History of sports medicine - 500bC-401bC

480 BC

The Greek bas-relief above, displayed in the Cyrene Archeological Museum in Libya, shows manual therapy as treatment of a shoulder injury.

The picture above shows how things happened in the Roman baths. The Romans used hot water to relieve painful conditions. They were known for their complex system of public baths.

472 BC

Four hundred years before Christ, lccus of Taranto (5th century BC) and later Herodotus (785-420 BC) used physical exercises and manipulations as a tool for restoring health.

Based on his own experiences, the Greek athlete Iccus of Taranto (5th century BC) designed a document about training methods for athletes, in terms of endurance, not only the importance of proper nutrition, but also the value of that exercise for the maintaining a healthy body. Iccus of Taranto was an Olympic athlete Magna Grecia who won competitions at the 472 BC Olympic Games. He is considered the father of athletic nutrition and his physical preparation was based on the ethical-religious concepts of the Greek philosopher Pythagoras (570-490 BC). He abstained from intercourse and ate specially prepared slender diets in preparation for the games.

The Greek physician Herodicus of Knidos (5th century BC) is still regarded as the father of sports medicine. He was the first to combine sports with medicine. Physical activity had a prominent place in ancient Greek culture, and athletics was considered not only as a form of entertainment but also as a means of education and self-improvement. Herodicist attempted to cure his own disease, presumably tuberculosis, by walking and wrestling, but also with steam baths and massages and discovered a system of healing exercises that would later be critizied strongly by Hippocrates (460-377 BC) in the sixth part of his 'Epidemics':

"Herodicus treated feverish diseases with running, wrestling and steam baths, but he was completely wrong given a feverish condition is the enemy of such exercises."

The Greek philosopher Aristotle (384-322 BC) also criticized Herodic's method:

"He makes old men young and prolongs their lives for too long."

By the discoveries of the philosophers, 'sports medicine' gained a new and important impulse. Crates of Thebe (365-285 BC), a pupil of Diogenes (404-323 BC), began daily walks to improve the diseases of his liver and spleen.

460 BC

The Greeks called their spas asclepias, in reference to Asclepius, the god of medicine

It is assumed that the Greek Hippocrates (460-370 BC) was the first practitioner of physical therapy.

Hippocrates (460-370 BC), the "father of modern medicine", promoted balance recovery to remedy disease, and supported hydrotherapy as part of this rebalancing. He spent a lot of time dealing with sports injuries, but also on the performance of his athletes.
The doctors who recognized the value of physical training for the organism as a whole and for health reasons became increasingly numerous, and even Hippocrates (460-377 BC) adopted some of Herodic's instructions. In his text about the diet mentioned to him, he noted:

"In order to stay healthy, the entire day should be focused exclusively on ways and means to increase your own strength and to stay healthy, and the best way to do that is exercise."

He was a great advocate of medical gymnastics, massages, manual therapy and hydrotherapy to achieve this. The science of sports medicine therefore flourished during the Roman Empire, especially in the time of the gladiators. He advised exercises as a compensatory factor "between the power that is being spent and the one that is absorbed". He recommended prescribing exercises that took into account both the individual's possibilities and the seasons and he banished excesses. However, his attempts at rationalization were influenced by the beliefs of that time, which were characterized by the theory of the four primary elements of air, water, earth and fire, from which each matter would be composed. This world vision transposed to the human body led Hippocrates to develop his "theory of the four bodily fluids": blood, mucus, black bile and yellow bile, the equilibrium of which ensured health and an imbalance caused the disease.

Today, the Hippocrates' statements are more pertinent than ever:

"All functional parts of the body remain well, stay healthy and become older slower if there are moderate requirements. In passivity, on the other hand, they age quickly and are susceptible to diseases."

"If we give the right amount of nutrition and physical activity to each individual not too little and not too much, we have found the safest way to health."

440 BC

In order to eat and sleep better, but also to improve his health, Socrates (470-399 BC) taught himself gymnastic dancing, for which he was ridiculed by his friends.

430 BC

Between 430 BC to 330 BC, the 'Corpus Hippocrates' was compiled, a Greek text on medicine. It is named after Hippocrates (460 BC-370 BC) and contains text specifically applicable to orthopedic surgery. For example, the text describes shoulder dislocations and various reduction maneuvers. Hippocrates perfectly understood the principles of traction and countertraction, especially with regards to the muscular system. The Hippocratic method is still used to reduce anterior shoulder dislocations, and its description can be found in many modern orthopedic texts. The 'Corpus Hippocrates' also describes the correction of clubfoot deformity, and the treatment of infected open fractures with black wax ointment and wine compresses, the treatment of fractures, the principles of traction, and the implications of poorly healing fractures.

For example, Hippocrates wrote,

“A shortened arm can be hidden and the mistake will not be great, but a shortened thigh leaves a man mutilated.”

The first orthopedic devices also appear with Hippocrates: he developed a wooden bench that reduced dislocations and fractures. The principle of this device is to immobilize the bone or joint so that it recovers. For the correction of spinal malformations, he developed an orthopedic extension device.