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To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.

—Sir William Osler

One of the pleasures of my professional life has been observing Clinical Sports Medicine’s birth, adolescence and maturity over almost 30 years. In January of 1993, I held up high a copy of the first print-run, first edition, 697-page plain red book to the audience at the South African Sports Medicine Association (SASMA) Congress in Cape Town’s Convention Centre.

I said that it was a revolutionary red book because it was very practical (symptom-oriented rather than pathology-based) and that with its five sections and 48 chapters, it propelled sports medicine beyond a narrow focus on athlete injury treatment (largely orthopaedic at that time). This red book defined what is now recognised as sport and exercise medicine—our specialty that provides comprehensive care (including prevention) for a much more inclusive constituency—any person who is active or who wants to be active. It was, as I already knew then, the book that would take an emerging yet immature discipline, across uncharted seas, to a land of hard science and clinical wisdom. Sport and exercise medicine could provide a beacon of all that is the very best in a patient-centred medical care, focusing on providing optimum health.

Fast forward to 2019, where Volume 2 of the fifth edition will again be waved aloft as a gold standard for clinicians who attend this year’s South African Sports Medicine Association Congress. Each edition of Clinical Sports Medicine has clearly raised the educational bar in our specialty—each has provided substantially more value for the user, a word I use deliberately over ‘reader’. Copies of this book are in tatters the world over because it is used! Now our field demands a two-volume fifth edition to do justice to the high quality science that now underpins our field. No more ‘Mickey Mouse medicine’—a term one of my professors reserved for sports medicine in the 1980s.

Volume 2: The Medicine of Exercise provides some solutions for the global epidemic of non-communicable diseases (NCDs). It responds to The Lancet’s 2012 and 2016 challenges in our field. As Richard Horton, the Editor, wrote: We urge all sectors of government and society to take immediate, bold actions that help make active living a more desired, affordable, and accessible choice for all population groups.

This dedicated volume of 40 chapters in six logical sections provides both the blueprint and the step-by-step instructions for clinicians to take ‘immediate bold action’. Clinicians have a wonderful opportunity to limit—dare I say reverse—some of the noncommunicable diseases from which their patients now suffer in ever-increasing numbers. The reality is that the advice is fairly straightforward; it is hardly rocket science. Yet it is based on the best available scientific evidence for promoting active living and rational eating.

I don’t apologise for my challenging this belief—that as physicians we have not done all that we can to advance the health of our patients. The ‘why’ we need to do this is clear to clinicians—we know we should encourage exercise and healthy eating—but it is the ‘how’ that has been difficult. This volume will help the clinician clear that barrier. Type 2 diabetes mellitus is just one condition that, we now know, can be reversed in the majority. And the ‘how’ is outlined in this volume.

It has been my privilege to be an author of Clinical Sports Medicine since the second edition (2001) and I have appreciated that opportunity to reach young clinicians the world over. Congratulations to my very dear friends, Professors Peter Brukner and Karim Khan, for their leadership in what was once a nascent field but one which through their passion, commitment, dedication, wisdom and scholarship they have raised to a level that none of us could have ever imagined when the first edition was launched in Melbourne in December of 1992.

Comparisons are of course odious but it is my opinion, and I do not offer it glibly, that future generations will conclude that what Sir William Osler’s Principles and Practices of Medicine did for medicine in the 1890s, Brukner and Khan’s Clinical Sports Medicine fifth edition will do for the practice of the profession of sport and exercise medicine globally.

That is how highly I rate the contributions of these two uniquely gifted and visionary sports physicians who have written what will always be, like Osler’s Principles and Practices, an utterly iconic text. A statement for the ages.

Following their lead, the challenge for the rest of us is to implement and promote what we now know is society’s best buy for public health—more physical activity and the replacement of ‘the diet of modern commerce’ with the consumption of the real foods that humans had always eaten before we were mistakenly told to change 40 years ago.

Volume 2 of Clinical Sports Medicine is an evidence-based compendium of how we, as clinicians interested in the perfectly functioning human, can help direct the world’s populations toward states of greatly improved health.

That is the opportunity that this epic work of meticulous scholarship delivers.

PROFESSOR TIMOTHY D NOAKES

OMS, MBChB, MD, DSc, PhD (hc), FACSM), (Hon), FFSEM (UK), (Hon), FFSEM (Ire)

Sports Physician and Exercise Physiologist

Former Discovery Health Professor of Exercise and Sports Science, University of Cape Town and Sports Science Institute of South Africa

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