Key result
Over a century, biomedical attitudes towards vigorous exercise evolved from viewing cardiac hypertrophy as pathological to a beneficial adaptation, ultimately medicalising sport to manage its risks.
This historical review highlights how medical perspectives on exercise and cardiac hypertrophy evolved from viewing it as pathological to a beneficial adaptation, eventually leading to the medicalization of sports.
Historical shifts in cardiac hypertrophy views caution against over-medicalization of exercise; leaves open integration into modern athlete guidelines.
The relationship between health and exercise involves risks as well as rewards. This article focuses on heart disease and the marathon to show how doctors have negotiated that relationship over a century. Three distinct changes in biomedical attitudes towards vigorous exercise are outlined. First, the mid-Victorian interpretation of pathological hypertrophy of the heart was overturned at the end of the nineteenth century. Secondly, hypertrophy was reinvented as a beneficial physiological adaptation in the 1940s and 1950s. Thirdly, these claims of distinctiveness were challenged by the leisure revolution. Sports doctors and cardiologists reinvented exercise as a drug that could only be safely used with the guidance of a medical professional. Medicalising sport reduced its risk and maximised its reward, both to the individual and the state.
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Vanessa Heggie (2009) conducted a review in Heart disease and vigorous exercise. Vigorous exercise was evaluated. Over a century, biomedical attitudes towards vigorous exercise evolved from viewing cardiac hypertrophy as pathological to a beneficial adaptation, ultimately medicalising sport to manage its risks.
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