A South African Trek

Deputy Editor Jim MacDonald with Co-Presenters at IFSEMC, Winile Mothsoane (Left) and Phatho Zondi (center)

I’m coming off one of the most exceptional experiences of my professional life, and I want to share the good news about sports & exercise medicine in southern Africa.

A week ago, I was in Pretoria South Africa at the International Festival of Sports, Exercise and Medicine Conference (IFSEMC).  I was sponsored by one of CJSM’s Affiliated Societies — the American Medical Society for Sports Medicine (AMSSM).

The AMSSM has been gracious enough to sponsor me in the past when I traveled in 2015 to South Africa to attend the South African Sports Medicine Association (SASMA) biennial conference.  I wrote about that experience in this same blog seven years ago.

On this visit, the conference was a true festival — a joint venture put on by SASMA, the Biokinetics Association of South Africa (BASA), the African Physical Activity Network and The South African Society of Biomechanics.

There is still so much I am processing from this visit, but I’d like to share with you some of the highlights after first encouraging you to do these things:

a) pencil in October 2024 in your calendar.  You must make an effort to come down to Cape Town for the upcoming biennial SASMA conference (dates and agenda full to be determined);

b) follow SASMA and BASA on Twitter if you don’t already; you’ll learn so much.

Now, a few of those highlights.

One of the most memorable moments of my entire journey was the Presidents’ Dinner, to which I was invited and which took place the night before the conference began.  I was seated next to two wonderful conversationalists:  Jon Patricios, past-President of SASMA, and Winile Mothsoane, International Director for BASA.  Among other things, we were discussing the field of biokinetics, a profession we don’t have in the USA.  

I cautiously (because I am ignorant still) would describe biokinetics as a combination of what we term ‘athletic training’ in the USA and kinesiology.  There’s an element of physical therapy in there too. And a dollop of strength & conditioning.  Ultimately, the field seems to me to be one of the most representative of that current mantra most clinicians in my profession embrace: that exercise IS medicine.  Movement is the key to both disease prevention and treatment in so many cases.  

As Winile and Jon were describing the various dimensions of this profession in South Africa, I realized two things:  1) I wish we had biokinetics in the USA, because when I want to ‘prescribe exercise’ for my patients, I am sometimes at a loss to direct them to the right person and 2) in medicine, and life in general, we draw these lines and create boxes to which we append names and titles; when in fact, the continuity of care for the patient is fluid, and without boundaries.  The names and titles are used to create pathways for training and licensing, and I think it’s natural to see these as fixed.  But they’re not.

Which made me think of….Willie Nelson.

“I think the lines are only imaginary and that you have to put them there, because they’re not there in the beginning. It’s music, you know? You can’t say it’s this, that, or the other. It’s not a Democrat or Republican. – Willie Nelson”

Willie Nelson and Ray Charles — genius

This was the thought that came to me when I was learning about the field of Biokinetics.  Substitute ‘medicine’ for ‘music’, and you’ll be in my head.

The thought has been one that has danced in my mind throughout my medical career, dating to my days as a full scope family physician, prior to my mid-career shift to sports medicine.  Taking care of older patients, pregnant patients, children, the disabled….so often the complaints my patients would seem to elude the compartmentalization of ICD10 diagnostic codes or the pharmaceuticals in my armamentarium.  ‘My’ conventional medicine would fail them.  

Photo James Minchin III

This drew me over time to a variety of modalities including medical marijuana (‘hello Willie Nelson!’) and acupuncture as just two examples of treatments I did NOT learn in medical school, but which I have used with my patients.

The entire spectrum of what my patients experienced, and the needs they had, could not be addressed in one compartment (allopathic medicine) or by one person (e.g. ‘me’).

For our athletes this is as true, and it surely takes a community of professionals to provide them the care they need: biokineticists, physiotherapists, nutritionists, mental health professionals, and clinicians like me (primarily needed when the athlete is injured).

With Phatho Zondi (L) and Winile Mothsoane (R); Nonhlanhla Mkumbuzi presenting remotely

A lot to chew on there. 

I’ll leave you with one other significant personal highlight, one which dealt with another subject that is big and all- encompassing for our profession:  Diversity, Equity and Inclusion (DEI).

My good friend Phatho Zondi, past-President of SASMA, asked me to provide an journal editorial perspective on the topic of Inclusive Research and Clinical Practice: The Building Blocks.  She brought biokineticist Winile Mothsoane on board, as well as physiotherapist Nonhlanhla Mkumbuzi.

In my experience, any good panel discussion will teach me more than that which I arrived with — whatever skillset I brought to this group, I know I walked away with more knowledge than I brought.  Phatho, Nonhlanhla and Winile are wonderful teachers.

If  I could  leave  you  with  one  concrete  item  from  that  talk  it  would  be  this:  make  sure  you  use  this  QR  code  to  take  you  to  a wonderful  diversity, equity  and  inclusion  tool  kit  you  will  find  invaluable.

Thank you AMSSM for sponsoring me.  Thank you SASMA and BASA.  Thank you Phatho for the invite to talk with you and learn so much.

And to the readers:  I hope to see you all in Cape Town in October 2024.  SASMA 2024 is sure to be worth the trek.