Anatomy: A Pressing Concern in Exercise Physiology - Commitment to Professionalism E-Book
Tommy Boone
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- Herausgeber: Bentham Science Publishers
- Kategorie: Ratgeber
- Sprache: Englisch
- Veröffentlichungsjahr: 2017
Anatomy: A Pressing Concern in Exercise Physiology is a thorough analysis of the importance of anatomy in exercise physiology courses. It presents a series of topics that cover key concept and terms in anatomy, muscle physiology, kinesiology, the use of imagery in anatomy, physical flexibility and the conventional study of cadavers. Readers of the book will receive reliable anatomical knowledge, well-researched cadaver information as well as information about good, useless, and dangerous exercises. Readers will essentially be equipped to supervise exercise training designed to be safe while providing a greater range of physical motion.
Anatomy: A Pressing Concern in Exercise Physiology serves as a textbook for exercise physiologists in training and as a handbook for healthcare professionals involved in the physical training or rehabilitation of clients or patients.
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Anatomy: A Pressing Concern in
Exercise Physiology
(Commitment to Professionalism)
Authored by
Tommy Boone
BENTHAM SCIENCE PUBLISHERS LTD.
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FOREWORD
In simple straightforward language, Dr. Boone has set forth important reasons for teaching anatomy in the exercise physiology curriculum. He believes that the students of exercise physiology cannot do their best in prescribing exercise medicine without an understanding of anatomy. This is especially true when it comes to flexibility training.
Anatomy: A Pressing Concern in Exercise Physiology presents the first-ever anatomical background to why there are good, useless, and dangerous flexibility exercises. Dr. Boone believes that without anatomy as part of the exercise physiology curriculum, exercise physiologists will continue to engage their clients and patients in useless and dangerous flexibility exercises. The result is a failure to increase their range of motion, a waste of time in achieving increased flexibility, and the possibility of damage to the muscles and joints. Such a practice is similar to prescribing exercise medicine without an understanding of exercise duration, frequency, intensity.
While it is possible that the students of exercise physiology can learn anatomy without hands-on dissection, it is not the desired approach. That is why Dr. Boone developed an Anatomy Laboratory with cadavers that were dissected by his students at Wake Forest University in Winston-Salem, NC, the University of Southern Mississippi in Hattiesburg, MS, and the College of St. Scholastica in Duluth, MN.
This book explains that we must close the door on yesterday’s views of “what is exercise physiology” and keep it closed. We live today, not yesterday. We are healthcare professionals who prescribe exercise medicine to prevent and treat chronic diseases and disabilities. This book is a big step into the 21st century commitment to the professionalization of exercise physiology.
PREFACE
For years the kinesiology course was the anatomy course in the health and physical education degree. Now, although students can still major in health and physical education, the title has changed in many academic institutions to exercise science, kinesiology, and numerous other degree titles. It is no secret that exercise physiology grew from this academic background of athletics and exercise in health and disease. Today, exercise physiology is increasingly recognized as the new 21st century healthcare profession. While exercise physiologists are educated to prescribe exercise medicine from a physiological perspective, there is the concern that they need an anatomy course to fully understand the depth and implications of flexibility training.
This ebook, Anatomy: A Pressing Concern in Exercise Physiology, is the opportunity to promote the academic importance of anatomy as part of the professional development of exercise physiologists. It describes in detail the anatomical reasons for the good, useless, and dangerous flexibility exercises. Without question, academic exercise physiologists should teach anatomy to the undergraduate and post-graduate students, and the students should have the same opportunity as other healthcare students to study cadavers to grasp the significance of the musculoskeletal system. The hands-on laboratory opportunities will help the students of exercise physiology to safely prescribe exercise medicine and to work as a professional with athletes of diverse sports. This work should also encourage the support and recognition of the ASEP Board Certified Exercise Physiologists as healthcare professionals.
CONFLICT OF INTEREST
The author confirms that author has no conflict of interest to declare for this publication.
ACKNOWLEDGEMENTS
Declared none.
Part I Introduction to Anatomy and Exercise Physiology
The Anatomy Challenge
Tommy BooneAbstract
Although there is an explosion of computer-based human anatomy material available to teach anatomy, cadaveric dissection by students and the integration of knowledge from textbooks and didactic lectures are still the most popular methods of teaching anatomy. The volume of time dedicated to teaching anatomy has steadily decreased over the past several decades. This has resulted in more college graduates with an inadequate understanding of anatomy. Do you want students of exercise physiology to be taught by qualified teachers? If the answer is “yes” -- then you must act now. Commitment to professionalism is imperative.
INTRODUCTION
For the purpose of clarification, the term anatomy is the study of the structure of the human body. For decades, it has been synonymous with the content of the traditional kinesiology course in the physical education major. In fact, for many years, kinesiology was always the academic course that the majority of the physical education majors looked forward to studying. They understood that anatomy was necessary to teach and coach physical activities and sports.
From a historical perspective, when the name of many physical education departments was changed to kinesiology, exercise science, and numerous other similar titles during the 1960s and 1970s, the kinesiology course remained as part of the curriculum. After all, there was then and still is today the belief that kinesiology is understood to mean the “science of movement”. Anatomy, as an integral academic area of study, has been firmly established in health and physical education.
The students were led to believe that the science of movement was synonymous with the anatomy of movement (Box 1). That is why the kinesiology (i.e., applied anatomy) course had been an important part of the academic course work in kinesiology and related academic majors. Most recently, in the late 1980s and 1990s, the emphasis away from teaching anatomy is clearly a radical change that reflects the emphasis on exercise physiology research.
With increased emphasis on research at the doctorate level, little to no attention has been given to applied anatomy. This has resulted in a significant decrease in doctorate prepared exercise physiologists, kinesiologists, and physical educators who can teach anatomy. Also, it is clear that the emphasis on biomechanics, graded exercise testing and prescription, and sports nutrition has served to some degree to diminish the teaching of bodily structure. Yet, an understanding of the structure and internal workings of the body is critical to a rigorous science-oriented education.
Hence, even though it was accepted years ago that anatomy was essential to the students’ education, the exposure to anatomy today has decreased to essentially being non-existent in many academic majors. This means the majority of the students at academic institutions throughout the United States are unable to describe the muscles of the shoulder region and how they are different from the hip region. The students’ education is inadequate and, therefore, is likely to have an adverse effect on their interaction with clients and patients. Most graduate without being able to identify specific muscles in the human body or attachment sites, innervations, functions, and variations.
While sport biomechanical principles are important, it should be obvious that an understanding of anatomy even more is critical to the students’ education. It is very likely that this view is understood by academic exercise physiologists without having to elaborate on it. However, given the emphasis on research while pursuing the doctorate degree, the majority of the graduates are either not interested or unprepared to teach anatomy. As a result, the students graduate from college without the ability to accurately apply anatomical concepts to the human body at rest, during exercise, and when correcting musculoskeletal disabilities. No doubt that is why Somerset Maugham wrote in his book, On Human Bondage, about a lecturer advising first-year medical students that, “You will have to learn many tedious things which you will forget the moment you have passed your final examination, but in anatomy it is better to have learned and lost than never to have learned at all.”
A strong base of functional human anatomy is thought to serve as the foundation for all subsequent exercise physiology courses. That is why functional human anatomy is considered as a cornerstone for exercise physiology practice. Several decades ago no one would have thought about graduating students interested in fitness programs and/or sports training without a solid grasp of applied anatomy. In fact, it was believed to be so important that college teachers actually taught origins, insertions, and functions of all the major muscles. After all, anatomy is a discipline with its own language to describe structures of the body that, then allows for an increased understanding of the physiology of the body as well.
The Language of Anatomy
Only a small percent of the exercise physiology teachers know how to teach students the language of anatomy. This point is more complex than it sounds, especially since it is not the same as being well-informed. In many ways, it is an entirely new mental frame of reference. Understanding functional anatomy is not just about memorizing the facts about muscles. It is also about having the knowledge and understanding that allows for determining whether an anatomical comment or statement either makes sense or not.
Understandably, anatomy is complex. It requires intellectual effort and time to identify specific structures and relationships (Box 2). But, unfortunately, the perception that learning anatomy is little more than memorization, which has kept has kept it a secondary subject. However, this thinking is wrong. It also misses the point of an important three-dimensional view of anatomy. Students are taught facts, but they must also learn the ability to describe the “why”.
As an example, students must be able to explain anatomically why the brachialis is a stronger elbow flexor than the biceps brachii muscle. Figuring out what makes one muscle stronger than another or how the different muscles work together to carry out a specific function across a joint among other competing ideas is critical to speaking the language of anatomy. Thus, the goal is not to learn just that the brachialis flexes the elbow (i.e., what to think), but why the brachialis is the powerhouse of the elbow flexors (i.e., how to think). The rationale for this thinking is as follows.
Anyone who is responsible for sports training programs may understand that both muscles flex the elbow joint. But, as a healthcare professional, the exercise physiologist should understand the functional significance of the brachialis as a one-joint muscle that inserts on the ulna that permits only one motion (i.e., flexion) when it contracts. The biceps brachii muscle is a two-joint muscle that inserts on a forearm bone that allows for lateral rotation of the radius as well as flexion of the elbow joint. In other words, knowing the origin and insertion of a muscle defines its functional limits.
That is why it is the responsibility of the teacher to be very specific with the presentation of each skeletal muscle. After all, a muscle’s shape (as defined by its origin and insertion) gives rise to its function and/or its purpose. To grasp this point, students should be encouraged to ask questions and to look for anatomical information that justifies and/or clarifies their thinking when considering the musculoskeletal differences (e.g., as just presented with the brachialis and the biceps brachii).
Information that comes with visualization (i.e., mentally creating a mental image) of muscles is as simple as accessing information about specific muscles and their relationships. The ability to create mental images is the key to understanding the language of anatomy. Literally speaking, it means “to see in your mind a mental image of a muscle or muscles” and, then, to play the image dynamics over and over again. It is the process of transforming anatomical information into a visual picture that enables the student to observe, make sense, and understand the context of a muscle and its relationship to other muscles.
Because of the interest in fitness and athletics, it is believed that exercise physiologists know anatomy and can apply it to human movement to help reduce injuries and improve performance (Box 3). Do you think this is true today? The truth is that it is not true. Doctorate prepared exercise physiologists with a thorough knowledge of anatomy are a diminishing pool of individuals. As stated earlier, the majority of the academic exercise physiology and/or related academic programs do not teach anatomy. This is especially true at the doctorate level. So, turning to a doctorate exercise physiologist, perhaps, one who was just recently hired at the assistant professor level to teach anatomy and cadaver dissection (i.e., if both were to exist in the curriculum) is rather foolish.
But, unfortunately, it is not all that self-evident in exercise physiology that academic exercise physiologists do not know anatomy. Moreover, in addition to the failure to teach anatomy at the doctorate level, there is little talk about the importance of an applied anatomy class or the course simply no longer exists since it was dropped from the academic major years earlier.
Only a few academic exercise physiologists are actually prepared to visualize, that is, to “see” anatomy (Box 4). Ironically, these are the facts and, strangely enough, it has become all too obvious at a time when the students’ knowledge of anatomy is critical to the safety of clients and patients in exercise medicine programs. This means that the profession of exercise physiology should create with great urgency career opportunities for exercise physiologists with training in anatomy.
If exercise physiologists were to argue that they can teach anatomy as well as they teach other exercise physiology courses, it simply cannot be true. Defining the anatomical site of a muscle or related muscles to resolve a question about weight lifting, flexibility, or a developmental anomaly is important if the exercise physiologist is to accurately convey a sound knowledge of anatomical structures and functions. This can only be achieved by an extensive study of functional anatomy. For example, consider the following questions?
How many muscles produce shoulder flexion? Answer: 1, 2, 3, 4, 5How many muscles contribute to shoulder flexion as a functional part of a larger muscle? Answer: 1, 2, 3, 4, 5How many shoulder flexors do not original from the anterior perspective of the body? Answer: 1, 2, 3, 4, 5How many shoulder flexors cross more than one joint? Answer: 1, 2, 3, 4, 5How many nerves contribute to shoulder flexion? Answer: 1, 2, 3, 4, 5How many nerves that contribute to shoulder flexion innervate more than one muscle? Answer: 1, 2, 3, 4, 5How many nerves that contribute to shoulder flexion contribute to elbow flexion? Answer: 1, 2, 3, 4, 5How many muscles at the shoulder joint perform both abduction and adduction of the upper limb? Answer: 1, 2, 3, 4, 5How many shoulder flexors perform inward rotation of the arm? Answer: 1, 2, 3, 4, 5How many shoulder flexors have a functional part that performs shoulder extension? Answer: 1, 2, 3, 4, 5Questions: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
Answers: 5, 2, 1, 1, 4, 1, 1, 2, 4, 1
Although these are simple and straight forward questions, there is no way to answer the questions correctly without studying the anatomy of the shoulder muscles and nerves (Box 5). Unfortunately, this problem is only going to get worse over time. This means the students’ understanding of the science of health and human movement will not improve, which is ultimately a negative outcome. This thinking is inconsistent with the anticipated academic and professional qualifications and standards of exercise physiologists as healthcare professionals.
Any thinking otherwise (such as from the strength and conditioning perspective) is unlikely to generate the right answers. Essential to this perspective, that is, confronting those who act as though they know anatomy when they do not is hugely problematic. They are often heard to say, “Get serious. Who really cares about anatomy?” Of course that kind of thinking is seriously missing the point. It is also self-defeating because a thorough knowledge of anatomy is imperative to the professional education of all healthcare practitioners.
There should be no resistance to the importance of teaching anatomy, even on the level as common as is biochemistry. The valued of anatomy is on the same order as the other content areas in exercise physiology (e.g., ECG, biomechanics, and cardiovascular physiology to mention a few) and yet, it is more than obvious that almost every other subject is emphasized more than the teaching of anatomy.
It’s all about Physiology
Contrary to popular opinion, not knowing anatomy at the same level as students and teachers are expected to know, for example, the enzymatic steps in glycolysis or the role of Kreb’s cycle in making electrons available to the electron transport system (ETS) makes little sense. Similarly, expecting students to know that cytochrome A3 is the final electron acceptor for molecular oxygen, thus allowing for the oxidative phosphorylation of ADP to ATP, while not expecting or even teaching students to know that the superior gluteal nerve innervates the tensor fascia latae, gluteus medius, and gluteus minimus make no sense much less not knowing why the muscles function as they do individually and/or collectively at the hip joint as primary abductors of the lower limb.
The academic exercise physiologist’s interest in biochemistry is understandable, but so is his or her need to thoroughly understand (McArdle et al. 2010). After all, it is important that exercise physiologists thoroughly understand the intricate mix of structure and function of the human body. This thinking requires the study of both anatomy and biochemistry along with numerous other science-oriented courses. One might conclude the same with an increased emphasis on the neurology of weight lifting. However, it should be self-evident that is not the case. Given that the problem seems obvious, it is believed the solution appears to be equally simple.
Yet, the truth is that anatomy has been dropped from the exercise physiology curriculum in favor of other subjects that are more entrenched in physiology (Box 6). The exercise physiology curriculum is essentially an exercise science and/or sports medicine series of courses that do not address anatomical instruction. Applied anatomy as clinical kinesiology, for example, and gross cadaver-based anatomy are no longer taught. Common sense suggests that this dramatic change of events cannot continue.
Since the teaching of exercise physiology applies science to healthcare, the academic major in exercise physiology should emphasize the importance of all the subject areas if students are to understand the human body. This thinking also applies to psychology, self-management and cognitive skills, and the power of one’s thinking along with business skills, and beliefs in maintaining and/or developing the integrity of the mind-body complex.
In particular, the failure to delve into the psychophysiology of the client’s lifestyle, chronic diseases, and/or disabilities is unacceptable. Students must be prepared to come up with answers for such issues and concerns that arise in regards to the mind-body interconnectedness. Self-management procedures is but one of the many options that need accurate assessment and application to help increase the client’s level of function and well-being.
Final Thoughts
Once considered the cornerstone of exercise physiology, applied anatomy is no longer a regular feature in the academic curriculum. This is a problem since non- doctorate exercise physiologists are healthcare professionals first and researchers second. Thus, it is important that they get a thorough academic course in anatomy with application to athletics and healthcare. Failure to teach anatomy impairs the students’ ability to: (a) correct and/or enhance the style and execution of regular exercise programs and weight lifting to improve health and wellness; (b) identify appropriate (i.e., good vs. useless or dangerous) flexibility exercises to improve range of motion and/or prevent musculoskeletal injuries; and (c) evaluate athletic performance and training programs that require the efficient utilization of the musculoskeletal system.
The anatomy challenge is to put the teaching of anatomy back into the curriculum, and to design teaching strategies to help students develop anatomy vocabulary for articulating anatomical knowledge (Box 7). This means there should be an increased emphasis on the memorization of anatomical facts and the visualization of the musculoskeletal system to understand anatomy.
GLOSSARY
Applied anatomyPractical application of anatomical knowledge to diagnosis and treatment and/or specific enhancement of the muscles, bones, and tendons.BiochemistryScience deals with the chemical processes that occur within living organisms.BiomechanicsStudy of the mechanical laws relating to structure and movement of living organismsExercise physiologistA healthcare professional who either has an academic degree in exercise physiology or who is certified by ASEP to practice exercise physiology [via the Exercise Physiologist Certified exam (EPC)] and, therefore, is recognized as an ASEP Board Certified Exercise Physiologist, or who has a doctorate degree in exercise physiology from an accredited college or university.KinesiologyScience of human movement.PhysiologyBranch of biology that deals with functions of living organisms and their parts.VisualizationRecall or formation of mental visual image.REFERENCES
Maugham W.S.. , . Of human bondage.. 1915 [Accessed 8th February 2016]. Available from: maugham. thefreelibrary.com/of-human-bondage/54-1McArdle W.D., Katch F.I., Katch V.L.. , . Exercise physiology: nutrition, energy, and human performance.. 7th ed. New York, New York: Lippincott Williams & Wilkins; 2010.Persaud T.V.. , . The early history of human anatomy: from antiquity to the beginning of the modern area.. Massachusetts: Thomas Books Springfield; 1984.Why is Anatomy Important?
Tommy BooneAbstract
Knowledge of anatomical structure of the body is basic to understanding musculoskeletal function and how both structure and function are modified by exercise or disease. Ironically, at a time when knowledge of anatomy is increasingly important, exercise physiologists are facing a major crisis in anatomical education. There is a major shortage of academic exercise physiologists willing to teach gross anatomy. Many faculty members are simply not academically prepared to teach anatomy. Yet, the students of exercise physiology need a thorough anatomy education to be credible healthcare professionals. This is true for professionals in physical therapy and athletic training and it is true for exercise physiologists too.
