The New Face of Exercise Physiology
Tommy Boone, PhD, MPH, MAM, FASEP, EPC
Professor and Chair
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN 55811
There isn’t any question that regular exercise contributes to the primary and secondary prevention of disease that associates with early death.
Exercise physiology has a rich scientific history supporting exercise as medicine. And yet, most exercise physiologists come across as blind to the seriousness of this point. Others get it, particularly medicine and physical therapy. If only they had exercise physiologists as teachers, they would then understand the scientific aspects of the exercise prescription process. Most healthcare professionals aren’t even sure how to perform a VO2 max, much less analyze the underlying physiology. It is not part of their academic education. For the most part, they don’t have the right laboratory setting, a metabolic cart and related equipment, or the staff trained to assess cardiovascular function.
As I think about it, however, this isn’t likely to stop them from moving forwards in assessing aerobic and anaerobic fitness in the evaluation of a client’s health status. Interestingly, the typical exercise physiologist is desperate to do another traditional research study. Only a few have broken free to search for the path that helps to ground exercise physiologists as healthcare professionals. Of course this has only exacerbated the frustration and disillusionment of those who get the big picture. After all, it isn’t like we just figured out that exercise is medicine!
It has been said that the call to wake up and change comes in many guises. The list of how a person may think about health-related physical fitness is endless. With respect to everyone who wants to be an exercise physiologist, at times it seems to come across as a matter of self-esteem, money, security, and reputation. Who is everyone? How about the students? If a college degree is to help students become exercise physiologists, then the degree must be an exercise physiology degree. This is exactly what other professions have done. Nursing students do not graduatefrom something other than a nursing program with a nursing degree. Nurses have a degree in nursing before they are allowed to call themselves a nurse.
If exercise physiology is to change and grow, it must be led by fluid leadership, not static and ossified leadership. Then, as other professions have done and continue to do, the profession must (and can) change and take shape as necessary. Remember, as Henry David Thoreau said, “Things do not change. We change.” If the academic community continues to resist the ASEP leaders’ effort to change exercise physiology from a research discipline to a healthcare profession, students will continue to be viewed as instructors or specialists.
This is exactly why ASEP is so important. In my work as co-founder, I am profoundly grateful to colleagues who have the ego strength to seek a solution to their students’ malaise by joining and supporting the ASEP infrastructure. The ASEP organization is the new face of exercise physiology. Nothing about it is threatening or insulting. It is the reality of the necessary changes to move exercise physiology from the 20th century to the 21st century. The focus is not on being nasty to anyone or any organization. It is all about looking square on at the problem and calling it as it is.
Our lives begin to end the day we become silent about things that matter.
-- Martin Luther King, Jr.
As we know, liberation, change, and growth do not come by avoiding the reality of what is going on around you. This message is very simple but by no means is it acceptable by those who wish to keep exercise physiology as it has been for decades. Many students of exercise physiologists are now aware of the power of exercise, but they lack credibility in society. Why? Everything they have done and continue to do falls outside the normal path towards professionals and credibility.
There is a new path; one that isn’t clinging or grasping to sports medicine. It is a path with new hopes, dreams, and possibilities. This path is ASEP. It originated in the minds of the ASEP leaders. It has manifested itself with a new reality – exercise physiology is a healthcare profession.
This healthcare reality has resulted in a new focus on the profession and a sense of continuity and self-awareness that is in itself a healthier sense of self yet to fully emerge. It is only when we allow ourselves time to experience this awareness that we see through the subtle illusion of our deep-rooted tendency to cling to a sense of identity with sports medicine. If you will, it is a comfortable indifference that cannot be allowed to continue. When exercise physiologists finally come to that realization, then, at that moment, the journey begins towards the 21st centuryliberation, healing, and transformation of the profession of exercise physiology.
This realization is consistent with the ASEP vision of what is possible. In a sense, it is an awakening for the welfare of exercise physiologists, and that we have the potential to benefit society in ways that previously were inconceivable. It is this vision of the profession that enables the leaders to cope with distress, frustration, and challenge to stay the course. It reminds the members that they can achieve a state of being that allows them to recognize the differences in being a profession, not a discipline -- a professional, not a specialist.
Today, as never before, exercise physiologists are responsible for improving and developing themselves as healthcare professionals. They do this by joining ASEP and becomingboard certified. They are also responsible for supporting the ASEP vision even should they be apprehensive and even should they be reluctant to trust their new colleagues. Courage, individuality, and self-realization lead to integrity and knowledge of our place in healthcare. So, why not look around you and study what you see?
If you are a teacher, there is a good chance that you see students. If you are a student, you probably see yourself somewhere in the future. Perhaps, it is a few weeks or several months after graduation. What is on your mind is a job, but not just any job. You want an exercise physiology job. After all, your desire is to be an exercise physiologist. So, what is the problem? It is rather simple. Recently, you overheard several conversations from recent graduates of your university. They talked about the economic hardship, and what their future looked like. There was also talk of going back to school, but majoring in a different area altogether. Physical therapy and nursing were mentioned.
It disturbs me that good students would leave exercise physiology because they feel they can’t make it financially. Today is the beginning of a new month, August. In one month, I start a new academic year at St. Scholastica. It will be my 17th year at the College. I am especially happy that I am a department chair of an accredited exercise physiology program. I also value knowing that the degree is by title -- Exercise Physiology. That is a good thing because I am an exercise physiologist. I do not work in a kinesiology department or exercise science department.
Change your thoughts and you change the world.
-- Harold R. McAlindon
My point is this: Exercise physiology is not either exercise science or kinesiology. This is especially important because physical therapists teach in the physical therapy department and nurses teach in the nursing department. Shouldn’t exercise physiologists teach in an exercise physiology department? Of course the majority of the exercise physiologists don’t. That fact alone is symptomatic of the lack of leadership in exercise physiology.
In 1997, the American Society of Exercise Physiologists was founded in the state of Minnesota to put the professional infrastructure in place to recognize exercise physiology as a profession. But wait a minute. Weren’t you saying something about recent graduates having difficulty locating a job? Yes, that is right. Change is a process, not an event. The Society is just a little older than a decade. By comparison, physical therapy was founded in 1915. It has been around 10 times longer! Hello, anyone listening? And, just think about it, the profession of physical therapy is still evolving with the DPT degree created several years ago. So why shouldn’t it take 3 or 4 or even 5 decades for exercise physiologists to get their feet on the ground?
My point is the future isn’t black or white, but shades of grey. Yes, USA is at war and somewhere cyborgs lead to the near-extermination of “something.” This vision, in the latest "Terminator" movie, is just a movie idea. It isn’t your reality. Why? Because you control your reality – let me repeat, “You control your reality.” How? By showing some backbone!
Yes, I said BACKBONE – meaning, do what you have to do to get the job done. If you want to make money, then create your own circumstances by which you can have control over what you make. If you work for someone, that can be a good thing, but they control what you make. If you work for yourself, how much you make is determined by just how hard you work at what you want to make. Yes, it is that simple for me.
You see, I imagine your future different from what you think it is going to be (or should be based on what your teachers may have said). They emphasized cardiac rehab and, indeed, that is important but it is a narrow concept of the profession of exercise physiology. Remember, the reason your teachers don’t get it is because they think of exercise physiology as a research discipline. That too is misdirected thinking.
If only I could stand up and say to all exercise physiologists, “Get a grip. Get over yesterday’s thinking.” Yes, pardon me, grow up and look around you. The world has changed since the 1950s and 1960s. Honestly, people, it is time to do something right on behalf of your students and exercise physiology. In fact, it is 60 years or more in lost time. That’s right. Whatever you do, if you do it on behalf of the evolving profession of exercise physiology, you are doing the right thing.
But, first, let me be specific here. By “profession” I mean something altogether different from the idea that it is all about “acute and chronic adaptations to exercise.” All I can do is try to keep myself from laughing when I read or hear the definition espoused by a colleague. Here is deal, look at the words for they are meaningless aside from the research perspective. Even then, it is an idea that paints the person into a corner (unless you have a doctorate degree). The words have nothing to do with the profession of non-doctorate exercise physiologists.
So, since I believe exercise physiology is a healthcare profession, the definition of exercise physiology is altogether different. Right, of course it is. That is why ASEP has an entirely different definition from that of what is commonly written in the exercise physiology introductory sections of typical textbooks today. You can find that definition on the ASEP website ( I should add, if anyone hasn’t figured it out, the content of chapter 1 (introduction) of many exercise physiology textsis old and outdated. It has little to nothing to do with the contemporary 21st century view of exercise physiology. Not getting this point is by now embarrassing.
Exercise is medicine! Hello, actually nothing else has to be said to those who are thinking. To think differently is to delimit the truth of something that will only allow, if not encourage, others to take from us and do what they will with exercise. Personally, I have a hard time accepting the view that physical therapists, medical doctors, or the generic sports medicine personality should represent “exercise as medicine,” and yet I understand that is taking place. Moreover, I live it everyday.
In conclusion, yes, it is true that I am now beyond just publishing a research article as a definition of what I am or what I do. I understand that as an exercise physiologist I have the power of prescription, if not actually a medical intervention, to help millions of people. It doesn’t matter that I am not a medical doctor. The fact is I’m not practicing medicine. Having grown up with a father as a lawyer and state senator, I understand the difference. However, as a Board Certified “exercise physiologist,” I can (and I have the right to) practice exercise physiology and, specifically, that means I can prescribe exercise as medicine.
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