Introduction

The recognition of Sport and Exercise Medicine (SEM) as a new medical specialty in the UK in 2005 represented a landmark in an area of medicine that began its journey in Greco-Roman times, 2500 years ago. The fathers of our specialty, Herodicus (480 bc), Hippocrates (460–370 bc) and then Galen (ad 129–210), recognised the need to promote and prescribe exercise for health-related benefit, and the need to provide general medical care for the athletic individual.1 2 Such principles form the core components of our specialty today.

High-performance sports medicine (HPSM) is a small area of SEM that is specifically focused upon high-performance (‘elite’) athletes—those competing at national or international level, and those involved in professional sports. It is clear from the writings of Hippocrates thatHPSM clearly did exist in Greco-Roman times.1 2 He described the use of medical approaches to optimise the effects of, and recovery from, training, and indeed he dedicated the second volume of his series ‘regimen’ to this subject.2 HPSM subsequently faded until the 19th century, re-emerging when a new era of formal competitive sport began. In those times, there was considerable medical debate relating to the needs of the athlete; there were views that intensive training represented serious adverse physical and physiological consequences. There was negativity towards the pursuit of athletic excellence, resistance to the concept that sports medicine was not ‘real medicine’ and disinterest in understanding the challenges of human physiology at the extremes.3 Some of these views persist in some of the less informed today. Nevertheless, in the modern era, high-performance sport plays a central role in our culture, society and our national identities, and with thatHPSM has an evolving identity and an increasingly prominent and positive profile.

In this series of three short articles on HPSM, we aim to describe …