrate what they called the ‘dynamics of ;ical exercise involves sport, for what sport groups’. They wrote: ry component of sport — the competi s absent from many forms of physical From the starting position evolves a fluid figuration formed by both ierently competitive, it must involve teams. Within it, all individuals are, and remain throughout, more or can exercise alone, one cannot play less interdependent; they move and regroup themselves in response to ent. This relatively obvious difference each other. This may help to explain why we refer to this type of game tant implications for their potentially as a specificform of group dynamics. For this moving and regrouping of interdependent players in response to each other is the game. cited earlier were concerned with the It may not be immediately clear that by using the term ‘group hythmic and regular’ exercise. One dynamics’ in this context we do not refer to the changing figurations 22 Sport and health
of the two groups of players as if they could be considered in separa tion, as if each had dynamics of its own. That is not the case. In a game of football, the figuration of players on the one side and that of players on the other side, are interdependent and inseparable. They form in fact a single figuration. If one speaks of a sport-game as a specific form of group dynamics, one refers to the overall change in the figuration of the players of both sides together.
One aspect of the complex structure of sports such as football is that each match tends to develop what is often called a ‘gamepattern’. Though there is sometimes a tendency to speak of this game pattern as though it were something separate from the players, it is important to remind ourselves that it is in fact nothing other than the complex interweaving of the actions of a large number of players. However, it is also important to note that, as the game pattern becomes more complex — for example, as we move from a two-person game such as tennis to a multi-person game such as soccer — it becomes increasingly beyond the ability of any single player to control this game pattern and, indeed, from the perspective of any single player, this game pattern may appear to have a life of its own. An associated aspect of the complex structure of many sports is that, in comparison with non-competitive exercise, any individual player is much less able to control their own movements and the pace and intensity at which they are required to play. Thus while the lone jogger and walker can determine their own movements with minimal reference to others, the movements of, for example, a soccer or rugby or ice-hockey player can only be understood in relation to the movements of other players on their own and the opposition side. Moreover, as a means of beating opposing players, players frequently initiate moves, or respond to the moves of others, involving rapid changes of pace and direction. In most sports, this gives rise to a pattern of movement which is the very opposite of rhythmic, for it often involves sharp and intensive bursts of activity, interspersed with short periods in which individual players may be able to take a ‘breather’. It is important to emphasise, first, that the frequency and intensity of these bursts of intensive activity are, at least in complex games, largely beyond the ability of any single player to control; second, that players are almost inevitably constrained by the moves of their opponents to engage in activities which are anything but rhythmic; and third, that many of these movements, such as those involved in rapid acceleration and deceleration, or the twisting or turning movements involved in rapid changes of direction, impose considerably greater stresseson the body than do the much more rhythmic movements involved in non-competitivewalk ing, jogging or swimming. These considerations, however, do not exhaust the health-related differences between sport and exercise. The competitive character of sport, in particular, requires further elaboration. Sport, health and ideology 23 if they could be considered in separa SPORT AND COMPETON )f its own. That is not the case. In a of players on the one side and that Dunning (1986a) has pointed out that the growing competitiveness of interdependent and inseparable. They modern sport is a long-term trend which may be traced back over two or • If one speaks of a sport-game as a more centuries. This process has, however, been particularly marked in the s, one refers to the overall change in ost-19 period, and has been associated with, amongst other processes, oth sides together. 4Sthe increasingpoliticisation and commercialisation of sport, both of which havehad the effect of greatly increasing the importance of, and the rewards of sports such as football is that each associated with winning, while downgrading the traditional value asso called a ‘game pattern’. Though there ciated with taking part (Waddington and Murphy, 1992). This trend this game pattern as though it were towards the growing competitiveness of sport has not, however, been with ;, it is important to remind ourselves out significanthealth ‘costs’ for athletes, most particularly in the form of ie complex interweaving of the actions more stress injuries and overuse injuries, and increased constraints to con er, it is also important to note that, as tinue competing while injured (for a detailed example, see the situation in plex — for example, as we move from relation to professional football in England, described in Chapter 4). a multi-person game such as soccer — A common sight in many sports is that of the trainer or physiotherapist ability of any single player to control running on to the field of play to treat an injured player, often by the appli i the perspective of any single player, cation of an aerosol spray to a painful area, thereby enabling the player to e a life of its own. continue. However, as Donohoe and Johnson (1986: 94) have pointed out, ex structure of many sports is that, in one of the functions of pain is to “warn” us that we need to rest the ercise, any individual player is much damaged area’, and they suggest that most athletes and coaches ‘fail to ments and the pace and intensity at recognizethe damage that can be caused by suppressing pain’. This issue is ius while the lone jogger and walker part of the more general concern about overuse and recurrent injuries, a with minimal reference to others, the growingproblem which is clearly associated with the increasing constraints r or rugby or ice-hockey player can on sportsmen and women to compete and more particularly to win with, movements of other players on their one suspects, often scant concern for the potential longer-term health risks. over, as a means of beating opposing Donohoe and Johnson (1986: 93) have noted that to ‘succeed in modern moves, or respond to the moves of sport, athletes are forced to train longer, harder, and earlier in life. They ace and direction. In most sports, this may be rewarded by faster times, better performances and increased fitness, vhich is the very opposite of rhythmic, but there is a price to pay for such intense training.’ Part of the price of such nsive bursts of activity, interspersed intense training and of the readiness — often encouraged by coaches and dual players may be able to take a medical advisers — to continue training and competing despite injury, is hasise, first, that the frequency and unquestionably paid in the form of overuse and recurrent injuries, which activityare, at least in complex games, now constitute a serious problem in sport, and not just at the adult - elite ingle player to control; second, that level. As Donohoe and Johnson (1986: 93) have noted, the ‘long-term med by the moves of their opponents effects of overuse injuries are not known, but some concerned doctors iything but rhythmic; and third, that have asked whether today’s gold medallists could be crippled by arthritis tose involved in rapid acceleration and by the age of 30’, and they cite world-class competitors who have, in their Lrning movements involved in rapid words, ‘been plagued by a succession of overuse injuries’. In this respect, rably greater stresses on the body than the preliminary results from an ongoing study at Coventry University are nts involved in non-competitive walk very revealing. Of 284 former professional football (soccer) players who isiderations, however, do not exhaust completed a questionnaire from the University’s Psychosocial Rheuma n sport and exercise. The competitive tology Research Centre, 49 per cent had been diagnosed with osteoarthritis, tiresfurther elaboration. a percentage which is fivetimes as high as that in similarly aged males in the general population. Of all the respondents 15 per cent were now registered 24 Sport and health disabled while a third of ex-players had, since retiring from professiona] football, undergone surgery for football-related injuries (Hicks, 1998). Examples of athletes with painful and potentially serious injuries whe have continued to compete are almost innumerable. In her autobiography. Olga Korbut, the former Olympic gold-medal-winning gymnast, described how, following the 1972 Munich Olympics, the successfulSoviet gymnas tics team was taken on a tour of what was then West Germany. She wrote: ‘During that tour of Germany, the lumbago in my back began to hun more and more. The novocaine injections took away the pain for a while. but I needed time to rest and heal. By the end of the tour, I walked a though I had a stake in my spine.’ She added that ‘My strongest memories of that entire period are fatigue, pain, and the empty feeling of being a fl) whose blood has been sucked out by a predatory spider’ (Korbut, 1992 81—2). It would be very wrong to imagine that such incidents only occurrec under the now defunct communist systems of Eastern Europe, for example of athletes playing on despite painful and potentially serious injuries ar commonplace and there is considerable evidence to indicate that, particu larly at the elite level, there are considerable constraints on players to pla) through pain and injury ‘for the good of the team’. As Roderick (1998 65) has noted, an important aspect of sporting culture at the elite or pro fessional level involves a ‘culture of risk’, which ‘normalizespain, injuries and “playing hurt”. Consider, for example, the following extract from pre-match team talk to the Wigan Rugby League team by their coach John Monie:
There’s just one more thing I want to enforce. It doesn’t matter what’: wrong with you when you’re injured, I want you on your feet and ii
the defensive line. . . . I don’t care if the physio’s out there and h wants to examine you and all that stuff. That’s not important. What’
important is . . you’ve got twelve team-mates tackling their guts out defending like anything inside the 22 and we’ve got the physio tellin a guy to see if he can straighten his knee out.
I don’t care what’s wrong with you . . . if the opposition’s got th ball, I want you on your feet and in the defensiveline. There are no exceptions to that rule. So from now on, the only reasoi you stay down hurt and get attention from the sideline is becaus. there’s a break in play or you’re unconscious — no other reasons wil be accepted. (Hanson, 1991: 77
Monie’s team talk may perhaps be regarded as the Englishequivalent of th American view that ‘you play unless the bone sticks through the meal which, as Young (1993: 382) has noted, has long been used to rationalis injury in the NFL. Although it may not always be expressed in such blun Ii
Sport, health and ideology 25 s had, since retiring from professional that, particularly at the elite level,there is a common expec terms it iS clear ball-related injuries (Hicks, 1998). shared by many players — that whenever possible players tation — which is il and potentially serious injuries who through injury ‘for the good of the team’, even if should continue to play Dst innumerable. In her autobiography, with pain-killing injections. Hanson reported, for I thismeans playing exam ;old-medal-winning gymnast, described League players frequently played after having been le that Wigan Rugby )lympics, the successful Soviet gymnas Before Rugby League givefl painkilling injections. the Cup Final at then West Germany. She at was wrote: WembleYin 1990, so many players had pain-killing injections that the club lumbago in my back began to hurt doctor, Dr Zaman, came into the dressing room ‘clutching a collection of ctions took away the pain for a while, used syringesand needles’ and asked of a Wembley official, ‘Do you have By the end of the tour, I walked as [used needles]?’ 1991: 193). Don Strock, a box for sharps (Hanson, former he added that ‘My strongest memories quarterback with the Miami Dolphins, has described how players would in, and the empty feeling of being a fly group around ‘injured teammates during a game to screen from spectators by a predatory spider’ (Korbut, 1992: the use of pain-killing injections, then hide the needles under the carpet- likesynthetic“turf”’ (cited in Young, 1993: 376). iine that such incidents only occurred It is clear that experiences of this kind are commonplace among elite ystems of Eastern Europe, for examples players. Some aspects of the culture of ‘playing hurt’ within professional ful and potentially serious injuries are football (soccer)in England are examined in Chapter 4; for the moment, able evidence to indicate that, particu we might note that a survey of 725 professional soccer players carried out siderable constraints on players to play by the magazine Four Four Two (October 1995) revealed that 70 per cent ood of the team’. As Roderick (1998: of players had been asked to play when not fully fit. As Young et al. of sporting culture at the elite or pro- (1994: 190) noted: risk’, which ‘normalizes pain, injuries, example, the following extract from a Overt and covert pressures are brought to bear on injured athletes to Rugby League team by their coach, coercethem to return to action. These may include certain ‘degradation
ceremonies’ . . . such as segregated meal areas, constant questioning from coaches, being ostracized at team functions, or other specialtreat ant to enforce. It doesn’t matter what’s ment that clearly identifiesthe injured athlete as separate. ijured, I want you on your feet and in care if the physio’s out there and he An example of this kind of ostracism was provided by the former Liverpool hat stuff. That’s not important. What’s Football Club manager, Bill Shankly, regarded by many as one of the lve team-mates tackling their guts out, greatest-eversoccer club managers. Shankly refused to speak to any player :he 22 and we’ve got the physio telling who was unavailable to play because of injury (On the Line, 1996). his knee out. Young et al. (1994: 190) argued that ‘Pressure placed on the player to ith you . . . if the opposition’s got the return to action before full recovery is in one sense intended to enhance the Ld in the defensiveline. . team’sability to win, but in the process, the long-term health of the athlete rt rule. So from now on, the only reason is often given little consideration.’ attention from the sideline is because Although such pressures on players to tolerate and to play through pain re unconscious — no other reasons will may in some respects be associated with particular conceptions of mascu linity (to be examined later), it is also clear that there are broadly similar (Hanson, 1991: 77) constraints on women athletes to continue competing despite pain and injury and that many women athletes respond in a broadly similar way to egarded as the English equivalent of the their male counterparts. For example, in comparing their research in ess the bone sticks through the meat’ Canada on female athletes’ experience of pain and injury with their earlier toted, has long been used to rationalise research on the experience of male athletes, Young and ‘Wbite(1995: 51) not always be expressed in such blunt write that ‘Ifthere is a differencebetween the way male and female athletes
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of of 1
Sport, health and ideology 27 ain and injury, it is only a matter of incidents a year resulting in recurrent injuries (Sports Council, 1991: 25). :1women adopt similar techniques to Quite clearly, we are not dealing with a phenomenon which is confined to in their sports lives’. An example of elitesport, but one which is extremely widespread. ovided by the example of D, one of y Young and White: SPORT, VIOLENCE D AGGRESSiVEMASCULINITY I ignored it assuming it would go and pains. Bruising, swelling, and Many sports, unlike most forms of non-sporting exercise, involve physical basketball. Once the pain persisted, contact and are, in effect, mock battles. This is perhaps most evident in the rred to me at the age of 14 that my case of combat sports, in some of which — for example, boxing — a central eded a rest. I simply pushed harder object is to inflict physical damage on one’s opponent. Clearly, however, to fall behind in my progress. the use of violenceis not confined to combat sports, for though the level of (1995: 51) physical violence permitted in sport has, in general, shown a long-term declineas sports have become more ‘civilised’(Dunning and Sheard, 1979; Dunning, 1990), the use of physical violence to a greater or lesser degree remains a central characteristic of modern sport. In this regard, Dunning ye seriously weakened D’s knees and (1986b: 270) has noted that: rtilage tears has left her legs badly ) remains in pain, is unable to play All sports are inherently competitive and hence conducive to the arousal ost daily. of aggression. Under specificconditions, such aggression can spill over (1995: 52) into forms of open violence that are contrary to the rules. In some
sports, however — rugby, soccer, hockey and boxing are examples — nage years suggests that the problem violence in the form of a ‘play-fight’ or ‘mock battle’ between two t confined to adults and, as we shall individuals or groups is a central and legitimate ingredient. is, in health terms, a worrying trend thletic involvement for younger and Many sports have, in present-day societies, become enclaves for the expression of physical violence, not in the form of unlicensed or uncon :ter of much modern sport, it is not trolled violence, but in the form of socially sanctioned violence as expressed recurrent injuries are very common. in violently aggressive ‘body contact’; indeed, in the relatively highly paci nple, have noted that a study of 123 fied societies of the modern West, sport is probably the main — for many found that 37 per cent of all injuries people the only — activity in which they are regularly involved in aggressive sh study of 180 senior male soccer physical contact with others. iries were caused by overuse. FIFA’s The link between sport, aggression and violence provides an important held in the United States, indicated key to understanding why sport is a major context for the inculcation and players were for chronic injuries or expression of gender differencesand identities, for sport constitutes perhaps Cup Finals (Nepfer, 1994: 190). It the most widely available arena for the legitimate expression of masculine Eiinkthat such injuries only occur at aggression and for the display of traditional and dominant notions of that in most western countries sport masculinity involving physical strength and courage. Thus, Young et a!. ompetitive and this has given rise to (1994: 176), drawing upon their interview data with Canadian adult male t the non-elite, as well as the elite, athletes, noted that the use of force and violence and the tolerance of risks, in England and Wales for the Sports pain and injury are valued by many male athletes as masculinising, while juries resulting from participation in the sporting performances of women, gay men and men pursuing alterna ries. On the basis of this study, the tive versions of manliness are, by contrast, trivialised. In similar fashion, md and Wales there are 10.4 million Sheard and Dunning (1973), in their essay on the rugby club as a type of 28
clubs contact cepts also ‘male men Messner
violent to example game with American players self-sacrifice
and lence associated injury (1978: for associated
Zealand rugby
Young
In
injure
Studies
example,
In
pain, that turned and
gay
The Sport
them rugby means
play inclusion are dropped but
such
of
most
stress preserve’,
its for
many
rates
are
than
121)
sports, and
men.
masculinity winning) that injured noted:
and
is
is,
et bellicosity
percentage
sport
(Hume serious
a young
football and
to
substantially are,
with
provided
from
not with al. into
sports,
context,
and
associated
fans these
it
called of to
those
Guttmann which
to
miss
in
(1994)
health was
precisely
in
be
our this that
noted
non-competitive
3.2 several
reinforce a the
injury, and
men
most
England alike,
an
is
injured
list are weapon
who at
‘a relatively
in
most
and
years,
players may
league’s every
predicated involve, by
it
intensely of
Marshall,
pointed
certificate
the
least
that
to
among
with
activities
other relatively
requires,
American above
players pointed times. because and
its are
popular
mean demonstrate
and,
late
masculinity
NFL
which
and
many
similarities
to
one
are
such
not
even
pension
as
violent;
out
what sports confrontational
those
nineteenth
when
The
be
expected
player
on
that
1994)
Wales
incurring Out
injured of a of
game
exercise.
in
sports
is
violent of
while death. sports,
that
football
used central
their
virility,
the
not average
they
that: which
in
the injured,
plan.
bodies
and
it
these similarly
by
is their
any to
a
successful
(Sports long
against
are are violent
songs
injury
is
to see the
injured sports
season
century,
actual
In mocking,
proposition,
injuries
which,
very
other a
the significant
give
more considerably
traditional
length
masculinity.
to are
as relation
enough achievement
badge
manner.
traditionally
‘take
character, the
indicate
human
becomes
such
Council, other
much and
warfare
used
at sport.
is
than
though
utilization
remains,
severe
of
positive
least over
of
not
it
to
to
to
as
a
as
like
bodies,
courage’. that
In
offset the in and
take
qualify
American
body
that American playing
only
once
and
higher
Not
100
weapons
considerably of
what the
enough
arenas
1991)
excess
a
idea
dominant
by
sung
proponents features
‘hard man’.
goals
(1988:
of injury
by
more
the
women,
percent;
each surprisingly,
is
resulting
(1990:
comparison
a
violence
than that
Guttmann
those
career
For
par
player
and routinely in
pain
of
knocks’,
to
football,
A (scoring
football
violent
for,
rates
season,
rugby
161—2)
of
prime
excel
many
‘real’
those cause those
con 203)
New
who
but
and
less
this
the
has
as for
in
of —
in Sport, health and ideology 29 the songs traditionally sung in rugby THE EPIDEMIOLOGY OF SPORTS INJURIES y by mocking, not only women, but Sports injuries are extremely common and, quite clearly, the risk of injury it these traditional and dominant con has to be taken into account in any attempt to assess the health ‘costs’and ntral proposition, the idea that ‘real’ ‘benefits’of sport and exercise. The largest and most comprehensive study intational manner. In the more violent of the number and cost of sports injuries in Britain was carried out by bodies are used as weapons for, as SheffieldUniversitr Medical School for the Sports Council (1991). The study,which related to England and Wales, provides a great deal of relevant information and is worth examining in some detail. )rts, the achievement of goals (scoring A postal questionnaire, which asked about participation in sports and he successful utilization of violence — exercise and injury experiences in the previous four weeks, was sent to a which the human body is routinely sample of 28,857 people, selected at random from the lists of family ed against other bodies, resulting in (primary care) physicians. The response rate was 68 per cent. Of the 17,564 usable responses, 7,829 respondents (45 per cent) had taken part (1990: 203) in vigorous exercise or sport; 1,429 had been injured, and they reported a total of 1,803 injuries (1991: 2). cted to give and to take ‘hard knocks’, From these data, it was possible to provide estimates of the annual injured, to ‘take it like a man’. A prime incidence of sports injuries in England and Wales. On this basis, it was otball which, though considerably less estimated that there were 19.3 million incidents resulting in new injuries enth century, remains, by comparison and a further 10.4 million incidents resulting in recurrent injuries, making it is significant that proponents of a total of no fewer than 29.7 million injuries a year. The direct treatment :hey see as the positive features of the costs of new and recurrent injuries were estimated at £422 million, with es to actual warfare and the pain and costs of lost production (due to days off work) estimated at £575 million, tile injury becomes what Guttmann giving a total annual cost of sporting injuries of £997 million (1991; 25, irility, a badge of courage’. For many 31). In the light of these data, one can understand why one text on lent sports such as American football sports injuries (Vinger and Hoerner, 1982) is sub-titled ‘The Unthwarted ieir violent character, arenas par excel Epidemic’. :e their masculinity. Not surprisingly, Three years after this major study, a team from Sheffield University rts are considerably higher than those Medical School (Nicholl et al., 1994) undertook a survey to ascertain the and very much in excess of those direct health-care costs and benefits associated with exercise. The health rcise. In relation to American football, benefits of exercise (such as avoidance of certain chronic illnesses such as that: cardiovascular disease and osteoporosis) were weighed against the costs of treatment of exercise-related injuries. It was found that, whereas there rring injuries severe enough to cause were clear economic benefits associated with exercise for adults aged 45 te a season is over 100 percent; this and over, for younger adults (aged 15—44),the costs avoided by the r is injured at least once each season, disease-prevention effects of exercise (less than £5 per person per year) ed are more than offset by those who were more than offset by the medical costs resulting from participation in verage length of a playing career has sport and exercise (approximately £30 per person per year). Put another lot long enough to qualify a player for way, for every 15—44-year-oldwho regularly participates in exercise, there plan. is a net cost to the British taxpayer of £25 per year. The authors concluded, (1988: 161—2) ‘thereare strong economic arguments in favour of exercisein adults aged 45 or over, but not in younger adults’ (1994: 109, emphasis added). A Dutch es (Sports Council, 1991) and New study which produced similar findings to those of Nicholl et at. noted that [) similarly indicate that injury rates in ‘thisis an amazing result, and it contrasts heavily with statements of people [n any other sport. who use the supposed health effect of sport as an economic argument to 30
tact rugby another 1994).
most Marshall, hockey an
rate,
tion
ball,
States that (1994: 70 rhythmic
incidents associated
joggers (2.9). been habitual
while stantial required found 1,000
injured involved resulted ing cent A were
hospitalisations sated In
and argued
As
Not promote
Although
injury
per study
sports. Sport
this
between
days
rugby
the
while
also dangerous was
estimated
was
However, of
which for
by
spinal
that 37 surprisingly, 170—1)
cent
with,
(24.8)
number that: taking sustain
activities
in context
treatment
runners consultations
in
a per
(and some
the rate
the and
sports
1994)
per by noted
other
league,
with
The
year
sport’ 25 the
of
New
the physical
found
far injuries not
Accident
risk
100
cite
health
injuries cent and per of
largely
participants
part
that
restriction
Sports
a
are even
sport high-risk are substantial
injuries, majority in similarly
the
earlier,
Young surprisingly,
with
59.3
Zealand experience
(Reijnen
of a
basketball
participants musculoskeletal
cent
by
cricket
New
that the
of
study
lost
in more
in
most
serious
each contact relatively
non-competitive)
a
was
in
the Council the new
Compensation
per sports
of
Sports at
family
in
66
injury Zealand, the
which
(1993:
of
sports
new
serious.
dangerous of
found
on
United year lowest
England the
(Hume
(20.2). and
soccer
taking 100
per
injuries
injury
youth
injury,
and
indoor
sporting
lower and
activities.
or
the
Council
doctor, injuries
per
rhythmic
Dunedin
study
Velthuijsen,
as cent
participants
also risks
included
exercise, that
snow-skiing.
377),
injury
risks
States, highest
The
time (39.3)
and outdoor a
A
and
risks. four
injury
and
increase
extremity
and
league
result
of
sport, accounted
study
(1991:
rugby
Corporation. vary
injuries
hospital
and
Sports
of study
Marshall,
off writing
activities 17
This injuries
Wales risk
weeks)
and
Hospital 43
Heil
a followed
horse-riding,
risks
injury
each though
work; per
of
31 third
and
resulted
in
markedly
in
is
in 1989,
union
per
33) restriction per
non-contact
in
Council swimmers
That terms
per injury,
clear; are (1993:
as
or
New more cent
being
indoor
year
in
and
of for England
were
of
involved found,
cent
four
in a
other
1994)
7
cent
relatively the
Emergency
by cited
American
had there result
the
9 Both
from
of
all, per of
Lynch
swimming
violent Zealand
and
associated
per
while
5)
the
of
study
from martial
outdoor weeks.
soccer
soccer,
risk all of
health
nation’s
was
the
11.5
for
cent
found
diving
in
is
noted and
the
recurrent
physical
of
recurrent activities
nearly cent non-contact
in
injuries
a
and
Nicholl of
example, highest
sports there
contact usually (1991:
one
minor,
close
‘keep
million
risk
of
in
Wales
football, injury, professional, The
cricket,
(Hume
arts
of
Department
that league
into and
that Carcasona
the
with
all 15
a
sport
of
all
associa contact.
are compen
fit’
injuries.
may second
(36.3),
injuries million United injuries half
injuries
18—19)
et
injury
a water. diving 15 on found
sports. injury,
it
work
injury
with con
that
net- and
sub (6.5 and
al., also and
has
to
per the has
be
of 9.3) imic )w-skiing. 7), n he ajury isks. t ad es extremity ates, our ticipants ighest nd din md ye) y .s utdoor g cii huijsen, rcise, ne r, ncrease ks ury uded and es.
league
result
of
accounted
sport,
study
(1991:
Corporation. rugby
injuries
hospital
vary
and
Sports
Marshall,
study of
writing
off
17
This activities
injuries
Wales
risk weeks)
and
Hospital
43
Heil a
followed
horse-riding,
injury though each
risks
per work;
of
31
third
and
resulted
in
markedly
in
in
is
per
restriction union 1989,
33) non-contact per
in
Council swimmers
That terms per
injury,
are (1993:
clear; as
or
more cent
New
being
year indoor
of for and in
England
were
of
involved cent
found,
four a in
other
1994)
7
cent
relatively the
Emergency
American
by cited result
had there the 9 Both
of from
per all,
of swimming
Lynch
violent
and Zealand
associated
per
while
5)
the of study
outdoor martial from weeks.
soccer
all of
soccer,
risk
health
nation’s
was
11.5
the
cent
found
diving for
in
noted is
and
the recurrent
of physical recurrent
cent activities nearly
non-contact
in injuries
a
and
of
Nicholl
sports highest contact usually there
example,
(1991: minor,
one
close million ‘keep risk
of
in
Wales
football,
professional,
The injury,
cricket, (Hume
of arts
Department
that
league
into
and
that
Carcasona
the
all
15
with
a
of sport
all
compen are contact.
associa
injuries. fit’
may
second injuries injuries half injuries million
United
(36.3),
18—19)
et 15 on a injury diving water. sports.
injury, found
work it
injury
with
con
that
net sub and
and (6.5 also and
al.,
has
per has the
to
be
of
I
What CONCLUSION
cise, assumption to relationships is simple they
ships quences between and important.
sight, rhythmic hand, claim, health.
rhythmic, from tively health move
that
If
In
emerge
No injury
review to and,
between over
By place,
miners, we non-contact routine other rugby
sport
involve,
and,
conclusions,
general,
may
there
non-contact
from
it amateur
which
high
generalisation
workplace
benefits
On make any
is 60 for most
types
and .
associated
single
non-competitive
and and
clearly of
from replete
appear .
the
that
years
does
non-competitive
measure,
oil
degree, health. injuries 1968 .
between
appears
as
these
heat
football
moderate
catastrophically,
it
the and
health?
drillers, other
and
substantially
we ‘sport
milieu, sport
the seem
without
is
necessary
then,
and matches
with to like.
stresses
distinctions, to
levels
have
The
probably professional
with under
of
data
hand,
to
be professional
sport,
can
to
contact injuries
and
is
1978
Do
or
can
team
relate exercise its
including
radically
third good
be
seen,
this,
a
of
construction
reviewed
adequately
between
such football
exercise the
the
own player
Young we to
overwhelming
exercise
exercise . sport,
outweigh
sports
primarily
may
they
differentiate
reasonable .
for
sport,
point
rather draw data
blindness,
it
control .
as
has
unique
football
may
the
incompatible
the
one’s
death. sport
are
include
(1993:
cramp,
for where
with elite
in
support
and a
to about
is
such
so 1990
different
risky
be
encapsulate
significant
likely
site
either this
that
the
competitive
to
of
health’?
is
and
forms
the
health.
possible
the
paralysis .
Sport,
to
evidence
373) North body
as
a
arthritis, between
the
workers, exhaustion
the
season .
health
and
chapter.
to we
violent
the mass
health
distinctions .
suggest
the football,
relationships
reported
have
patterns
findings.
individual of
may
movements also The
labor-intensive
Three
health
widely
America,
and
to
regularity
sport
‘industrial
represented
costs. the
and
indicating
sport, exercise
concussion,
reconcile rather
costs, and
can
also second,
need The
beneficial
that
points and
ice-hockey, complexity
and
even
of
taken-for-granted
29
being
Thus,
compare
hazardous
However,
between
be
and
first
participant,
different that:
to social
in
in
stroke
player
between
or
and
ideology
are,
correct
related
death
what,
disease’. that would
differentiate
the
the particularly
as
the
severity
on
is
impact settings
fractures,
sport,
to
we relation
with
that
form
regular,
the
contact related
case first
deaths
of
soccer,
conse
at .
a
work
as
in point
exer
seem
move .
rela
first
one
the .
No for 31
the
no
the his
of
on we
in
of
a of of competing regular much public increase are chapter,
considerably ,
tiort
less
policy
and
begin
in
we
constraints
persuasive
and
through
the
moderate
examine
in
to
health
relation
health
less
mount.
pain
in
persuasive
to
exercise
some
risks.
relation
to
train
Similarly,
and
sport
of
longer
The
may
injury
the
to
in
and
health-related
elite,
relation
be
implications
as
health. and
also
overwhelming,
we
or
more
move
professional,
to
increase,
competitive
intensively
of from
arguments
these
with
but
mass
sport.
and
such
conclusions
sport,
a
sport
in
concomitant
to
In
arguments
favour
and
continue
the
to
next very
elite
for
of