Medical Common Sense about Athletics

To start with the most basic facts, very minimal physical fitness results in disproportionately large health benefits;  and physical fitness throughout life, even if modest in its degree, greatly exceeds the benefit of any relatively brief, prowess in youth.

A study of Ivy League athletes from the early 1900s showed that track and field athletes averaged five years longer lives than football players and wrestlers 1).  The interpretation was that runners have a personal commitment to fitness all year around—football players do laps only on orders from the coach during practice sessions. 

My experience with patients for sixty years tells me that many football players go through life with residual disability from injuries, especially knees that interfere with even ordinary daily activities.  So some degree of athletic fitness equates with fitness for living—just as fishing from a steep slippery bank (where the fish are) makes more sense if you can swim.  And this benefit depends somewhat on avoidance of unnecessary injuries.  Swimming itself is an athletic activity which, incidentally, enhances the enjoyment and safety of many activities.

What is most important after avoiding unnecessary injuries?  The answer is endurance exercise—this goes on long enough to strengthen the heart and improve blood circulation to the active skeletal muscles and, of course, to the heart itself which is also involved with all exercise.  When our bodies “realize” that a steady intensity of exercise will be sustainable, the sensation of second wind results.  At this point, if the intensity is increased, a new second wind will soon result but only if the new intensity is still sustainable—sprints never qualify because the oxygen debt increases until the maximum possible debt is reached and collapse ensues when stored chemical energy is all gone.  During rest after exertion, increased depth and frequency of breathing persists until the debt is repaid in terms of extra oxygen (up to 30 liters) removed from inspired air beyond what would have been removed in a resting state 2).  Summary so far: any exercise that produces the second wind sensation always increases the type of athletic fitness that increases health and longevity.  Above all else, physical activity helps to match your appetite to your higher food requirement.

You scarcely have to concern yourself about exercise to strengthen muscles because they tend to get strong enough to sustain your normal activity.  However, when you are increasing your level of activity, or starting a new activity, build it up gradually.  Early warning of building up too quickly is cramping in the affected muscles while resting quietly afterwards.  Incipient cramps respond completely to prompt stretching.  For strong leg muscles this will require standing or walking to use your weight to do the stretching.  There are some specific situations that are greatly benefited by weight training for specific muscles that have atrophied from favoring a painful joint.  For example, the muscle in the front of the thigh, called the quadriceps femoris, is very necessary for stabilizing the knee joint.  After favoring a painful knee, exercise directed at strengthening this one muscle hastens recovery when started as soon as pain permits.

Young people, when considering athletics, could gain by seeking some sport that can be continued beyond youth like tennis or golf.  Very nearly all the rare eye injuries to tennis players occur in doubles play—singles play never involves two players nose to nose at the net. Golf is expensive and time consuming and no more exercise than bowling if you ride a cart (carts are not permitted in golf tournaments).  So, if you enjoy golf, play occasionally to keep the option open for retirement when time and money may be plentiful.  Avoid golf courses that require carts (even if you use one yourself—poor public policy). 

My personal bias is to do something useful instead of paying money to work out.  Walking and bicycling for local transportation come to mind, but if you are traveling in a country where they drive on the left, prefer an automobile to a bicycle, or be extra careful. The steering wheel on the right side is a constant reminder to drive on the left—you cannot obtain a bicycle with the handlebars on the “wrong” side.  (In New Zealand bicycle hand brakes are switched so you don’t use the front wheel brake while signaling a turn across a lane for opposing traffic.)  If you have an efficient house, you may have to cut firewood by hand in order not to get too much too quickly.  For tips on splitting elm forks and sharpening saws, see reference 3).  Here is an additional tip on splitting wood: always wear glasses; modern spectacles made of polycarbonate plastic will not shatter.  (We are concerned about high speed fragments of steel wedges propelled by the sledge hammer.)

Speaking of safety 4): let it be known that sudden death precipitated by sexual activity occurs almost exclusively in sedentary individuals.  In addition, for the safety of mankind, please try to refrain from sexual activity with partners who would not make adequate parents.

Summary:  Arrange your life so that physical activity is part of your routine and not a chore to be endured.  The second wind sensation may be the key to the “runner’s high”.

John A. Frantz, MD

June 9, 2011


1) This was probably from an article by Paul Dudley White (1886-1973) from New England Journal of Medicine.  I did find an article that more than makes my point on Up to Date titled Overview of the benefits and risks of exercise by Douglas M. Peterson  (214 references from the last 20 years) last viewed June 13, 2011.

The following references are from  2) For more details, see Second Wind under the category Basic Medical Science.  3) Tips on splitting red elm forks and bow saw sharpening under Some Do-It-Yourself Ideas in the category Miscellaneous.  4) See Safety in the category Staying Healthy