Opinion
Mind-Body Medicine Completes Sports Medicine: Development of a Prophylaxis Model Through Sports Medicine
by Robert Erbeldinger1
1Diploma in Sports Science, Johannes Gutenberg University Mainz, Germany
Professional Master´s Degree in sports medicine, publisher sportärztezeitung, Mainz,
Germany
Cite as: Erbeldinger, R. (2025). Mind-Body Medicine Completes Sports Medicine: Development of a Prophylaxis Model Through Sports Medicine. THE MIND Bulletin on Mind-Body Medicine Research, 7, 23-30. https://doi.org/10.61936/themind/202504306
Abstract:
In a nutshell:
1. Sports medicine has significant health-preserving potential.
2. Mind-body medicine is developing as a complementary approach to sports medicine to promote holistic health ("whole person health") and is being integrated into sports medicine in prehabilitation on an equal footing with exercise, sport, and nutrition.
3. The prophylaxis model results from prehabilitation.
Sports medicine is changing from a diagnostic discipline focused on competitive sports to a holistic, conservative, multidisciplinary, and multimodal therapy concept to promote health (Harvard Medical School, 2025; Nehrer, 2025). The number of scientific publications, congresses, and demands from athletes and patients is enormous (Musumeci, 2022). The importance of sport and exercise for mental health is widely recognized (Ströhle, 2024; Khan & Burton 2023; Laube, 2022).
Maintaining health through sports medicine
The focus is more on health maintenance (Casasco, 2025) and active involvement of patients (therapy & training) or non-patients (hygiene-intervention / training) and athletes (Harvard Medical School, 2025; Nehrer, 2025) than explicitly on the treatment of injuries and performance diagnostics.
The interdisciplinary additional training program in sports medicine (Joisten, 2025) is not an independent subject. It is traditionally characterized by orthopaedic trauma surgery and focuses predominantly on conservative, physical, and regenerative methods, some of which are complementary (Gerbing et al., 2013). In practice, however, there is a lack of sufficient conservative training opportunities, especially in comparison to the high standard of orthopaedic-surgical training (Psczolla et al., 2017).
This makes sports medicine, especially its increasingly integrated complementary (Gerbing et al., 2013) measures such as mind-body medicine, nutrition, and sports nutrition (Gerbing et al., 2013; Esch, 2020; Marshall, 2023), susceptible to informal approaches (Myall et al., 2023; Dossett et al., 2020) without coordinated guidance for the athlete as well as patients and non-patients (Gerbing et al., 2013).
Sports medicine and integrated mind-body medicine
A promising integrative approach in sports medicine is the increasing use of mind-body medicine (Dossett et al., 2020) with regard to its direct interaction with psychosocial stress factors (Tschaffon-Müller et al., 2023; Deutsches Ärzteblatt, 2023), accelerated regeneration and wound healing (Schubert, 2023) with the involvement of the patient and athlete. Topics such as psycho-social support (Deutsches Ärzteblatt, 2023), self-management (Stöve & Halder, 2025), self-care (Benson, 2011), and self-healing (Esch, 2020; McSwan et al., 2021; Mobasheri, 2022; Schubert, 2025) are of particular importance.
Mind-body medicine is based on the human potential to regulate one's own body physiology or to heal oneself. It focuses on activating and strengthening individual resources to improve one's own health (Schubert, 2025). The underlying psychoneuroimmunological modulation capacity as a reaction to injuries and infections, for accelerated wound healing and, as is known, for an adapted stress response is fundamental (Schubert, 2023; Schubert, 2025).
Mind-body medicine, whose origins and development history can be traced back to people such as Walter Cannon, Hans Seyle, Herbert Benson, Jon Kabatt-Zinn, and Dean Ornish in the USA (Michalsen, 2015), today generally encompasses mental and behavioral approaches as well as techniques from the areas of exercise, relaxation, stress regulation and nutrition (Esch et al., 2003). Of particular note is the strong evidence for exercise and nutritional interventions (Esch, 2020), including the central importance of exercise and relaxation in promoting physical and mental health (Esch & Stefano, 2010). The combination of these elements shows particular potential when a personalized connection and relationship is established (Schubert, 2025). It complements sports medicine with a holistic and comprehensive approach.
This approach considerably expands the spectrum of conservative sports medicine therapy. A comprehensive conservative treatment concept for osteoarthritis of the knee shows positive results in terms of reducing depressive symptoms, anxiety, pain, and improving physical functioning (Lim & Al-Dadah, 2022).
The problem of patients' pre-existing anxiety and avoidance behavior, which occur even before the actual treatment planning, should be particularly emphasized (Kavka et al., 2024).
Mind-body medicine supports sports medicine in prehabilitation
Sports medicine developed in this way with a holistic and comprehensive approach is used to provide targeted support for prehabilitation and patient education (McIsaac et al., 2025). As complementary medical measures of a first-line treatment integrated into various specialties, mind-body medicine attempts, among other things, to counteract the body's own stress response (Schubert, 2025) and reduce unnecessary activation: "The founding principle is trying to counteract the stress system while reducing the unnecessary activation of the stress system" (Baim, personal communication, 31 October 2024).
Prehabilitation includes mind-body medicine, sport, exercise & nutrition
In the field of sports medicine, the concept of prehabilitation (Bloch, 2023) represents a forward-looking and promising development, with the aforementioned anchoring of mind-body medicine. The potential of this connection goes beyond sports medicine, assuming an adequate definition and training (Bloch, 2023; Deutsches Ärzteblatt, 2023). It serves to optimally prepare patients and athletes for the therapy process (Kavka et al., 2024) – an educational process in which a social relationship is also to be established.
Prehabilitation includes preventive measures such as physical training, psychological counseling, and nutritional adjustments (Valle et al., 2023) to prepare and strengthen the body and mind for an upcoming surgery or therapeutic intervention (McIsaac et al., 2025; Valle et al., 2023). These measures can also be particularly important in preparation for major life changes, such as pregnancy or childbirth (Geweniger & Bohland, 2024).
A combination of exercise, nutrition, and psychosocial prehabilitation improves quality of life and physical recovery the most (McIsaac et al., 2025). Exercise and nutrition in particular have great prophylactic potential for the future (Kow, 2019): "Combined exercise, nutritional and psychosocial prehabilitation was most likely to improve health-related quality of life and physical recovery. Individually, exercise and nutrition were most likely to improve all critical outcomes" (McIsaac et al., 2025, "Intro").
The focus on psycho-social factors and psychological support with the aim of reducing anxiety and depression, increasing motivation for the prehabilitation program, and reducing pain and stress are of enormous importance (Deutsches Ärzteblatt, 2023; Valle et al., 2023).
Prehabilitation as a pioneer of prophylaxis by sports medicine
Prehabilitation is becoming increasingly relevant in sports medicine (McIsaac et al., 2025) as well as in oncology (Frank et al., 2022) and as a further developed transfer to future prophylaxis by sports medicine (sportärztezeitung, 2021). It focuses on the patient and athlete through an individualized, educational approach - a concept that requires a high level of compliance but at the same time makes it difficult to generate generally valid evidence (Schubert, 2025). In specific clinical pictures, such as tumor diseases, targeted protective and supportive measures – such as physical activity and indication-specific nutrition – can make a decisive contribution. However, there is often a lack of standardized implementation strategies and a sustainable care structure, which hinders the wider use of this promising approach (Tumour Therapy Online, 2020).
Based on previous experience and scientific findings in the field of prehabilitation, this can also be used as a prophylactic approach - even before injuries or illnesses occur (sportärztezeitung, 2021). Preventative measures should be integrated, and the active involvement of athletes, patients, and non-patients should be specifically encouraged and trained. Unambiguous communication is essential: "The athlete has to know what to do before he can replicate it" (McGill, personal communication, June 2021). The focus is on an initial motivational counseling session (Bischof et al., 2021), including a screening based on solid foundations and helpful tools, the personal hygiene factors, an interplay in the context of the bio-psycho-social model (sportärztezeitung, 2021). This procedure is carried out by medical professionals (Casasco, 2025). Dental prophylaxis and dental hygiene serve as a model (Geurtsen et al., 2016).
Formal sovereignty of interpretation through training and education
The recommendation and advice of the doctor and therapist on exercise therapy, for example in prehabilitation, serves as a decisive incentive for many patients to start regular training (Matziolis, 2019). This applies equally to all additional techniques to be taught from the previously mentioned subject areas (Esch, 2020; Schubert, 2025; McIsaac et al., 2025; Valle et al., 2023) – stress regulation, exercise, relaxation (Matziolis, 2019) and nutrition – as well as for athletes and non-patients in prophylaxis.
Health awareness, lifestyle medicine, self-care, and prophylaxis by sports medicine
The development and promotion of health-conscious behavior are therefore at the forefront (Matarazzo, 1984) of prehabilitation and in the model of prophylaxis by sports medicine (sportärztezeitung, 2021) to promote general health, as well as to reduce illnesses and secondary diseases and improve therapy and surgical outcomes (Hirst, 2024). The aim is to optimize psychoneuroimmunological functions (Institute Tech Technological University, 2023), whose interaction or interplay can be understood as a form of internal communication with a continuous multidirectional interaction of information (Ader et al., 1995; Schedlowski et al., 2006). In the long term, this can also reduce the burden on the healthcare system (Casasco, 2025), including a possible reduction in costs (Esch, 2020).
Prophylaxis by sports medicine is an educational, communicative, and practical model that considers patient education and training (Matziolis, 2019) as part of the Whole Person Health approach (Casasco, 2025; National Centre for Complementary and Integrative Health; National Institutes of Health 2022) and lifestyle medicine.
Sports medicine is further developed and specifically trained through the additional integration of complementary interventions and targeted training – preventive and prophylactic. New professions are emerging. Comprehensive preventive healthcare – prophylaxis instead of avoidance – must become attractive for all medical specialties and beyond. Specific scientifically established frameworks for action such as BERN (Esch & Stefano 2022), the SMART program (Traeger et al., 2022; Fricchione 2023), Whole Person Health (National Centre for Complementary and Integrative Health), and lifestyle medicine (American College of Lifestyle Medicine) can serve as a guide here.
Numerous guidelines and specialist articles relevant to sports medicine (Laube 2022; Valle et al., 2023; Stöve & Halder, 2025; Matziolis, 2019; Sturm et al., 2024) emphasize the importance of integrating the aforementioned multimodal and multidisciplinary interventions – exercise, relaxation, stress regulation & nutrition (Esch, 2020) with special consideration of the psychosocial context (Mc Auliffe, 2021). It is unequivocally recommended to consider these aspects and to provide appropriate guidance through motivational counseling (Emery & Wimmer, 2023). Current concepts for the integration of a possible self-management, self-care, and self-healing approach in the context of sports medicine have already been published (Casasco, 2025; Esch, 2020; Dossett et al., 2020; McSwan et al., 2021; Mobasheri, 2022; Schubert, 2025).
This must be offered in a professionally coordinated manner and be formally and thoroughly trained and educated (Myall et al., 2023) to reach and integrate all specialties, patients, athletes, and non-patients (sportärztezeitung, 2021) as a connection within society.
These interdisciplinary connections between all personalized measures and participating people give rise to relationships as social systems. This should be integrated and trained in adaptive dynamic groups such as in Group Medical Visits (Thompson-Lastad, 2018; Thompson-Lastad et al., 2025; Thompson-Lastad & Gardi 2020; Boyd et al., 2023). One conceivable approach is the sports club culture established in Germany (Jütting et al. 2006) after an initial medical screening. The German Pension Insurance's (Deutsche Rentenversicherung) prevention program RV Fit supports employees with initial health impairments to secure their ability to work in the long term (Deutsche Rentenversicherung, 2020).
It is not necessary to develop new methods, as existing ones can exhibit emergent properties through specific inductively organised combinations on a scientific basis. In this way, self-management can become self-care and prophylaxis by sports medicine can develop (sportärztezeitung, 2021).
We have the necessary resources and capacities to achieve the overarching goal of educating the next generation in preserving health and increasing individual salutogenetic potential (Esch, 2020).
Keywords: sports medicine, mind-body medicine, prophylaxis, prehabilitation, nutrition.
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