Athletes Who Cheat!

July 27th, 2010

You might be wondering what is on the drawing board, right? Well, wonder no more. Consistent with earlier postings is another one on genetically enhancing athletes! Sounds like a great idea. Or, does it? Frankly, I haven’t heard any of my colleagues in exercise physiology talking about it. But, honestly, why would I think exercise physiologists would be against cheating in athletics? Most aren’t against using performance enhancers, especially the faculty members who have had the opportunity to do research in sports supplements. What is scary to the core are the human enhancers on the verge of being promoted. The technology is there or it is just around the corner. Read what C. Ben Mitchell, PhD, wrote in an Editorial [1]. “…through the use of preimplantation genetic diagnosis, human embryos are screened for undesirable genetic traits and embryos with those traits and embryos with those traits are not transferred to a woman’s uterus — they are discarded or used in embryo-destructive research. This is not enhancement, but negative eugenics.”

Is it a good thing that parents will be able to make their children different before their children have the opportunity to think about it. Is it their life? Or, is it they will be great full for their parents’ actions? Will the children be happy about their additional athletic skills or will they wake up wishing for a different life? Will the genetically-defined athletes be human life everybody else? Will they understand the work it takes for the “average” to excel? Must athletics be about winning and nothing else? Will parents wake up one morning hearing the screams of the their son or daughter saying, “Enhance me or kill me!”

When will athletes wake up and say to the world, “This isn’t right.” Coaches and others, especially the sports nutrition types, and the gone-wrong exercise physiologists, will then sense the need to run for the hills. Will they run or will they stand on the street corner and sale sports supplements much like the snake oil salesman decades (or should I say) yesterday on television? The act of gaining a “competitive advantage” is over the edge. It is now a battlefield of stupid ideas. Many athletes, certainly not all, are no different from junkies who need their fix.

But, of course, when they are caught, the message changes. “I did it for the fans.” Or, “Everyone’s doing it. Might as well be approved.” “Really, sudden death, forget it. That doesn’t happen.” “Side effects, get serious. Do I look like I’m growing a third arm?” Did I hear you say it is all about hard work and dedication? Get serious. Athletics, like most things in life, is all about cheating, whether it is a game or friends. If you can cheat your way to a position, do it. That’s life as most people know it. This is not only bad news, but bad news for humanity as well.

Reference

1. Mitchell, C. B. (2008). Genetically Enhancing Athletes? International Journal of Bioethics. 24:1:5-6.

Sex Before An Athletic Competition

June 11th, 2010

Here we are…the World Cup 2010 and more questions about “sex and athletics.” I have to admit that “the time for talk is over.” Sex before an athletic competition has “zero” to do with whether the athlete performs well or not. Sex is an amazing thing. Under no circumstances should it be implicated in an athlete’s failure to perform well. So, let me provide a few facts. First, the most aggressive sex requires an average of 250 calories per hour or 4 calories per minute. If sex intercourse leads to orgasm in 5 minutes on average, the caloric cost is 20 calories! That’s it. The energy cost of “the sexual release, that is, orgasm,” is essentially 25% of what it would cost to walk a mile in 20 minutes. Why, because everything other than the orgasm itself, which is admittedly the most aggressive physical aspect of love-making, is on average 5 minutes or less once the business of sex gets underway. I should add that some experts say 2 minutes after penetration, orgasm is the name of the game.

This thinking (i.e., energy cost) is consistent with the man-on-top and an average heart rate of 130 beats per minute versus woman-on-top of 110 beats per minute. Yes, blood pressure is increased, but not too high. It is consistent with the body muscle contractions. Think about it. Sex requires “on average” 3 to 5 METs. Remember that one MET is equal to resting metabolism. So, say “4 METs” or 980 ml/min (based on an average of 250 ml/min at rest) is the energy cost of sex, which is equal to walking 4 miles an hour on a treadmill. Please appreciate that after 30 minutes of continued walking, sexual intercourse that led to orgasm was completed 25 minutes ago. Of course the walking doesn’t wear out or exhaust the athlete or even the non-athlete. So, why would 5 minutes of sex to orgasm diminish the athlete’s physical abilities? The obvious answer is that it wouldn’t.

That’s why sex before an all-out athletic event can’t hurt the athlete, that is, unless the athlete is convinced that it would. Who would convince the athlete of such thinking? The most obvious person is the COACH. This brings up an interesting point. If there isn’t any scientific data that says athletes shouldn’t engage in sex before competition, then, why are coaches telling their athletes to abstain from sex the night before? It is time that they get the facts straight. Hello, this is the 21st century! Why in the world would the British coaches tell their athletes “no sex” and that “coaches would monitor their hotel rooms.” It makes no sense whatsoever. Why? What if the athlete’s aerobic power is 60 ml/kg/min? This is equal to a little more than 16 METs, which provides the athlete a 75% aerobic power reserve above the actual cost of sex. The Argentine team doctors and the Brazilian coaches have it right. They understand that sex doesn’t hurt athletics, and they get that sex actually can have numerous positive benefits (such as sleeping better, facilitating a sense of well-being, decrease stress, and increase self-esteem.

I hope this helps.

Genetically Enhanced Athletes

April 24th, 2010

If you are a parent, have you thought about the connection between your children and athletics? More specifically, have you any idea of the people who are betting that you will buy into human enhancement? The role of genetics in sports is just around the corner. Maybe you should think about whether it is a good idea today while your children are still young. The technologies for human enhancement are in the future, but not too far. In fact, just over the horizon is an awakening! That is why it is likely that the use of preimplantation genetic diagnosis is something you should think about. Screening embryos for genetic traits isn’t athletics as usual. It is about DNA winning-at-all-cost. Is that a good thing?

There isn’t any question that athletics is a battlefield. Athletes are already trying to access genetic intervention for physical enhancement (refer to Scientific American, July 2004). By now, everyone should know that athletes are big-time steroid users and everything else they can get their hands on to get the medal. Hardly anyone thinks of the bad effects anymore. Regardless of Congress signing into law HR 6344 in 2006, gene doping is big time U.S.A. Sports! Sure, of course, athletes work hard. They are dedicated to their sport. Achievement is everything. Winning is even more. But, “cheating” is still cheating! Hello, wake up athletes, coaches, trainers, doctors, exercise physiologists, and anyone else involved, including parents, the use of performance-enhancing drugs or performance-enhancing genetic modifications to gene-doping is unethical.

Athletes, amateur or professional, regardless of age, keep sports clean. Celebrate sports for what it should be, not for what it is.

Have You Heard Anything So Ridiculous?

April 3rd, 2010

After getting a degree in exercise science, graduates can choose a career path in fields such as nursing, teaching, nutrition, therapy, counseling, coaching and research.

Being Successful…

March 8th, 2010

My intention is to tell
of a new exercise physiology.
The sports medicine folks and everyone else,
specialists and trainers alike,
All disappear,
And we, the EPCs,
Become visible.

The power of wisdom is power! But, first, what is wisdom? Maybe it is simple as “stop digging when you find yourself in a hole.” New thinking is always a historical event. If one does not believe that the birth of new ideas is possible, why suffer from speaking out? But, if one could affirm a new idea, perhaps, then sports medicine could be suspended in a timeless existence never to influence exercise physiologists again. If only, there was just one person with a new idea, something different from the countless statements of fussy thinking.

I’m compelled to state that you should not hold your breath looking for that one person with insight and determination to think afresh. Instead, the empire continues unabated with its usual cruel and oppressive functions. The cult of sports medicine personalities is a politically driven life line of decades of failed rhetoric. The imposing reality of exercise science as if there were exercise scientists and/or actually real jobs in the public sector where exercise science graduates are hired isn’t laughable. It is sad, hurtful to students and their parents, and it should be a crime. Remarkably, at least the present time, it isn’t. Personally, I believe it will be at some point in the future. The common culture of education isn’t just to educate, but to set the stage for graduates to work, to make a living, and to be in position to pay back tuition loans and still financially survive.

Even from this brief sketch it is evident that the power of an education is not linked to misinformation and/or a certification that isn’t part of the complete identity that communicates professionalism. Thus, when you decide to go to college, do not play around with the academic major. Pick a major that has the greatest potential for being successful. Do not allow yourself to be ambushed by those who keep telling you the same old stories. Honestly, they will tell you that exercise science is exercise physiology. It isn’t. They will tell you that there are a lot of clinical exercise physiology jobs and you should join a clinical exercise physiology association. This is absolutely untrue, and it borders on hypocrisy, if not some kind of morbid fantasy.

My point here is that the common everyday social ritual of the sports medicine puppet is just that “common.” Each one approaches every student with the same line. For example, if you like strength training, get a strength and conditioning certification and work as a strength and conditioning trainer. Hello, have you looked as to how many such jobs actually exist? To the college graduate who will emerge just long enough to call his or her parents to tell them “there are no jobs and I would like to come home” — “help, please help me, please help me.”

Yet, on the other hand, “being successful” is all about thinking straight and standing up for one’s rights. It has something to do with critical thinking, that is, the ability to think clearly and objectively. But, more than anything, it is all about understanding the symptoms of failed rhetoric. Once stupid thinking is understood for what it is, one can be beyond the vomiting and nausea of being a loser for so many years. In conclusion, it is always good to recall as William Bolitho said, “The adventurer is within us….”

Being successful means thinking, and I mean seriously taking the time to think and uncover the facts, then face the reality of what you find, and finally “stay the course” of something better.

“20″ Truths About Leading Change

January 18th, 2010

1. Change takes time — years and decades.
2. Change takes people out of their comfort zone.
3. Chnage begins with an idea or vision of something better.
4. Change starts with a few people more so than a lot of people.
5. Change requires talking and writing about the vision.
6. Change starts with action.
7. Change takes place with commitment.
8. Change is associated with mistakes.
9. Change requires creative thinking.
10. Change is an emotional roller coster.
11. Change is carried out by ordinary people.
12. Change requires persistence.
13. Change is too much for some people.
14. Change is about creating a new culture.
15. Change requires a core of people who share the same vision.
16. Change involves people.
17. Change is driven by an acknowledged reality.
18. Change is dependent upon a trusting environment.
19. Change is associated with resistance.
20. Change is difficult.

Sounds of Silence

January 14th, 2010

There are many sounds of silence, but occasionally you hear a sound of life. Usually, it is a tap-tap, much like “I’ve been thinking about joining ASEP.” For all those who have moments of “sound” that says, “Join ASEP and support the organizational leaders in the professional development of exercise physiology.” There is truth that “the whole is greater than the sum of its parts.” In short, there is strength in numbers. Join ASEP. Join the American Society of Exercise Physiologists on behal of all exercise physiologists worldwide.

Your Power to Choose

July 5th, 2009

Your power to choose your future is your right. Every minute of the day every exercise physiologist should be in the state of mind to choose his or her future. Is it the exercise specialist’s path or is it the professional organization of exercise physiologists, the American Society of Exercise Physiologist? The more I think about it, the more I’m convinced that failing to choose the right path is a function of not knowing you are in charge.

For those of us who work towards change in exercise physiology, it should be comforting to know that it is possible to be in charge. One can only imagine how difficult it must be for those on the outside of ASEP (i.e., those who can’t imagine something other than what they have been doing for decades). Hopefully, it is just a matter of time before it becomes clear to them that they need their own professional organization. That moment will be by choice a very special one. Then, their future in exercise physiology will be defined and guided by them.

The outcome of this thinking will help to define the professional experiences the exercise physiologists will come to understand, and how their work will be interpreted in terms of surviving financially as professionals in the healthcare market. With each of these considerations, it will increasingly become your choice to create and/or sustain the work towards the professionalism of exercise physiology.

Each of us has been granted the power to choose. We possess the power to choose what to believe or not to believe. If you choose to believe that you have no control over the future of exercise physiology, your outcomes will continue to manifest exactly as they have, based on that belief. On the other hand, if you believe you have the power to choose what your future will be, then you are part of a profession that you helped to create. Enjoy it. Understand that you have the power to change. Choose wisely.

You are THE Leaders of the Future

April 13th, 2009

Behind the scenes of every academic program, there are faculty members who are responsible for teaching courses in the physical education major, others who teach courses in the athletic training major, and still others who teach courses in the exercise science major. As an example, consider the following department titles:
1.Sports Sciences
2.Human Performance
3.Health and Exercise Science
4.Physical Education and Exercise Science
5.Health and Human Performance
6.Kinesiology
7.Exercise and Sports Sciences
8.Human Movement
9.Movement Arts and Health
10.Kinesiology and Physical Education
11.Health Sciences, Health and Fitness Management
12.Sports Studies and Physical Education
13.Health, Wellness, and Physical Education
14.Health and Human Services
15.Exercise, Health, and Human Performance
16.Exercise and Athletic Training
17.Kinesiology and Exercise Science
18.Sports Sciences and Fitness
19.Physical Education, Wellness, and Sports Studies
20.Applied Physiology

In one analysis, out of nearly 900 department web sites, I found close to a 100 different department titles. Frankly, that is a problem. It demonstrates more than anything the lack of leadership, purpose, and sense of direction.

I’ve been a college teacher for nearly 40 years, If you were to ask me the question, “What has changed?” – I would say Nothing! The original mess, since physical education was challenged in the 60s for being a meaningless degree for athletes, has gotten worse. The issue of diverse department titles and quality of education has seldom been addressed.

Most of these departments are stuck in a phase of growth that no longer serves the students. Keeping things as they have been serves the department and the academic institution rather well. 150 to 300 student-majors represent a significant income and security, but it does relatively little to benefit the students in the long run.

In fact, just this week I was reminded of why ASEP exists. While getting some grocery items at Super One, the guy at the cash registered said: “You’re a teacher, right? I said ‘Yes.’ What do you teach? I’m an exercise physiologist. Oh, one of the other clerks just graduated as an exercise physiologist. I said, “That’s interesting. Where did he graduate? “From University of Wisconsin, in Superior”, he said. Then, I said, almost without thinking, “He isn’t an exercise physiologist.” He looked at me rather strange like, then, I said “He needs either an academic degree in exercise physiology or he must pass the EPC exam to earn the professional title, Exercise physiologist.” He just kept staring at me as I left the counter.

Transformative change is never easy. It takes time, resources, and the perseverance. Unfortunately, the entire exercise physiology community must be involved in solving their problems and, frankly, most academic EPs just don’t get it.
•They aren’t comfortable moving in the direction of the unknown on the promise that ASEP is the right course of action.
•And, it is clear that people like to remain connected to those they know, those who have taught them, those with who they are familiar, even at times of their own detriment. In other words, change is not a trivial process.

I am, after all, a product of years of failing to change. I performed academic functions entirely without knowing that I didn’t think differently because it was comfortable doing what others had done for years.

It wasn’t until I became a department chair that I realized neither more nor less academic titles, concentrations nor emphasis areas will help students from the inadequacies of the traditional ways of solving problems. There are simply too many false assumptions. For all intents and purposes, there is a lack of leadership today with respect “what is exercise physiology.”

Not surprisingly, exercise physiology is still defined as “acute and chronic adaptations to exercise training.” This thinking simply will not help us solve the challenges we now face. Instead, it requires radical rethinking of the most basic and foundational ways we view ourselves.

But, you may be thinking, “How can you say that?” First, there are essentially no other comparative academic departments with such in-house confusion about its purpose. For example, although most academic institutions graduate primarily physical educations majors, more often than not, they refer to the students as exercise science majors. My young friends, you are not living in ordinary times. The minds of many, if not most, academic exercise physiologists are closed to the fact that students majoring in academic programs that is essentially 90% a physical education major.

Calling it an exercise science major or even a concentration will not (cannot) make it an exercise physiology degree. That’s why students should not be encouraged to think of themselves as exercise physiologists when they graduate from an exercise science major or a kinesiology major. There are many other examples as well.

Second, what I’ve said is true despite the bursts of published papers by exercise physiologists in non-exercise physiology departments. Research by itself is not enough to bring about a change in awareness of the need for one’s own professional organization.

Academic exercise physiologists have lost sight of the distinction in professional titles that exist among other professions. They have also failed to appreciate that “exercise is medicine” and that exercise physiology at its core is a healthcare profession no different from PT, OT, or nursing.

There is no reason why exercise physiology should feed physical therapy programs, unless of course you already understand that exercise science is not a career-driven academic major.
Research is important and, in fact, it is an obvious requirement for being a profession. There are other requirements, too. One that is critical to any profession is the support of its professional organization. Others include a code of ethics, accreditation, and standards of practice.

The glue that holds every profession together is the sense of common identity that is tied to a common purpose. None of this exists within departments that embrace a failed sports medicine rhetoric; one that is infectious but misleading.

Graduating exercise scientists with an undergraduate degree is make-believe! Understandably, I don’t say this lightly. I’m not interested in offending anyone. My brain tells me that unless we change the way we think and talk about exercise physiology, many of us will continue to stumble and fall about.

This is not acceptable, given the expense of going to college today. No student should graduate to a fitness gym-job without medical benefits and a salary to pay the bills. Regardless of what some may think, I don’t believe being a “personal trainer” is the job most
parents hope for when their son or daughter graduates from college.

Also, in my opinion, exercise science, either as a degree or a concentration, is not an academic program that is pulling us into the future. It represents no-change from past thinking or, worst yet, change in the wrong direction. At least physical educators have a concrete connection to job opportunities. Exercise science is on a collision course with failure.

Note the following statements taken directly from several popular department web pages:
•The Exercise Science major prepares for work in clinical exercise physiology in hospital/clinical settings, as well as graduate school allied health programs such as occupational or physical therapy, exercise science or biomedical sciences.
•Exercise Scientists study the relationships among exercise participation, physical activity and human health and focus on the development and delivery of preventive and rehabilitative physical activity programs that promote health and prevent disease.
•An undergraduate degree in exercise science can prepare you for a broad range of careers such as clinical testing, fitness, performance enhancement, physical therapy, and cardiac rehabilitation.

As long as this kind of thinking goes unchallenged, students of exercise physiology degree programs end up experiencing similar problems in locating jobs because neither the faculty (in general) nor the public knows the difference between exercise science and exercise physiology.
Learning to think differently is imperative. It must be learned and it can be learned – and this, of course, is part of what this presentation is about. We can already see how other healthcare professions have changed (and have do so for decades) and how they continue to create new ways of thinking and leading.

We need an entirely new vision of exercise physiology, and that is exactly why ASEP was founded. However, the process of transforming how we think is not an easy process. In short, it means getting rid of the old to make room for the new!

The newly emerging language of:
•professionalism – not another weekend certification
•code of ethics – not greed or opinions
•standards of practice – not just more research without focus or even meaning
•accreditation with a purpose, not an agenda item for competitive reasons, and
•board certification is very different.

Nine out of 10 academic exercise physiologists aren’t prepared to rebel against the established way of thinking. They operate within the boundaries of programs defined by very little to no change since PE became ES in the 70s and 80s.

Wouldn’t it be impressive for an exercise physiologist to say to a department chair the following? “The exercise science major needs to be updated to an exercise physiology major. This can be done in accordance with the ASEP Accreditation Guidelines. I know it will take work and dedication, but it is the right thing to do. Is it going to take time, of course it will.”

Although we may share fundamentally different views on what I’ve said and what I’m about to say, the objective is rather simple: That is, why not do what is best for our students? Exercise physiology today is not as it was 20 or 40 years ago. It is not just about research or calling oneself a “physiologist” or even a “scientist.”

There is little doubt that the academic exercise physiologist’s job should be an unshakable commitment to the student’s education, not to writing another grant or attending a meeting (even this one), even though both are important.

These things are all part of the job of a being a college teacher, just as service is. The name of the game is giving power to our students so that they may take the best of what we can give them to realize their true potential and happiness. This, it seems to me, is intuitively and morally the only course of action.

Therefore, it is only right that exercise physiologists, particularly, the Board Certified Exercise Physiologists should come together and agree that the institutional thinking of the past is obsolete and that new ways of thinking about the profession should be taught, crafted, and implemented. I know I’ve said it to myself 100s of times, “Tommy, be strong, stay the course, after all, my students should have the same rights to a future in healthcare as the students of PT, OT, nursing, and dietetics.”

Understandably, it isn’t easy to “stay the course” but it is possible. I’ve taken risks and done things that some of my friends are not willing to do. The bottom line is that the old paradigm is dead and it should be buried and put away!

It is time to clean away the old thinking, and replace it with a new way to think about who we are and what we do. I imagine the new way might look something like this and, if you will, a recipe for coming together:
1.Fill the cooking pot with fresh 21st century ideas, especially the ones that speak to healthcare, sports training, and professionalism.
2.Fill the pot with more discussion among colleagues, more papers on the exercise physiologist’s code of ethics and standards of practice.
3.Stir in equal parts of focus on students and the role of a college degree in their future and financial well-being.
4.Bring to a boil and blend a liberal portion of research by exercise physiologists at all levels of education.
5.Fold and slip in precisely the right amounts of credibility, accountability, and legal responsibilities to clients and patients.
6.Simmer until smooth, thick, and strong, stirred with a common purpose driven by a shared vision and leadership.
7.Season with a dash of business courses and a pinch of courage to commit to building one’s own financial athletic and healthcare enterprise.
8.Let cool, then garnish with a topping of specialized certifications that further supports the EPC’s professional status and recognition.
9.Serve by teaching “professionalism” and self-worth as a course of study as one would teach exercise physiology.

To make this recipe work, to embrace a vision of the future that is compelling and inclusive for all, we must have the courage to do and say what we believe is right, rather than what is convenient or popular. Also, we must find ways to build partnerships based on shared aspirations.

Notice the emphasis on the word “we” – which is another way of saying “Self-Leadership.” Students (and especially those of you here today) need to take stock of this point because “leaders of the future” come from YOU. You must be willing to engage in self-change, and to bring into being what never existed before and couldn’t have been predicted based on the past.

As I was thinking of this meeting, I thought about asking students in particular, “What are you going to do to make the most of your life?” I thought, “Please God, let me find that person who will transcend the normal everyday way of thinking, who is going to break through, inspire us, challenge us 24/7/365, and call forth from all academic EPs the spirit of imagination. Bill Moyers said it best: “You know the spirit of which I speak. Memorable ideas sprang from it: “life, liberty, and the pursuit of happiness”…”created equal”… “government of, by, and for the people”…”the only thing we have to fear is fear itself”…”I have a dream.”

Never have we been more in need of transformational changes to create and anticipate the future; changes that are profound both in behaviors and new competencies. Of course this will require massive amounts of collaboration with all the stakeholders involved so that there is broad-based acceptance and support of the ASEP vision and mission.

The logic is clear: Whatever your politics or academic background, my friends, we cannot go on under false pretenses that non-exercise physiology majors or concentrations have merit (especially when young people need our guidance when it comes to “what is exercise physiology”). It simply is immoral to ask students to go on paying hard earned tuition money for the wrong reasons.

And, frankly, we cannot win the battle as quickly as we should when our leaders don’t have the will or courage to ask everyone to sacrifice. Exercise science and whatever else it may be called needs fixing, because it is badly broken. Think it over: Those who graduate without a degree in exercise physiology aren’t sharing in the profits. Their incomes cannot keep up with costs and, therefore, because it’s harder and harder to figure out how to make ends meet, they go on to other fields of study. I believe this is the reason ASEP exists.

Please appreciate that challenging yourself to get out of your comfort zone is not easy. In fact, most can’t or will not do it. There are many kinds of risks in life: emotional, intellectual, and physical. The important ones are those that help you grow and express your values, especially in the service of others.

So, in summary, challenge the old assumptions, question the status quo, and develop new solutions, knowing there is no straight line to some future point. There is only learning along the way, adapting, and trusting your instincts.

When you do these things, you will be different, and your example will provide hope for others. After all, what you do defines who you are, what you stand for, and what you are willing to do to get what you want.

Why ASEP Matters!

March 22nd, 2009

In exercise physiology, as in other academic majors, the idea that all college teachers are working on behalf of students, that is good intentions, is often lost in other concerns. Perhaps, it isn’t so obvious that traditional values, even those recently acquired, set the direction of each day, much less the obvious definition of who we are and what we believe is important.

Okay, so with that understanding, what is the problem of not honoring a professional organization? The problem is that good intentions per se aren’t enough. College teachers need to be on the right track with contemporary thinking, especially that of the ASEP organization, leadership, and the professionalism of exercise physiology.

Most leaders love to make strategy, but it is vision and values that spawn strategic action. The absence of a vision will doom any strategy — especially a strategy for change. A true vision shapes assessment and promotion, and behavior towards professionalism, partnerships, and investors in the future. Having a vision is a more powerful tool for leading an organization than any market analysis or spreadsheet.

But defining the right vision, the right expression of what ASEP wants to accomplish, and articulating the values that govern how the organization operates are not easy or painless. As with all organizational development, evolving from one idea to the next is hard work.

The first step in visioning is to assess your organization, your industry, and your sector of the economy. What do you do uncommonly well, and how do you fit into the changing landscape of exercise physiologists as healthcare professionals? For me, it is obvious. For others, it is much slower in coming around to the understanding that exercise is medicine.

Hence, ASEP matters…