Dear Colleagues,

Physical activity, as part of activities of daily living (ADL), has declined rapidly among humans in the western world since the advent of the industrial (~250 years) and, later, technological revolution (~20 years). This is evident in the global rise in obesity and obesity-related diseases. Children are among the most active members of the population, but the emergence of childhood diabetes (~20–30 years ago) and declining physical literacy across Europe suggests that children are also suffering from modern environments that are considered recent in our evolutionary history. While it is evident that the total amount of movement humans undertake has declined, modern environments have removed much of the environmental complexity that required a variety of movement strategies, e.g., hunting, gathering, tree climbing, and navigating variable terrain while barefoot. It can be argued that we are required to move less but also to move less variably.

Sport participation is often cited as a tool to promote physical fitness amongst children and adults. However, in order for sport or health related exercise to be enjoyed and continued, it requires a robust musculoskeletal system and physical literacy. The extremely high incidence of injury in running, a simple recreational sport and one which we evolved to do, is indicative of how modern environments are reducing our capacity to maintain healthy physiological and musculoskeletal systems. It is highly likely that most modern athletes and exercisers also lead sedentary lifestyles, meaning they are less conditioned for vigorous physical activity. Furthermore, the modern foot-surface environment is likely exacerbating the issue. Modern footwear use is associated with weak foot muscles and injurious running biomechanics, and modern surfaces such as concrete are unyielding and offer little in the way of variability underfoot.

Colleagues, it is time we placed greater emphasis on prevention rather than treatment. To do this, we must look to the past, to understand the current mismatch between our bodies and our environment. This Special Issue calls for papers which aim to use a preventative lens in our understanding of sports and exercise medicine.

Dr. Peter Francis
Guest Editor

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• evolution
• sport
• exercise
• movement
• injury
• developmental
• medicine
• musculoskeletal
• physiology
• biomechanics