Marc Apkarian, PhD
Associate Professor, Biola University, La Mirada, CA

Abstract: In the discipline of exercise science, the attributes of physical fitness lie in the domains of cardiorespiratory endurance, muscular endurance, muscular strength, body composition, and flexibility. If combined conceptually, most commonly performed categories of exercise among the general population could be identified as muscular strength, cardiorespiratory endurance, and flexibility, or simply strength, endurance, and flexibility. In scientific understanding, muscular strength is usually inclusive of maximum ability, as the maximal force that muscles can generate. Cardiorespiratory endurance has a continuous nature, as the ability of lungs, heart, and blood vessels to deliver oxygen adequately to tissue and cells to sustain prolonged physical activity. Flexibility follows unimpeded movement, whereby the body’s joints can move through a full range of motion. In spiritual terms, strength, endurance, and flexibility also can be seen to possess great significance in Christian faith. At times, a Christian needs to stay firm in convictions and be strong, as Ephesians 6:10 exhorts one to do. In other circumstances, the challenges of life require patience and endurance, as referenced in James 1:3. Being yielded to various ways God leads one’s life as a believer, or being flexible, is also an important aspect of behaviour, as illustrated in James 4:13-15. Unlike physical training, the development of spiritual strength, endurance, and flexibility is not necessarily a guided, strategic endeavour, often occurring in response to circumstances outside the control of an individual, though it could be a deliberate pursuit as well. Strength, endurance, and flexibility are robust, dynamic attributes of significance in physical fitness and in the Christian faith, with manifold illustrations in exhortations, biblical directives, experiences of those in scripture, and in the life of Christ.

Keywords: Strength, Endurance, Flexibility, Training.

Statement of Original Unpublished Work: By submitting this document to the Editor in Chief of CJSCF, I am making a Statement of Original Unpublished Work not submitted to another journal for publication.

Introduction

In the disciplines of exercise science and kinesiology, physical fitness has been a construct of significance for well over a century. The study of physical fitness and its assessment dates back to the pioneering work of researchers in the late 1800s and early 1900s, even gaining political attention when President Dwight D. Eisenhower created the President’s Council on Youth Fitness in 1956 (Institute of Medicine 2012). Over time, definitions of physical fitness have also been created, such as “the ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy to enjoy leisure-time pursuits and to meet unforeseen emergencies” (President’s Council on Physical Fitness and Sports 1971).

While such a description of physical fitness is broad and holistic, its wide scope led to further distinction between health-related physical fitness as of importance for all people, and skill-related physical fitness as of predominant interest for athletes (Pate 1983). Moreover, physical activity has been identified distinctly from exercise (which specifically confers physical fitness), in that physical activity is broadly inclusive of all forms of human movement performed by an individual, including daily activities, while exercise is a subset of physical activity, being performed in a structured and deliberate fashion (Caspersen, Powell, and Christenson 1985). The goal of this discussion is to utilize the construct of health-related physical fitness as physical fitness, with its broad applicability to the physical health of the general public, and relate its attributes with spiritual parallels and principles of significance in Christian faith.

Characterizing the Attributes

The components, or attributes, of physical fitness classified within the arena of health-related physical fitness have been identified as encompassing the domains of cardiorespiratory endurance, muscular endurance, muscular strength, body composition, and flexibility (Caspersen, Powell, and Christenson 1985). While other components of fitness could be distinguished as well, such as those related to physical skill (e.g., for instance, agility or balance), these five attributes have received the greatest attention in scientific study, given their fundamental importance and relationships with the physical health of individuals. Of the five, many commonly performed exercises and training programs for general health and fitness tend to involve three of them specifically – muscular strength, cardiorespiratory endurance, and flexibility development. These distinct domains have been defined scientifically by various authors as follows.

Strength. Muscular strength, commonly referenced with the inclusion of maximum capability, is defined as “the maximal force that a muscle or muscle group can generate” (Kenney, Wilmore, and Costill 2020, 228).

Endurance. Cardiorespiratory endurance is by nature continuous, and is defined as “the ability of the lungs, heart, and blood vessels to deliver adequate amounts of oxygen to the cells to meet the demands of prolonged physical activity” (Hoeger et al. 2019, 37).

Flexibility. Flexibility has complete, unhindered movement as its central concept, and is defined as “the ability of joints to move through their full range of motion” (Insel, Roth, and Insel 2020, 345).

Although muscular endurance appears individually among the domains, and can be distinctly developed and targeted in training, it is often enhanced alongside muscular strength or cardiorespiratory endurance training, in a “side effect-like” fashion. Additionally, the very essence of body composition, or ratio of muscle to fat tissue quantity, is related to and functionally dependent on the development of muscular strength (hypertrophy, or “muscle size”) and cardiorespiratory endurance. Thus, from these five domains of physical fitness, if body composition is disregarded as an entity due to its dependence on other physical fitness components, and the modifiers “cardiorespiratory” and “muscular” are removed as well, the terms strength, endurance, and flexibility remain. Indeed, strength, endurance, and flexibility are fundamental key attributes of physical fitness, applicable in several contexts, including general health, exercise, sport, and/or rehabilitation.

Developing the Attributes

Numerous guidelines for developing aspects of physical fitness have been created over time, endeavouring to offer specific parameters by which individuals might enhance their physical well-being. With on-going discovery about the science of exercise and its implications for physical health and well-being, the standards given for the development of strength, endurance, and flexibility have been modified according to factors such as age, prior training experience, and health status of various populations, and have appeared in numerous books, journals, and reports.

The second edition of the United States Department of Health and Human Services (HHS) publication “The Physical Activity Guidelines for Americans” is a systematic review compiling the results of extensive physical activity and health research over decades, and presents broad public health recommendations for performing physical activity among Americans of all ages (Piercy et al. 2018). The American College of Sports Medicine (ACSM) position stand “Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise” is another authoritative pronouncement summarizing a wealth of physical activity and exercise science research based upon decades of studies (Garber et al. 2011). Its comprehensive collection of recommendations for various aspects of physical fitness development includes minimum thresholds or target ranges for the general population. Although the focus of this discussion is not on technical detail concerning physical fitness, a brief summary of broad recommendations for the three domains addressed herein is provided for reference.

Strength – Guidelines. Muscular strength: > 2-3 days/week; 8-15 repetitions/set; 1-4 sets; resistance training exercises for each of the major muscle groups

Endurance – Guidelines. Cardiorespiratory endurance: > 30 minutes/day; > 5 days/week; or in total, > 150 minutes/week (moderate intensity); OR > 20 minutes/day; > 3 days/week; or in total, > 75 minutes/week (vigorous intensity); continuous exercise such as running, walking, cycling, swimming

Flexibility – Guidelines. Flexibility: > 2 days/week; 10-60 seconds/exercise; flexibility exercises for each the major muscle–tendon groups

Connecting the Attributes

Having established a foundational understanding of the attributes and characteristics of physical fitness from a scientific standpoint, it can be realized that each physical fitness component – strength, endurance, and flexibility – possesses a figurative counterpart in the Christian faith. Throughout the lifetime of a Christian individual, there will be the need to remain strong in certain situations, endeavour to endure through specific experiences, and be flexible in particular circumstances. Expressed differently, a Christian may need to stay firm in convictions and actions, reflecting strength. At other times, the challenges of life require a Christian to exhibit perseverance and patience, reflecting endurance. Finally, it is important for a Christian to remain yielded to, or actively seek, various ways God may lead the course of life for a believer, reflecting flexibility. 

It is intriguing to note that in a majority of cases, the attributes are involved or expressed in response to circumstances outside the control of the Christian. Strength, endurance, and flexibility are often engaged by choice – actively, intentionally, and willingly through life’s experiences, challenges, and hardships. In some instances, as with physical training, attributes develop by purposeful engagement – flexibility can be seen in seeking to be led by the Spirit of God, such as through a concerted effort to pray for wisdom, in a decision-making process. This, however, is much more of a fluid, subjective pursuit – it does not follow according to performance of minutes in a session, number of days per week, or some metric of intensity.

To that end, participation in physical activity as a means to experience spiritual activity in some regard requires an accurate understanding of how each attribute is engaged, and a sensible strategy for its engagement. For instance, strength training exercises typically involve lifting weights for a specific goal number of repetitions in a set to reach momentary failure by the end of the set. When the exercise is repeated for consecutive sets, fatigue makes it increasingly difficult to reach the goal number each time, as the developing discomfort and sensation of “burning” in the muscles requires a strong, deliberate effort and tremendous resolve to endure in order to reach the goal.

Although occurring in a completely different context, on a different scale, and with entirely less significance, the determination to “work through the pain” in order to reach the end of a set has been likened to persecution and physical suffering for the Christian faith. That is, as one considers or reflects – with all due reverence – upon the extreme suffering and pain endured in physical persecution, it may provide the psychological fortitude necessary during the painful moment of exercise for one to continue movement, persist to the end of the set, and not “give up”.

Alternatively, endurance training commonly takes the form of activities such as running, cycling, or swimming. These all share the need for dedication, perseverance, and the determination to maintain continuous, rhythmic movement until the prescribed end of the exercise timeframe is reached. Given the challenge that extended duration endurance exercise can present to the will of the exerciser, an approach to engage in meaningful spiritual activity can involve prayer. Praying before an exercise session for help to remain committed to the timeframe goal, and determining to see the session as an act of sacrificial worship, can sustain the spirit and will of an individual as they persevere through the exercise, further developing both physical and spiritual endurance.

Finally, the development of flexibility often occurs through slow movement leading to a fixed body position. When performing static stretches, it is beneficial to move into and out of stretched body positions slowly, both to avoid injury, and to ensure adequate focus is placed on the correct position attempting to be reached and maintained. In performing such stretches, a deliberate effort can be placed on being calm, breathing slowly, and minimizing movement. Doing so fosters the opportunity for a concerted effort to be made toward such things as reflective prayer, meditative thoughts on the character of God, or recalling to mind a scripture that reinforces the activity (such as a portion of Psalm 46:10 “…be still and know that I am God…”).

These spiritual attributes of strength, endurance, and flexibility are reflected in multiple contexts throughout several books of the Bible, and by various means or applications. In certain cases, they are expressed as commandments or admonitions, in others, as examples in life experiences of an individual, group, or nation, and in still others, illustrated by a story or other biblical passage.

Thus, scripture can function as an exhortation, warning, guideline, or aim in the life of a Christian. The experiences of the Israelites wandering in the desert, the writings of several Psalms, the words of Paul to the early church, and the life of Jesus all present excellent illustrations of strength, endurance, and flexibility. The scriptures which follow depict examples throughout books of the Old and New Testaments of each of these attributes (New International Version).

Strength – in Scripture

Exodus 14:14. The Lord will fight for you; you need only to be still.

Joshua 1:9. Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go.

Psalm 91:1-2. Whoever dwells in the shelter of the Most High will rest in the shadow of the Almighty. I will say of the Lord, “He is my refuge and my fortress, my God, in whom I trust.”

Isaiah 40:30-31. Even youths grow tired and weary, and young men stumble and fall; but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.

1 Corinthians 1:27. But God chose the foolish things of the world to shame the wise; God chose the weak things of the world to shame the strong.

2 Corinthians 12:9. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me.

Ephesians 6:10-11. Finally, be strong in the Lord and in His mighty power. Put on the full armor of God, so that you can take your stand against the devil’s schemes.

2 Timothy 4:17. But the Lord stood at my side and gave me strength, so that through me the message might be fully proclaimed and all the Gentiles might hear it. And I was delivered from the lion’s mouth.

Endurance – in Scripture

Deuteronomy 2:7. The LORD your God has blessed you in all the work of your hands. He has watched over your journey through this vast wilderness. These forty years the LORD your God has been with you, and you have not lacked anything.

Joshua 5:6. The Israelites had moved about in the wilderness forty years until all the men who were of military age when they left Egypt had died, since they had not obeyed the LORD. For the LORD had sworn to them that they would not see the land he had solemnly promised their ancestors to give us, a land flowing with milk and honey.

Romans 15:4-6. For everything that was written in the past was written to teach us, so that through the endurance taught in the Scriptures and the encouragement they provide we might have hope. May the God who gives endurance and encouragement give you the same attitude of mind toward each other that Christ Jesus had, so that with one mind and one voice you may glorify the God and Father of our Lord Jesus Christ.

2 Corinthians 1:6. If we are distressed, it is for your comfort and salvation; if we are comforted, it is for your comfort, which produces in you patient endurance of the same sufferings we suffer.

Colossians 1:9-12. For this reason, since the day we heard about you, we have not stopped praying for you. We continually ask God to fill you with the knowledge of His will through all the wisdom and understanding that the Spirit gives, so that you may live a life worthy of the Lord and please him in every way: bearing fruit in every good work, growing in the knowledge of God, being strengthened with all power according to His glorious might so that you may have great endurance and patience, and giving joyful thanks to the Father, who has qualified you to share in the inheritance of His holy people in the kingdom of light.

1 Timothy 6:11. But you, man of God, flee from all this, and pursue righteousness, godliness, faith, love, endurance and gentleness.

Hebrews 12:1-2. Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before Him He endured the cross, scorning its shame, and sat down at the right hand of the throne of God.

Hebrews 12:7. Endure hardship as discipline; God is treating you as His children. For what children are not disciplined by their father?

James 1:2-4. Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance. Let perseverance finish its work so that you may be mature and complete, not lacking anything.

Flexibility – in Scripture

Genesis 12:1-4. The Lord had said to Abram, “Go from your country, your people and your father’s household to the land I will show you. I will make you into a great nation, and I will bless you; I will make your name great, and you will be a blessing. I will bless those who bless you, and whoever curses you I will curse; and all peoples on earth will be blessed through you.” So Abram went, as the Lord had told him; and Lot went with him. Abram was seventy-five years old when he set out from Harran.

Exodus 13:17-18. When Pharaoh let the people go, God did not lead them on the road through the Philistine country, though that was shorter. For God said, “If they face war, they might change their minds and return to Egypt.” So God led the people around by the desert road toward the Red Sea. The Israelites went up out of Egypt ready for battle.

Exodus 13:21-22. By day the LORD went ahead of them in a pillar of cloud to guide them on their way and by night in a pillar of fire to give them light, so that they could travel by day or night. Neither the pillar of cloud by day nor the pillar of fire by night left its place in front of the people.

Psalm 5:8. Lead me, Lord, in your righteousness because of my enemies – make your way straight before me.

Psalm 27:11. Teach me your way, Lord; lead me in a straight path because of my oppressors.

Psalm 61:1-2. Hear my cry, O God; listen to my prayer. From the ends of the earth I call to you, I call as my heart grows faint; lead me to the rock that is higher than I.

Psalm 139:24. See if there is any offensive way in me, and lead me in the way everlasting.

Acts 10:17-23. While Peter was wondering about the meaning of the vision, the men sent by Cornelius found out where Simon’s house was and stopped at the gate. They called out, asking if Simon who was known as Peter was staying there. While Peter was still thinking about the vision, the Spirit said to him, “Simon, three men are looking for you. So get up and go downstairs. Do not hesitate to go with them, for I have sent them.” Peter went down and said to the men, “I’m the one you’re looking for. Why have you come?” The men replied, “We have come from Cornelius the centurion. He is a righteous and God-fearing man, who is respected by all the Jewish people. A holy angel told him to ask you to come to his house so that he could hear what you have to say.” Then Peter invited the men into the house to be his guests. The next day Peter started out with them, and some of the believers from Joppa went along.

Galatians 5:18. But if you are led by the Spirit, you are not under the law.

James 4:13-15. Now listen, you who say, “Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.” Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. Instead, you ought to say, “If it is the Lord’s will, we will live and do this or that.”

Conclusion

Given the examples of strength, endurance, and flexibility found in scripture that are presented above – and myriad others which could be identified throughout the Bible – the life of Jesus Christ provides a unique example. While several experiences, teachings, and words of Christ, along with many passages in the Bible, might reflect one or another of the attributes, it is difficult to identify situations or circumstances that truly require the three attributes to operate in concert with one another. However, the experience of Jesus being tempted by Satan in the wilderness presents a case unlike others, as an incredible depiction of the attributes engaged together.

Jesus, full of the Holy Spirit, left the Jordan and was led by the Spirit into the wilderness, where for forty days He was tempted by the devil. He ate nothing during those days, and at the end of them He was hungry. The devil said to him, “If you are the Son of God, tell this stone to become bread.” Jesus answered, “It is written: ‘Man shall not live on bread alone.’” The devil led Him up to a high place and showed Him in an instant all the kingdoms of the world. And he said to Him, “I will give you all their authority and splendor; it has been given to me, and I can give it to anyone I want to. If you worship me, it will all be yours.” Jesus answered, “It is written: ‘Worship the Lord your God and serve him only.’” The devil led Him to Jerusalem and had Him stand on the highest point of the temple. “If you are the Son of God,” he said, “throw yourself down from here. For it is written: “‘He will command his angels concerning you to guard you carefully; they will lift you up in their hands, so that you will not strike your foot against a stone.’” Jesus answered, “It is said: ‘Do not put the Lord your God to the test.’” When the devil had finished all this tempting, he left Him until an opportune time (Luke 4:1-13).

As Jesus was tempted by Satan in three different circumstances, He stayed strong, and did not waver or give way to temptation. As Jesus fasted and remained in the wilderness for 40 days, He maintained endurance throughout the experience. As Jesus allowed the Spirit of God to lead Him into the challenge of the desert ahead, He remained flexible – with the additional aspect of letting Satan even lead Him to a high place to see the kingdoms of the world, and then to stand atop the highest point of the temple.

There was opportunity to engage each attribute, or not to, but Jesus made the decision to be strong, to endure, and to remain flexible. This account of what Jesus underwent is an incredible illustration that goes far beyond the realm of the usual human experience, portraying an extraordinary combination of strength, endurance, and flexibility as an example for the life grounded in faith. For the Christian, it presents the ultimate example of victorious achievement throughout adversity, and through no one better to look to than Christ Himself.

Bibliography

Caspersen, Carl J., Kenneth E. Powell, Gregory M. Christenson. 1985. “Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.” Public Health Reports 100 (2): 126-131.

Garber, Carol Ewing, Bryan Blissmer, Michael R. Deschenes, Barry A. Franklin, Michael J. Lamonte, I-Min Lee, David C. Nieman, David P. Swain. 2011. “Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise.” Medicine & Science in Sports & Exercise 43 (7): 1334-1359. https://doi.org/10.1249/MSS.0b013e318213fefb.

Hoeger, Werner W.K., Hoeger, Sharon A., Fawson, Amber L., & Hoeger, Cherie I. 2019. Fitness and Wellness (13^th Ed.). Boston, MA: Cengage. Pg. 37.

Insel, Paul M., Roth, Walton T., Insel, Clarie E. 2020. Connect Core Concepts in Health (16^th Ed.). New York, NY: McGraw-Hill Education.  Pg. 345.

Institute of Medicine. 2012. Fitness Measures and Health Outcomes in Youth. Washington, DC: The National Academies Press. https://doi.org/10.17226/13483.

Kenney, W. Larry, Wilmore, Jack H., Costill, David L. 2020. Physiology of Sport and Exercise (7^th Ed.). Champaign, IL: Human Kinetics. Pg. 228.

Pate, Russell R. 1983. “A new definition of youth fitness.” The Physician and Sportsmedicine 11 (4): 77-83.

Piercy, Katrina L., Richard P. Troiano, Rachel M. Ballard, Susan A. Carlson, Janet E. Fulton, Deborah A. Galuska, Stephanie M. George, Richard D. Olson. 2018. “The Physical Activity Guidelines for Americans.” JAMA 320 (19): 2020–2028. https://doi.org/10.1001/jama.2018.14854.

President’s Council on Physical Fitness and Sports. 1971. Physical Fitness Research Digest. Series 1, No. 1. Washington, DC: President’s Council on Physical Fitness and Sports.

Author Bio: Marc Apkarian (PhD) is an Associate Professor of Kinesiology at Biola University in La Mirada, CA, having been a faculty member there since 2003, and served as department chair for 12 years. His teaching specialties and involvement span the areas of exercise physiology, exercise physiology laboratory, fitness evaluation, fieldwork and internships, and exercise and health, with particular interest in Christian faith integration. Dr. Apkarian enjoys incorporating applied learning, skill acquisition, and professional development opportunities to empower students to think analytically, solve problems, and reach others, being passionate about enabling them to appreciate stewardship of health and the human body. Marc is also an American College of Sports Medicine Certified Exercise Physiologist, and National Strength and Conditioning Association Certified Strength and Conditioning Specialist, and has worked with individuals of all ages in contexts ranging from exercise training and athletic development to post-rehabilitation conditioning since entering the health and fitness industry in 1995. Marc and his wife enjoy time with their daughter, family, and friends, exercise, travel, and involvement in both youth and adult ministry opportunities at church.

Lacie Webb, PT, DPT1
Physical Therapist, SporTherapy

Colin G. Pennington, PhD
Assistant Professor, Tarleton State University – Fort Worth

Abstract: Religion, medicine, and healthcare are related. Research states that religiosity and spirituality have a positive effect on a patient’s health. There is a high belief in God in the United States, but clinicians are not inquiring about religion and spiritual aspects in patients’ healthcare today as patients would prefer. In the case of some physical therapy preparatory programs, the concepts of health and Christ-like values are related, if not, dependent on one another. This sparks intrigue into research exploring the intersectionality between faith, spirituality, and physical recovery. The purpose of this article is to (a) discuss what the medical and physical therapy community states are their broad missions and where those missions overlap with faith, (b) provide examples in the literature where faith and the pursuit of health have been connected and successful in terms of positive healing, and (c) express the benefit of spiritually-charged preventative health and physical therapy returning to healthcare.

Keywords: Physical Therapy, Faith Intervention, Occupational Therapy, Spirituality, Physical Activity.

Statement of Original Unpublished Work: By submitting this document to the Editor in Chief of CJSCF I am making a Statement of Original Unpublished Work not submitted to another journal for publication.

Introduction

Religion, medicine, and healthcare have all been related in one way or another in all population groups since the beginning of recorded history (Koenig, King and Carson 2012). The departure from the history of linking health, religion, and spirituality is currently taking place in most cultures. This departure has been particularly prevalent in American culture for a number of decades. Research denotes that the religious and spiritual practices and beliefs of patients are powerful factors in coping with serious illnesses, making ethical choices about treatment options and decisions about end-of-life care (Puchalski 2001; McCormick et al. 2012). In a collection of 2013 polls, 56% of individuals asked claimed that ‘religion is important in their own lives’ and 22% stated that religion is ‘fairly important’ (Gallup 2013). It is shown that, in the United States, 77% of medical patients would like to have their spiritual issues discussed as a part of their medical care, but less than 20% of clinicians discuss these issues with their patients (King and Bushwick 1994). These polls indicate there is a high belief in God in the United States, but clinicians are not inquiring about religion and spiritual aspects in healthcare today as patients would prefer.

Therefore, the purpose of this article is to (a) discuss what the medical and physical therapy community states are their broad missions and where those missions overlap with faith, (b) provide examples in the literature where faith and the pursuit of health have been connected and successful in terms of positive healing, and (c) express the benefit of spiritually-charged preventative health and physical therapy returning to healthcare.

The Mission of Medical Care and Physical Therapy

There has been an increased call for attention to various aspects of spiritual challenges as part of whole-person or holistic care. The National Consensus Project for Quality Palliative Care has established standards for clinical practice that include the spiritual, religious, and existential aspects of care as among the core domains (VanderWeele, Balboni and Koh 2017). Spirituality is defined as a multidimensional part of the human experience and includes cognitive, behaviour, and philosophic aspects. The cognitive and philosophic aspects include searching for meaning, purpose, and truth in life, and the behavioural aspect as the way an individual externally manifests spiritual beliefs and inner spiritual state (Anandarajah and Hight 2001). Religion is defined as an attempt to respond to mankind’s spiritual questions and that each has developed a specific set of beliefs, practices, and teachings (Anadarajah and Hight 2001). However, action to include these aspects in the core domains of care is, at best, limited. Over half of medical schools in the United States provide opportunities for instruction in spiritual care to their students, but most practicing physicians did not receive spiritual training while in medical school despite research-based evidence that including chaplain involvement improved patient satisfaction in the hospital setting (VanderWeele et al. 2017). Official collaboration between spiritual educators and clinicians is absent.

In accordance with the American Physical Therapy Association (APTA), promoting health and wellness is an integral responsibility of the therapist. Because therapists often educate their clients on the benefits of a variety of health-enhancing behaviours, and provide a variety of movement opportunities, physical therapists may be in an ideal position to promote overall health and wellness in their patients and clients (Benzer 2015). Movement is a key to optimal living and quality of life for all people that extends beyond health to every person’s ability to participate in and contribute to society (APTA 2014). With the broad goal of physical therapy to allow individuals the opportunity to reach their full potential of health and wellness, it is practical that physical therapy schools would be considerate of individual’s religiosity and spirituality in this process. The correlation between health outcomes and religious commitment has been evaluated, and while some disagree, most authors report that positive relationships between religious commitment and mental and physical health were found in up to 84% of studies that involved a measure of religious commitment (Anadarajah and Hight 2001). Therefore, a spiritual history could – if not should – be incorporated in a school’s curriculum[1].

 For example, one Christian-affiliated, accredited physical therapy doctoral program emphasized that their overall mission and vision is to promote the following:

[The program aspires to…] prepare graduates in an interprofessional, Christ-centered learning community to promote and improve the health and well-being of individuals and communities. … [The program] emphasizes healing the body, nurturing the mind and inspiring the spirit through rigorous academics, local and global service and innovative scholarship… Our mission is to prepare leaders in a Christian environment who promote health, wellness and quality of life through excellence in professionalism, scholarship and service. (Samford University 2019)

In the case of this physical therapy preparatory program, the concepts of health and Christ-like values are related, if not, dependent on one another. This sparks intrigue into research exploring the intersectionality between faith, spirituality, religiosity, and physical recovery.

The Healing Power of Faith

Research has stated that religiosity and spirituality have a positive effect on a patient’s health. Religious and spiritual commitment tends to lead to a quicker recovery from illness and surgery. In a study of heart transplant patients, it was found that patients who participate in religious activities and expressed that their religious beliefs were important complied better with follow-up treatment, had improved physical functioning at the 12-month follow-up visit, reached higher levels of self-esteem, and experienced less anxiety and fewer health worries than patients who did not view their religious beliefs as important (Harris et al. 1995). As a result, within the medical field, interest is rising concerning the role of religion as preventative medicine and an alternative (or supplementary) treatment to physical ailments (Koenig, King and Carson 2012; Price 2018). Prayer and being a member of a religious community has been shown to have physical, mental, and economical benefits for patients and physicians alike (Bopp, Peterson and Webb 2012; Campbell et al. 2007).

Many health professionals recognize that spirituality plays an important role in the adjustment of individuals and their families after traumatic injuries. However, spirituality is not always proactively addressed during rehabilitation efforts. Spirituality, and specifically religious belief, is perceived to sometimes raise difficulties for clients and staff (Jones, Dorsett, Briggs and Simpson 2018). There is potential for better incorporation of religion and spirituality into practice. The spiritual needs of clients and their family members during physical rehabilitation are important and could be better addressed. For example, Jones and colleagues (2018) suggested a range of initiatives including staff training and the use of standardized spiritual assessment tools.

Patients can uncover strength and peace in spirituality, by both deep connections with family and friends, as well as through religious communities (VanderWeele et al. 2017). However, modern day practicing clinicians often miss opportunities to include aspects of spirituality when assessing the health of their patients or even themselves. This recent neglect demonstrates the departure from history linking health, religion, and spirituality which is currently common in most cultures (Koenig, King and Carson 2012).

Clinicians can start to acknowledge spiritual health and wellness by incorporating religious/spirituality-focused questions within the routine social history interview. Brown University School of Medicine has developed a teaching tool to help begin the process of incorporating a spiritual assessment into the patient interview in which they employed the acronym of HOPE questions. The ‘H’ pertaining to the individual’s basic life spiritual resources such as hope, ‘O’ as organized religion, ‘P’ as practices that are most helpful for the individual, and ‘E’ as the effects of the individual’s perspective on end-of-life discussions (Anadarajah and Hight 2001). These religious/spirituality-focused questions do not need to immediately focus on words such as religion and spirituality, but can allow for open-ended exploration in the individual’s spiritual resources and concerns. For example, a question phrased, “Do you feel a positive presence while being physically active while in nature?” meets this objective.

Other example questions may include “Is faith and spirituality important to you?” and “In your times of need, do you have a religious or spiritual support system you could reach out to?” Questions such as these maintain respect for the patient while learning important information that might impact present or future care. In appropriate times, clinicians can also ask if a patient attends regular religious services, and how attending these services might affect the patients’ physical and emotional well-being outside of treatment (VanderWeele et al. 2017). Clinicians might also benefit from attending to their own spiritual health (VanderWeele et al. 2017), as pressing professional issues related to burnout, avoidable medical errors, attrition, and higher suicide rates among physicians than among the general population are an increasing concern (Balboni et al. 2013; Yoon, Daley and Curlin 2017). More opportunities to spiritual resources and practices for medical students and practicing clinicians could decrease these concerns. Just the act of clinicians providing spiritual care to patients may encourage clinicians to search for their own internal spiritual resources (VanderWeele et al. 2017).

Enacting Preventative Medicine

Preventative health is a personal passion of mine (Webb). Along that theme, it has also been noted that preventative health-measures (e.g., decreasing tobacco use, increasing physical activity and exercise, improving nutritional intake, engaging in safe sexual practices) also appear to be linked to religion and spirituality (Koenig et al. 2012). Research has suggested the importance of community leaders (e.g., physical therapists), while demonstrating healthy behaviours, can increase the chances of on-looking community members to also adopt healthy behaviours and to adhere to exercise programs (Webb and Bopp 2017).

Paradoxically, generally speaking, key leaders within faith-based organizations (e.g., ministers, pastors, preachers) are disproportionately affected by obesity and chronic disease (Bopp, Baruth, Peterson and Webb 2013). The effectiveness of preventative faith-based health and wellness programs can be strongly influenced by the attitudes, perceptions, and participation of key leaders within faith-based organizations. As a form of preventative medicine, physical activity programs endorsed by leaders in the faith community could potentially influence health-enhancing behaviours of those who look to them as examples for direction (Webb, Bopp and Fallon 2013).

Conclusion

Connecting to God through physical activity is a route many individuals may choose to take. For example, ‘prayer walking’ and ‘walking meditation’ have been shown to serve the dual purposes of spending time with God and achieving physical activity thorough movement (Koenig et al. 2012). Many Christians pursue to be active and connect with their faith, while maintaining a balanced approach to exercise, health, and physical well-being. That said, a balanced approach can be achieved when healthcare clinicians recognize different spiritual and religious values and beliefs, and integrate those values and beliefs in the development of the ‘care’ plan for patients. If done responsibly, healthcare clinicians can incorporate religious and spiritual aspects in their practice as patients would prefer. Respect for patient values and beliefs can be maintained by returning to the linkage of health, religion, and spirituality.

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Author Bio: Lacie M. Webb (PT, DPT) is a recent physical therapist graduate from Samford University in Birmingham, AL and received a B.S. in Biology from The University of Alabama in 2016. Lacie has a variety of clinical experiences including post-operative orthopedic surgery rehabilitation, acute care in cardiac intensive care unit, sports medicine rehabilitation, and rehabilitation to individuals with neurological impairments. She has served as volunteer, technician, and student physical therapist in numerous cities, and has experience working with patients possessing a wide-range of functional abilities. The majority of Lacie’s clinical interests have focused on sport-related injuries, and return-to-sport and injury preventative programs. Preventative health is one of Lacie’s passions and she incorporates all aspects of preventative health in her clinical practice. Outside of work, one of Lacie’s passions is involvement in medical mission trips. Her mission is to live out the message in 1 Peter 4:10, “Each of you should use whatever gift you have received to serve others, as faithful stewards of God’s grace in its various forms.”

Author Bio: Colin G. Pennington (PhD) is an Assistant Professor of Kinesiology at Tarleton State University where he works with Exercise Science majors and carries out research on physical education teacher effectiveness and other pedagogical and health-related applications of the kinesiology sub-disciplines. Colin currently teaches courses including Physiology of Exercise, Anatomical Kinesiology, Capstone in Kinesiology, and formally a number of courses within the sport pedagogy sub-discipline of kinesiology. His interests and research focus on teacher socialization, physical education teacher training, character development programs within physical education and sport, and health and wellness.

Footnotes:
[1] Furthermore, and providing attention to the bio-psycho-social-spiritual model, a patient’s spiritual history could be included in their personal medical records for reference.

Colin G. Pennington, PhD

Assistant Professor, Tarleton State University – Fort Worth

Abstract: Within the complex system of compulsory school physical education, there are opportunities for physical educators to meet goals beyond physical-health related objectives. Positive moral socialization can occur through physical education; students who develop prosocial competence during the years of their formative education are more likely to be successful throughout their lives, promoting the belief that character and Christian-like values are what we are supposed to teach in physical education more than anything else. This leads some to make the assertion that participation in Christian-based physical education and physical activity can help young people appreciate health, exercise, and fitness; learn about themselves and handling adversity; and experience teamwork and prosocial attitudes in safe environments grounded in Christian values and ideals. After a brief review of Muscular Christianity and the historical origins of church-based physical education, this article explores the concept of Christian faith and physical education. Finally, this article provides a brief review of successful health-enhancing interventions held in church settings.

Keywords: Physical Education, Physical Activity, Christianity, Faith-Based Intervention

Statement of Original Unpublished Work: By submitting this document to the Editor in Chief of CJSCF, I am making a Statement of Original Unpublished Work not submitted to another journal for publication.

Introduction

Many believe the main responsibility of school physical educators is to provide physical- and health-enhancing experiences for children in their care (Pennington 2017). It is also a broad goal of physical education to assist students in developing social and moral values (Hellison 2011). Therefore, one way teachers of physical education can reach these lofty goals is by demonstrating faith and Christianity through physical activity and facilitating meaningful student social interactions with their peers.

The purposes of this article are to: (1) briefly summarize the concept of Muscular Christianity, describing how Muscular Christianity laid the foundation for how physical education developed and is executed in K-12 schools, (2) establish the need for compulsory physical education in K-12 settings, and discuss how Christian physical educators can meet the needs of children in their care, and (3) remark on the success of church-based physical activity interventions occurring outside of, and in addition to, K-12 physical education.

Muscular Christianity

The concept of connecting Christ, Faith, and Christianity to bouts of physical activity is not a novel concept. In fact, by intent, England’s medieval games were originally closely related to the Church (Hartley 1969; Redmond 1978). The Church had stimulated interest in these games through annual feats of physical contest to which each village sent its champion. Games brought together all people and thus created better understanding among the social classes. The merit of such games was that they were social and universal. The games provided a place for every man who chose to participate (Winn 1960). As was a function of the times, women did not participate as robustly as the men during this period. At the turn of the twentieth century, American middle-class male Protestants turned to sports and muscular pursuits in the face of the increasing power of women (Millikan 2006). Recently, the question has again arisen as to when, how, and why ‘muscular Christians’ have also championed women’s sport (McLeod, Justvik and Hess, 2018; Putney 2009). Today, the legacy of the muscular Christian ethos lives on, but the gender politics have become much more ambiguous and complicated (Millikan 2006); this article will not make any attempts at providing a gender-based perspective. And of course, games also served the important function of strengthening the body; an important feature considering that individuals of this era were likely to perform physically demanding professional and/or agricultural roles.

Among the early manuscripts featuring faith is a classic article authored by William Winn (1960). Winn references the pioneering work of author Thomas Hughes, who penned the seminal novel, Tom Brown’s School Days (1857), which has become known for laying the ground work for Muscular Christianity. Winn (1960) described Hughes:

Tom Hughes had a natural love for boxing, and as boxing coach at the Working Men’s College, the school founded by himself and other Christian Socialists in London, he formulated moral and intellectual values for that sport. ‘To knock someone down, and to be a good fellow and a Christian ever afterwards’ was the creed of Muscular Christianity. (Winn 1960, 70)

This term, Muscular Christianity, was a philosophical movement that originated in England in the mid-19th century, characterized by a belief in patriotic duty, manliness, the moral and physical beauty of athleticism, teamwork, discipline, self-sacrifice, and “the expulsion of all that is effeminate, un-English, and excessively intellectual” (Newsome 1961, 216). The fundamental concepts of Muscular Christianity were derived from scriptural beliefs suggesting that since man was born with a body as well as a mind, the body should be given just as careful treatment as the mind (Watson, Weir and Friend 2005). Man’s body was a God-given gift. Therefore, man would be judged by the way in which he took care of this gift (Winn 1960). It should be acknowledged that the original advocates of Muscular Christianity promoted physical activity more for men than women, whereas contemporary society would be inclusive of all genders being physically active (Elliott and Hoyle 2014). Additionally, because the body and mind are connected, an individual who exercised properly would be able to achieve greater mental heights (Heckman 2018).

Muscular Christianity has continued through organizations that combine physical and Christian spiritual development (Roberts and Yamane 2011). One such example is through the Young Men’s and Women’s Christian Associations (known colloquially as the YMCA and YWCA, respectively), an outgrowth of Muscular Christianity, which in some areas has become largely secularized, albeit very valuable to society. Most results of Muscular Christianity have been very positive in character. In fact, it should be acknowledged that the compulsory physical education programs developed for schools were spawned from the concept of Muscular Christianity, and physical education has been extremely valuable (Winn 1960).

The Relationship between Youth Physical Education, Physical Activity, and Faith

Children can spend 50% or more of their waking hours at school. It is, therefore, incumbent on schools to provide students with sufficient opportunities to accumulate recommended levels of physical activity. Comprehensive school physical activity programs (CSPAP) advocate for a mixture of physical education, recess, classroom activity, before- and after-school physical activity programs, active transportation to/from school, and intra- and extra-mural sport (Centers for Disease Control and Prevention 2013). Promotion of physical activity through faith-based, self-regulated mindful movement – in lieu of sedentary behaviour – throughout the school day provides an additional option used alongside the commonly promoted CSPAP components (Kahan, Lorenz, Kawwa and Rioveros 2019).

To increase youth and adult physical activity success, the 2016 National Physical Activity Plan (NPAP) identified nine sectors for targeting strategies and tactics to increase physical activity. These include: business and industry; community recreation, fitness and parks; education; faith-based settings; healthcare; mass media; public health; sport; and transportation, land use, and community design (National Physical Activity Plan Alliance 2016). Bopp and colleagues (Bopp, Peterson and Webb 2012) argued for the potential of religious programs and spaces to positively contribute to physical activity behaviour. The merging of faith into religious school settings supports two domains identified in the NPAP: schools and faith-based organizations (Kahan et al. 2019). Among church-attending youth (11–13 years), most perceive some connection between faith and health and the need for churches to provide physical activity interventions for children (Wilmot, Martinez and He 2018). To wit, at least one Christian curriculum intervention aimed at increasing physical activity during Sunday school (using a similar approach as CSPAP) resulted in the intervention group accumulating a significantly greater step/minute rate during Sunday school than in the control group (Trost, Tang and Loprinzi 2009).

School Physical Education: Demonstrating Christianity

Compulsory K-12 physical education is often expressed as a means of encouraging students to become physically active (Gorely et al. 2011; Pennington, 2019). Some scholars view participation in physical education can provide health, social, cognitive, and affective benefits while also encouraging lifelong participation (Webster, Stodden, Carson, Egan and Nesbitt 2016). That said, some physical education scholars and health professionals (continue to) view physical education as a response to the growing concern of a public health epidemic, believing school physical education is the ideal setting for teaching students the benefits of leading a healthy lifestyle (Dwyer, Coonan, Leitch, Hetzel and Baghurst 1983; Sallis et al. 2012). Furthermore, given that part of the broad mission of education has continued to be to help students develop character and prosocial values (Stoll and Beller 1993), schools and teachers should allow children opportunities to develop healthy social skills (Pennington 2017). According to Hellison (2011), students who develop social competence during their formative education are more likely to be successful throughout their lives. The physical educator has the opportunity to create situations that will enhance students’ social and character development as well as advocate for participation in sport, physical activity, and positive social relationships (Pennington and Sinelnikov 2018).

Because past research has revealed that students hold mixed perceptions towards the merits of physical education or participating in physical activity (Bailey et al. 2009; Flintoff and Scraton 2006), discovering what barriers to enthusiastic participation is important to the field (Elliott and Hoyle 2014). In recent years, physical education pedagogues and researchers have studied, theorized about, and provided practical suggestions related to social identities (e.g., religious affiliation) and how those identities impact participation in compulsory physical education. Such efforts have had a profound impact upon those who have suffered the consequences of being ‘othered’ within physical education (ContinYou 2010). Few physical education scholars have focused closely upon the role that Christian religion affiliation might play within physical education (Robinson 2019); consequently, very little research exists regarding Christianity as a moderator to participation in K-12 physical education or the role physical education should/could play in providing opportunities for movement and physical health-enhancing behaviours. Be that as it may, some Christian physical educators believe that participation in physical activity should be encouraged (MacDonald and Kirk 1999; McLeod, Justvik and Hess 2018; Zang, Hong and Huang 2018).

The body is integral to the discourses of health and physical education just as it is to the discourses of religion. When health and physical educators hold particular religious views, there are implications for how the body is positioned in concert with questions of identity and lifestyle. (MacDonald and Kirk 1999, 131)

However, devout Christians and those adhering to the more traditional denominations (e.g., Pentecostals, Mormons) might experience religious-based barriers, in particular, issues surrounding modesty (Elliott and Hoyle 2014; Sporting Equals 2012). Those who hold fundamentalist beliefs may claim to follow a literal interpretation of the Bible. Nonetheless, despite a lack of direct evidence regarding Christianity and participation in physical activity in general, it does seem that for some Christian secondary school students, barriers to physical education might be impacted by their level of religiosity. Notwithstanding, it appears that for ‘typical’ and contemporary Christians, faith should have limited influence (Elliott and Hoyle 2014). In fact, many believe Christianity advocates for, rather than restricts against, physical activity for all (ContinYou 2010). Be that as it may, some religious-based issues (e.g., mixed-sex venues, dress code, family disapproval, and a belief that certain forms of physical activity, such as dance, can be perceived to be un-religious) might restrict sport and exercise participation, particularly for females (Elliott and Hoyle 2014). Further, some studies have determined that women participants have reported feelings of great discomfort if physical education uniforms do not meet the minimal modesty requirements (Pennington and Nelson, forthcoming).

Along with doctors, therapists, and nutritionists, physical educators are also widely considered members of their communities’ health-care team. Christian school physical educators can be resources for others who require education and guidance to maintain or improve physical health. Christian physical educators can provide emotional support and inspiration to those who need to make lifestyle changes. In fact, support for individuals looking to be physically active, physically fit, and emotionally well by adopting the principles taught in physical education may be greater in Christian-based groups (Whisenant, Cortes and Hill 2014).

Church-Based Health and Wellness Interventions

One commonly agreed-upon physical education goal is to establish the pursuit of life-long healthy behaviours (Pennington 2019). However, once a student’s time in compulsory physical education comes to an end, sometimes so does their engagement in general physical activity. Of those individuals, some choose to re-engage in health-enhancing behaviours, but may need a catalyst to re-ignite their physical activity motivation (Pennington, forthcoming). Here, church-based health and wellness interventions occurring outside of, and in addition to, K-12 physical education demonstrate their value.

Church-based health promotion interventions can reach broad populations and have great potential for reducing health disparities (Campbell et al. 2007). Christian affiliation and church attendance can improve physical and psychological health across demographic variables. Physiological benefits include less smoking, less substance abuse, better cancer and cardiovascular disease survival, improved blood pressure, body composition, waist circumference, and waist to hip ratio, increased steps/week, healthier systolic blood pressure, and burning more kcal/week (Bopp, Peterson and Webb 2012; Bopp et al. 2009). Psychological health improvements include greater longevity, less depression, less suicide, less divorce, greater social support, greater meaning and purpose in life, greater life satisfaction, more charitable giving, more volunteering, greater civic engagement, reduced depression, greater enjoyment in physical activity, and valuing social support from church members (Kark et al. 2006; Koenig, King and Carson 2012). Possible attributions to these welcomed effects include positive social networks and social support provided by fellow members, and the role of prayer, beliefs, and religious practices in psychological well-being (Fiala, Bjorck and Gorsuch 2002). Additionally, teachings about the body being a gift from God, or a temple wherein God dwells might encourage health-promoting behaviours such as exercise (VanderWeele 2017). A summary of physical activity interventions delivered in faith-based organizations revealed that overall, many of the faith-based interventions resulted in increases in physical activity among participants (Bopp et al. 2012). The effectiveness of faith-based health and wellness interventions can be heavily influenced by the attitudes, perceptions, and participation of key leaders within faith-based organizations such as the Pastor, Preacher, etc. (Webb, Bopp and Fallon 2013).

Conclusion

Physical activity has a tremendously great place of importance, but it should not be our only Christian priority, as the Lord desires other attributes from us than our physical fitness. Be that as it may, in his message discussing the value of physical fitness for the Christian, Daryl Wingerd (2014) pointed out four reasons for Christians to develop healthy physical behaviours leading to a healthy lifestyle (e.g., nutrition, regular exercise), which is promoted by modern, holistic, and meaningful physical education practices: (1) good stewardship, (2) learning self-control, (3) staying ready for usefulness, and (4) loving others. Each of these reasons holds a relationship between faith and physical activity. For example,

…establishing self-discipline in exercise can teach principles that help one become more self-disciplined in Bible study and prayer. The self-control required to [avoid] too much unhealthy food or the temptation to sleep in rather than work out can help you become more effective in resisting temptations to sin. (Wingerd 2014, 1)

The Bible acts as a guide, laying out important principles of how we are to live. “Christians are instructed that their body is the temple of the Holy Spirit, to cleanse from what harms body or spirit, to glorify God in whatever they do, and to present the whole self as a living gift to God” (Whisenant, Cortes and Hill 2014, 189). Therefore, it is the responsibility of physical educators to provide experiences for students in their care to demonstrate faith and Christianity through physical activity, and meaningful social interactions with their peers. In that way, both the teacher and the students are using their bodies and minds as stewards for God.

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Author Bio: Colin G. Pennington (PhD) is an Assistant Professor of Kinesiology at Tarleton State University where he works with Exercise Science majors and carries out research on physical education teacher effectiveness and other pedagogical and health-related applications of the kinesiology sub-disciplines. Colin currently teaches courses including Physiology of Exercise, Anatomical Kinesiology, Capstone in Kinesiology, and formally a number of courses within the sport pedagogy sub-discipline of kinesiology. His interests and research focus on teacher socialization, physical education teacher training, character development programs within physical education and sport, and health and wellness.

Diane M. Wiese-Bjornstal, PhD, CMPC

Professor, University of Minnesota Twin Cities

Abstract: Research in psychology and medicine supports that religiosity functions as a protective and resilience factor among people facing diverse health challenges. Athletes risking and responding to health challenges associated with sport injuries likely benefit from religiosity and religious ways of coping, and yet associated mechanisms of influence are largely unexplored within sport psychology. This paper introduces a religiosity-adapted version of the integrated model of psychological response to the sport injury and rehabilitation process as a conceptual framework for research examining religiosity within sport injury prevention and care. Examples from the Christian faith illustrate model predictions. Psychological antecedents expected to influence vulnerability to sport injuries include personality (e.g., positive values), life stress (e.g., lower stress perceptions), and coping resources (e.g., utilizing prayer). Once injury happens, personal (e.g., religious commitment) and situational (e.g., support of faith community) factors are hypothesized to affect athletes’ health and well-being (e.g., spiritual health), and in turn their psychological responses to sport injuries. These responses include cognitive appraisals (e.g., God controls injury recovery) that affect feelings (e.g., gratitude for God’s work through health care providers), influence religious behaviours (e.g., church service attendance), and impact recovery outcomes (e.g., stress-related growth). Religious interventions within sport injury contexts such as referring athletes to clergy or coaches praying with athletes are predicted to benefit religious athletes. Overall, an inductive consideration of research evidence for model predictions supports that religiosity likely advantages the mental and physical health of many Christian athletes during sport injury recoveries. The integrated model of religiosity and psychological response to the sport injury and rehabilitation process provides a basis for generating more explicit research investigations into the mechanisms of influence between religiosity and health within sport injury contexts.

Keywords: Sport Psychology, Sports Medicine, Religious Coping, Athletes, Spiritual Health

Statement of Original Unpublished Work: By submitting this document to the Editor in Chief of CJSCF, I am making a Statement of Original Unpublished Work not submitted to another journal for publication.

Introduction

Research examining the psychological aspects of sport injuries is of significant relevance to the work of sport psychology consultants, sport coaches, and sports medicine providers. These professionals can benefit athletes by adopting holistic approaches to the prevention and care of sport injuries that include consideration of psychological factors. Diverse psychological factors relevant to the sport injury experiences of athletes include personality, motivation, anxiety, stress perceptions, coping mechanisms, and rehabilitation adherence behaviours. This paper proposes that religiosity – the beliefs and behaviours of athletes as influenced by specific religious faiths – be considered among the many psychological factors affecting sport injury vulnerability and recovery. It presents a conceptual model illustrating hypothesized interconnections between religiosity and the psychological aspects of sport injuries. Research on religiosity among Christian athletes is used to provide research examples lending preliminary support to model predictions (Beck and Haugen 2013; Wiese-Bjornstal 2019a).

Religiosity, as described within the psychology literature, is a complex multidisciplinary construct exhibiting intrapersonal, interpersonal, and physiological dimensions (Hill and Pargament 2003). It encompasses attitudes, beliefs, emotions, and behaviours (Hooker, Masters and Carey 2014). Religiosity involves adherence to specific, institutionalized belief systems focused on gods, deities, higher powers, or ultimate truths, characterized by explicit codes of ethics and common rituals, and encompassing social connections to others of the same faith (Hill and Pargament 2003). A key function of religiosity is connection to one’s spirituality. Psychological and health care scholars describe spirituality as an individualized, abstract, and subjective construct referring to one’s beliefs and values concerning meaning, purpose, connection, and transcendent sacredness in life (Center for Spirituality and Healing 2016; Greenstreet 2006). Religious adherents such as Christians most often identify as both religious and spiritual, but individuals who identify as spiritual do not necessarily report being religious (Pew Research Center 2018).

A wealth of literature in psychology and medicine supports that religiosity is largely positive in protecting mental and physical health and in promoting psychological resilience among those facing health challenges (Koenig 2012; Pearce 2013; VanderWeele 2016; Wiese-Bjornstal 2019b). Yet, in spite of this relevance of religiosity to protective and resilience functions within health contexts, social science literature examining religiosity within sport in general (Gibbons and Braye 2019), and within sport injury contexts specifically (Wiese-Bjornstal, Wood, White, Wambach and Rubio 2018) is extremely limited. Thus, the purpose of this paper is to present and describe the integrated model of religiosity and psychological response to the sport injury and rehabilitation process as one means of stimulating research that explores intersections between religiosity and sport injury. This model was developed as an adaptation of the integrated model of psychological response to the sport injury and rehabilitation process (Wiese-Bjornstal, Smith, Shaffer and Morrey 1998), which is frequently adopted in the sport psychology literature as a conceptual framework for research examining the psychological aspects of sport injuries (Wiese-Bjornstal, 2019b). The purposes for presenting this adapted model are to (a) establish predictions upon which to base research examining the protective and resilience influences of athlete religiosity within the contexts of sport injury prevention and care, and to (b) operationalize expected pathways through which sport, medical, and psychology professionals could intervene to tap into the benefits of religiosity to athletes within these experiences. Examples are derived from literature review and incorporate consideration of Koenig’s (2012) theoretical models illustrating the ways in which adherence to Western monotheistic religions (i.e., Christianity, Judaism, Islam) influences mental and physical health. Research findings regarding the psychological and social aspects of sport injuries integrated with medical literature showing connections between religiosity and health provide preliminary support for the adapted model predictions. However, many of these predictions are speculative within the context of sport injuries and future research testing of these predictions is essential to determining the viability of the model.

In order to accomplish these purposes, the first section of this paper provides a visual schematic and general narrative overview of the model. This model captures a broad perspective about ways in which religiosity across multiple faith traditions connect to the psychological aspects of sport injury experiences. It is not exclusive to Christianity. In section two, however, examples drawn from the Christian faith tradition illustrate specific model components. The third section provides conclusions and future directions for research and professional practice connected to religiosity and its contributions to physical and mental health within sport injury contexts.

Integrated Model of Religiosity and Psychological Response to the Sport Injury and Rehabilitation Process

The integrated model of psychological response to the sport injury and rehabilitation process (Wiese-Bjornstal et al. 1998) has been widely used as a conceptual framework driving research on the psychological responses of athletes to sport injuries (Wiese-Bjornstal 2019b). Research generally has supported its basic premises, and thus it provides a relevant starting point for predicting how religious beliefs, behaviours, and relationships might serve as health protective, resilience, and intervention factors within sport injury contexts (Wiese-Bjornstal 2019a). Figure 1 displays the newly adapted integrated model of religiosity and psychological response to the sport injury and rehabilitation process. In the top segment of Figure 1, the flow begins with pre-injury psychological elements derived from the stress and injury model (Williams and Andersen 1998) that are predicted to continue to exert influence on post-injury psychological sequelae. Examples of religious constructs are integrated into these psychological elements in the religiosity-adapted model. Psychological antecedents (e.g., personality, history of stressors, coping resources) and pre-injury interventions independently and conjunctively affect the stress responses of athletes, as manifested in stress reactivity, attentional, and physiological effects. Antecedent psychological and intervention factors that promote and protect mental and physical health, such as religious faith and coping resources, are predicted to reduce the stress response, which lessens vulnerability to sport injuries (Ivarsson et al. 2017).

Figure 1. Integrated Model of Religiosity and Psychological Response to the Sport Injury and Rehabilitation Process
Source: Adapted from Wiese-Bjornstal et al. (1998). Reprinted by permission of the author.

Once a sport injury occurs, the psychological response and rehabilitation process segment of the model becomes relevant. The middle segment of Figure 1 shows that personal and situational factors frame an interactional approach to understanding the dynamic field of influences affecting holistic health and well-being. Personal factors such as religious values, beliefs, and behaviours interact with situational factors, such as the support of religious teammates and family, to influence dimensions of health and well-being. One of these dimensions, spiritual health, is of particular relevance to this paper, as it describes one’s relationship with God and sense of life purpose that affect health-related quality of life (Dhar, Chaturvedi and Nandan 2011). These global dimensions of health and well-being may influence sport injury-specific cognitive appraisals, affective responses, and behaviours, as depicted in the bi-directional cycles of Figure 1. Appraising sport injury as part of God’s plan, for example, may lead to feelings of calmness and comfort about care and support, which may lead to behaviours associated with diligence and commitment to a rehabilitation plan. Physical and psychological recovery outcomes shown at the center of Figure 1, such as return to sport and stress-related growth, are affected by these dynamic cycles of cognition, affect, and behaviour over time.

The bottom segment of Figure 1 represents religiosity-specific ideas about aspects of post-sport injury psychological care related to assessments, providers of psychological care, and types of interventions that may prove useful. The predictions based on this model would be that assessments could gather information about the religiosity-based health and well-being of the athlete, which in turn inform the selection of appropriate religious interventions used by mental and physical health care providers. It is essential that these health care providers demonstrate cultural competence through their recognition that religiosity may be an important priority for individual athletes, and through their willingness to cultivate and accommodate religiosity within their use of interventions and provision of health care.

Thus, the integrated model of religiosity and psychological response to the sport injury and rehabilitation process shown in Figure 1 provides an overarching framework of religiosity influences within the sport injury context, and sets the scene for the next section of the paper. This upcoming section illustrates specific examples of evidence-based support for predictions about how Christian beliefs, behaviours, and relationships might function as health protective, resilience, and intervention influences on injured athletes.

Model Components and Christian Illustrations

While an overarching model of religiosity within sport injury contexts is a useful starting point, it is unrealistic to suggest that it accurately depicts the mechanisms of influence within all religious faith traditions. As presently drawn, it admittedly depicts pathways consistent with Western monotheistic traditions. Thus, this section of the paper provides illustrations of model components drawn primarily from one specific monotheistic tradition (i.e., Christianity).

Pre-Sport Injury Psychology

Returning to Figure 1, the uppermost pre-injury segment of the model identifies psychological antecedents that exert their influence on the stress response and sport injury vulnerability before injuries happen. The premise of this paper would be that it would be beneficial to tap into the psychologically protective effects that religiosity offers as a means of reducing vulnerability to sport injuries through the stress response pathway. Faith-related antecedents, such as religious beliefs, may influence stress responses through direct or indirect pathways. For example, athletes with a strong Christian faith may simply not perceive potentially stressful sports events as worrying (thus, religiosity exerts direct influence on reducing stress perceptions). Alternatively, athletes may use internal and external religious resources such as prayer and social support to buffer the effects of negative life events and maintain an attentional focus on meaning and purpose in sports competition rather than on fear or anxiety (thus, religiosity exerts indirect influence on reducing stress perceptions). By either perceiving less stress, or by better managing perceived stress, Christian athletes are less likely to display high levels of stress reactivity such as increased muscle tension, elevated heart rate, or distracted attentional focus. In turn, then, the avoidance of these high stress manifestations is associated with a reduced vulnerability to sport injuries (Ivarsson et al. 2017).

Other potential benefits may accrue via the personality antecedent, such as through the influences of religious identities (Watson 2011), virtues, and goal orientations. Proios (2017), for example, found a relationship between religious and athletic identities among adult athletes. This requires further exploration to find out what this means, because athletic identity is a construct that encompasses important aspects of social identity and affect and has demonstrated relationships to sport injury risks and responses in prior research (Wiese-Bjornstal 2019b). So, the question is, does religious identity promote or protect health, or can it compromise health such as by feeling that one must sacrifice health in order to fulfill one’s God-given potential (Lee Sinden 2013)? Kretschmann and Benz (2012) examined the moral thoughts and actions of Christian athletes relative to their own health and well-being and that of their opponents. With respect to religious orientation, for example, they cited evidence showing that athletes with traditional Christian beliefs evidenced greater emphasis on goal/mastery rather than competitive/ego orientations, the latter of which is more strongly tied to a willingness to do whatever it takes, including injuring others, in order to achieve victory. One Christian athlete, when talking about moral limits of body contact and hurting someone on purpose, said the following:

[Winning] is not so important to me that I would risk an injury or something like that in this case. I wouldn’t do that. Or to get an advantage through such ways, I personally probably could not be happy about it. (Kretschmann and Benz 2012, 513)

Kretschmann and Benz (2012) reported evidence showing that Christian athletes rated honesty and integrity as high priority values, compared with nonreligious athletes who rated values such as perfectionism higher. Honesty is an important and beneficial Christian value, and in a secular sense is a health protective virtue or asset within a positive psychology view of character strengths. Perfectionism, particularly perfectionistic concerns, associates with increased risks of sport injuries (Madigan, Stoeber, Forsdyke, Dayson and Passfield 2018). Other examples of strengths or virtues associated with religiosity and a positive psychology view would be hope, compassion, and gratitude; again, with the prediction that these would protect, rather than harm, health and well-being (Worthington et al. 2014).

Pre-injury coping resources reflect the use of internal and external coping resources as a means of controlling the stress response. Reducing anxiety and preparing for competitions, such as via the use of pre-game religious rituals and practices such as prayer, are evident among many athletes. Their reasons for using these often include safety and protection from harm or injury in the coming contest (Jirásek 2018; Watson and Czech 2005). For example, in their interview study about the role of sports chaplains within English professional soccer clubs, Gamble, Hill and Parker (2013) reported that the chaplains noted player pre-game prayers often focused on preventing injury and playing well. The chaplains facilitated these team and individual prayers. One athlete working with a sports chaplain attributed his improved play to the adoption of a pre-game prayer ritual. The ritual provided him with the capacity to manage better his in-match emotions due to a sense of peace about his purpose and preparation. This example illustrates a potential protective effect of religious interventions in that by feeling peaceful and less anxious pre-game thanks to prayer rituals, the stress response lessens and risk of injury decreases based on the stress and injury model predictions (Wiese-Bjornstal 2019a).

Although religious rituals and practices are sometimes included in sport psychology and sociology studies describing “superstitions” in sport, thus relegating them to the realm of irrationality and chance control, several authors articulate the importance of distinguishing superstition from religious ritual and practices. Religious ritual and practices have specific rational and controllable meanings and serve functions beyond relying on luck (Hoven 2019; Hoven and Kuchera 2016; Maranise 2013). Maranise (2013, 84) contended, “Religious rituals practiced by athletes or integrated into sporting lifestyles promote greater holistic (mental, emotional, physical, and spiritual) well-being and add significant meaning to life in a way that superstitions cannot.” As such, it is logical to presume that religious rituals would serve not only a performance enhancing function (by focusing effort and promoting confidence), but also health protective (by promoting well-being) (Hoven 2019), and spiritual (by promoting meaning) functions.

Having explored some possible predictions relative to the role of religiosity as a health protective factor pre-injury, it is apparent that research on this topic is quite limited. In the context of health in general and allied literature, however, the evidence generally would support the predictions of the religiosity-adapted model and provide researchers with ideas for examining religiosity as psychologically influential during the pre-injury phase. Next, it is important to consider how religiosity influences psychological responses to sport injuries once they occur.

Post-Sport Injury Psychology

Based on the integrated model of religiosity and psychological response to the sport injury and rehabilitation process, personal factors such as religious commitment, religious schemas, and locus of health control would comprise factors predicted to influence the spiritual well-being of athletes. Among Christians, for example, spiritual well-being involves living by faith in proper relationship with God and trusting in God’s steadfast love and mercy through Jesus Christ as the purposes for one’s life (Evangelical Lutheran Church in America 2019). This spiritual well-being may influence athletes’ cognitive appraisals when sport injury occurs; for example, by interpreting sport injury as serving some larger purpose in one’s life. A few studies illustrate promising results regarding the generally positive influences of religiosity on spiritual well-being and coping with sport injuries. For example, in their qualitative study of religious well-being in intercollegiate sport, within one of their resulting coded data themes, Cope With Injury, Seitz, Sagas and Connaughton (2014) reported that some athletes used religious coping strategies indicative of positive religious well-being. One Christian athlete, Leslie, stated the following with respect to coping with a season-ending injury:

I think if most other people went through the same thing, injury-wise, they probably wouldn’t have stuck it out as long, and I think my faith had a lot to do with that. It made dealing with injury easy in the beginning because I was able to see that something good is going to come out of this. God has a purpose for everything, and I was trying to understand what that was. (Seitz, Sagas and Connaughton 2014, 227)

Spiritual well-being and associated cognitive appraisals influence emotional and behavioural responses and coping efforts of religious individuals (Newton and McIntosh 2010). Seitz, Sagas and Connaughton (2014, 227) reported that one athlete attributed his recovery from a career-threatening injury to the power of God: ‘‘My God rescued me from a pretty significant injury my freshman year. I was able to get back out there and play and I wanted to make the most of it.’’ Research examining the effects of religious beliefs and practices on the mental health and well-being of male professional athletes prior to surgery for anterior cruciate ligament injuries showed similar relationships (Najah, Farooq and Rejeb 2017). In comparing athletes who were high versus low in religious/spiritual belief and in praying/meditation practice, Najah, Farooq and Rejeb (2017) found that higher levels of religiosity/spirituality positively influenced adaptive coping and was associated with fewer negative emotions. Athletes higher in religiosity/spirituality at pre-surgery exhibited greater use of coping strategies such as acceptance, emotional support, and self-distraction, and reported lower scores on stress, anxiety, and depression.

A recent mixed methods study by Wiese-Bjornstal et al. (2018) correspondingly illustrated the roles of religiosity in cognitive, affect, and behaviour in response to sport injuries. Their study explored religiosity/spirituality specifically within the context of coping with sport injuries, based on predictions of the integrated model of psychological response to the sport injury and rehabilitation process. The responding sample of athletes and other physically active individuals were predominantly Christian, and the findings supported religiosity and religious coping as beneficial to psychological resilience following sport injury. The results showed that athletes identifying as religious and/or spiritual utilized more active coping strategies (e.g., acceptance, planning, positive reframing) than those identifying as not religious or spiritual. Further, stronger religious commitment predicted greater reliance on a God locus of health control for sport injury. It also predicted greater use of positive religious coping strategies such as seeing the ways in which God was caring for and strengthening them in their injuries. Higher religious commitment did not predict greater use of negative religious coping. Triangulation of quantitative and qualitative data reflected primarily positive benefits of religious coping strategies such as prayer, positivity, and priorities in managing the psychological challenges presented by sport injuries (Wiese-Bjornstal et al. 2018). For example, a 21-year-old Christian female athlete who suffered a concussion playing high school basketball illustrated these positive benefits:

I grew closer to God. I prayed for my injury and was prayed for. I felt strengthened by others when they prayed over my injury and just seeing the healing process come through strengthened my trust in Him over my body. (Wiese-Bjornstal et al. 2018, 13)

Overall, the findings from this study were consistent with the predictions of the integrated model of psychological response to the sport injury and rehabilitation process. They confirmed intersections between personal/internal factors (e.g., religious commitment) and situational/external factors (e.g., others’ prayers) on cognitive, emotional, and behavioural responses to sport injuries and the psychological and physical recoveries associated with these responses.

A related study focused on athletes embracing the Christian religion explored possible differences between Catholic/Mainline Protestant and Evangelical Christians in coping with their sport injury experiences (Wiese-Bjornstal, Wood, Principe and Schwartz 2019). The purpose of this study was to examine the relationships between religious commitment, religious engagement, God locus of health control, and religious ways of coping during the sport injury recoveries of athletes from diverse Christian denominations. As part of a larger mixed methods study, physically active adults (n=88) responded to an online survey including questions about their most serious or challenging sport injuries and several religiosity factors. The results showed that religious commitment (i.e., the importance and centrality of religious beliefs, values, and practices to one’s life) predicted religious engagement (e.g., attendance at religious services) and God locus of health control for sport injuries (i.e., a belief that God controls one’s health status). Further, religious commitment fully mediated the relationship between athletes’ Christian denominations and their use of positive religious ways of coping with sport injuries. Positive religious ways of coping were used significantly more than were negative, with seeking spiritual support, active religious surrender, and benevolent religious reappraisal the most frequently used strategies. Although negative religious ways of coping were less prevalent, self-directed religious coping, marking religious boundaries, and pleading for direct intercession were most used among them. This study illustrated the centrality of religious commitment as the driver of religious coping with sport injuries, regardless of Christian denomination, and demonstrated the intersections between spiritual health and cognitions, emotions, and behaviours following sport injuries.

These research findings demonstrate preliminary evidence showing that religiosity is associated with the use of primarily positive religious coping strategies among Christian athletes dealing with the stresses of sport injuries and recoveries. Koenig’s (2012; 2013) reviews of literature in the general medicine and health care fields also document that positive religious coping exerts beneficial effects for patients dealing with a wide variety of health challenges. Knowing this, culturally competent sports, medicine, religious, and psychology professionals should consider how tapping into athletes’ religiosity could play a role in psychological interventions designed to aid in the prevention and care of sport injuries, as next discussed.

Psychological Interventions/Return to Sport

Psychological interventions generally refer to professionals intervening via the development of interpersonal relationships and the utilization of activities or strategies with the purpose of improving individual health and well-being, such as spiritual, mental, physical, social, behavioural, or emotional health and well-being. The psychological care of athletes involves the integration of psychological assessments with the work of sport, religion, and medical professionals and the interventions they use, as depicted in the bottom segment of Figure 1.

Sports medicine providers, sport psychologists, sport coaches, and sport chaplains are among the many professionals that might intervene with varied religious strategies contained within the boundaries of their expertise and ethical standards (Gamble, Hill and Parker 2013; Wiese-Bjornstal 2000). Individuals within these professional roles are expected to demonstrate cultural competence. Cultural competence in health care and rehabilitation settings such as sports medicine or sport psychology refers to being culturally knowledgeable, sensitive, and effective in working with diverse populations in order to build resilience and restore health (Buse, Burker and Bernacchio 2013; Cartwright and Shingles 2011). This would include accommodating an athlete’s religiosity in sports training and health care (Wiese-Bjornstal 2019a). With respect to support among sports medicine providers for accommodating religiosity, findings of a survey of program directors in United States athletic training education programs showed that 89% of program directors believed there to be a connection between spirituality and health/healing (McKnight and Juillerat 2011). Further, survey results with United States intercollegiate athletic trainers reported that 82% of athletic trainers agreed that addressing injured athletes’ spiritual concerns leads to more positive rehabilitation outcomes (Udermann et al. 2008). Thus, the implication is that when working with Christian athletes, the effectiveness of culturally-competent sport professional practices is improved by recognizing that religiously-committed Christian athletes engage in religious activities, believe that God exerts control over their sport injury recoveries, and benefit from utilizing primarily positive religious ways of coping when injured (Wiese-Bjornstal 2019a).

Given this evidence of the need for considering religiosity in health care, Plante’s (2014) paper “Four Steps to Improve Religious/Spiritual Cultural Competence in Professional Psychology,” provides useful guidelines for psychology professionals incorporating religiosity-based interventions. Plante (2014) identified the following four steps for psychologists: beware of biases (e.g., against religion), consider religion just as one would other types of diversity (e.g., worthy of respect and consideration), take advantage of available resources (e.g., material available in American Psychological Association journals such as Psychology of Religion), and consult colleagues, including clerics (e.g., religious clergy as professionals with whom to consult, and to whom to refer). Sport psychology consultants could incorporate religious practices such as Christian prayer and music into mental skills training (Mosley, Frierson, Cheng and Aoyagi 2015; Watson and Nesti 2005), or tap into the benefits of religious rituals, as suggested by Maranise (2013):

…the multidimensional aspects of adherence to religious rituals for athletes cannot be understated in their importance for they provide opportunities for utilization in sport psychological consulting, therapeutic techniques, and life-coaching which ultimately concretize and provide visible, experiential outcomes to what many have long-viewed as merely abstract and intangible. (Maranise 2013, 89)

Wiese-Bjornstal (2000) recommended similar strategies for use by sports medicine-related professionals, such referrals of athletes by sports medicine providers to a network of religious clergy, praying or sharing Scripture with athletes if appropriate and ethical within the specific work environment (Egli and Fisher 2017), and weaving athlete stories of faith and recovery from sport injuries into interpersonal exchanges (Wiese-Bjornstal et al. 2018). The latter provides an example of tapping into the benefits of narrative health or narrative health psychology. Narrative health psychology is a research (Sools, Murray and Westerhof 2015) and communication model (Pallai and Tran 2019) through which health care providers and patients become better listeners, care providers, and patients through the sharing of personal stories, and, by extension, on drawing from the relevance of the stories of others negotiating similar health challenges.

These examples illustrate ways in which the model of religiosity and psychological response to the sport injury and rehabilitation process might help researchers and practitioners examine how religiosity may benefit the prevention and rehabilitation of injuries among Christian athletes. The ultimate benefit of exploring religiosity is to maximize the protective and resilience benefits it may offer to athletes. In the broadest sense, this paper has focused on the development of a model reflecting the integration of social science, religious faith, and health among religious athletes relative to the risks and consequences of sport injuries. Some concluding thoughts emerging from this review may be useful in guiding future research and professional practice.

Conclusions and Future Directions

Evidence-based findings evolved into an adapted conceptual model provided nascent yet potentially compelling evidence that religiosity, and Christian faith specifically, serves as a psychologically protective and resilience factor for athletes relative to sport injury risks and consequences. As a protective factor pre-injury, reduced stress reactivity accrues through the influences of strong coping resources such as those provided by religious social networks and through personal faith and rituals. Reduced stress reactivity may lessen the vulnerability of Christian athletes to injuries. This is a fruitful future direction for sport psychology research given that the extensive body of knowledge on psychological predictors of sport injuries has largely ignored religiosity. As a resilience factor post-injury, benefits of religiosity likely include positive mindsets, emotional control, adaptive behaviours, and stress-related religious and spiritual growth (Wiese-Bjornstal et al. 2018). Since religiosity shows strong support as a beneficial psychological resilience factor for persons facing a variety of health challenges (Helmreich et al 2017), it could be an asset to sports medicine health care for researchers to find support for similar mechanisms in sport injury contexts.

Although the role of religiosity seems to be largely positive in preserving and promoting health and well-being among athletes, future work should further examine some potentially negative or harmful aspects of religiosity relative to sport injuries. These might include the role of pain in religious sacrifice and expression (Glucklich 2015), and the use of negative religious coping strategies, such as blaming God when living in chronic pain and “imprisonment” (Hunt and Day 2019, 1), or feeling abandoned and withdrawing from religious support after injury (Wiese-Bjornstal et al. 2018). Career terminations resulting from sport injuries also represent vulnerable life transitions that could negatively affect, or be affected by, religious faith (Wiese-Bjornstal et al. 2018), such as believing that one has failed to live up to their God-given potential. There is evidence of some undesirable, conflicting, or negative influences of religiosity on health and well-being within sport that must be considered and addressed by scholars and practitioners moving forward (Lee Sinden 2013; Wiese-Bjornstal 2019a).

In conclusion, the integrated model of religiosity and psychological response to the sport injury and rehabilitation process provides one way forward in generating future research on the roles of religiosity in preventing and recovering from sport injuries. As theory often drives research initiatives, the hope is that the presentation of this model serves toward that purpose. However, the model derives largely from a psychological, medical, and positivist science view of religiosity, and thus would greatly benefit from elucidation by scholars and professionals trained in liberal arts fields such as religious studies and theology, philosophy, and sociology (Gibbons, Watson and Mierzwinski 2019; Sullivan 2019). These individuals may better articulate some of the less scientifically tangible sacred and spiritual aspects involved when considering religiosity’s role in sport psychology and sports medicine, such as a deeper capacity to tap into the spiritual dimensions of coping that may benefit athlete health and recovery (Pargament 2009).

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Author Bio: Diane M. Wiese-Bjornstal (PhD) is a Professor of Sport and Exercise Psychology, Associate Director of the School of Kinesiology, and Director of the Sports Medicine Psychology Laboratory at the University of Minnesota Twin Cities, USA. She is a Certified Mental Performance Consultant (CMPC) and a Fellow in the National Academy of Kinesiology, the Association for Applied Sport Psychology, and the Society of Health and Physical Educators. Her research focuses on sports medicine psychology, which encompasses multidisciplinary theory, research, and practice in the social, psychological, and behavioural aspects of injury prevention and rehabilitation among physically active participants across the lifespan. Recent publication venues include the Journal of Clinical Sport Psychology, Kinesiology Review, and the Scandinavian Journal of Medicine and Science in Sports. Dr. Wiese-Bjornstal’s professional service encompasses election as a member of the Science Board of the United States President’s Council on Fitness, Sports and Nutrition and Associate Editor responsibilities for Elevate Health, Research Quarterly for Exercise and Sport, and the Journal of Applied Sport Psychology. A former youth and collegiate volleyball and softball coach, she serves as an Affiliated Scholar with the Tucker Center for Research on Girls & Women in Sport at the University of Minnesota.

Louise McEwan, BA, BTh

Statement of Original Unpublished Work: By submitting this document to the Editor in Chief of CJSCF, I am making a Statement of Original Unpublished Work not submitted to another journal for publication.

Introduction

In a competitive culture, physical activity can become overly focused on results. Frequently, the enjoyment of movement, which first manifests itself as play, morphs into sport and competition.  But physical activity has another side. It can be an avenue for nurturing spirituality and a place of encounter with God. Both scripture and human experience support the role of physical activity in the quest to become a more mature, faith-filled individual.

A Definition of Spirituality

For the purposes of this discussion, a definition of spirituality is as follows. Spirituality is a receptiveness to the Holy Spirit at work in one’s life and the world. It involves an awareness of the transcendence and immanence of God. The spiritual journey is a quest to understand and deepen one’s relationship to the divine, to others, and to the world.

Wired to Move

The individual first experiences physical activity as movement within the womb. This movement includes small motions, such as swallowing and moving the eyes, to larger motions, such as vigorous kicking. After birth, the innate desire for physical activity manifests itself in the progression of basic gross motor skills, such as sitting, standing, crawling and walking. Young children experience physical activity in the form of exploration and play. Over time, exploration and play become more structured, and give rise to different dimensions of physical activity.

Physical Activity: A Good Gift from the Creator

The human person is made in the divine image. The human inclination to move reflects the creative energy of God. The opening chapters of the Book of Genesis describe the birth of creation. God speaks the cosmos and every living thing into being. “God said, “Let there be light,” and there was light” (Gn 1:3 NAB). This pattern repeats; God speaks and “so it happened”. Yet, the scriptures also describe God as making the dome of the sky, separating the waters, making and setting the sun and moon in place, making the great sea monsters, the animals, and last of all, man.

While one might envision God sitting passively, talking creation into existence like an armchair athlete coaching from the sideline, the work of creation entails an output of energy. The scriptures emphasize that God worked.

Thus the heavens and the earth and all their array were completed. Since on the seventh day God was finished with the work he had been doing, he rested on the seventh day from all the work he had undertaken. God blessed the seventh day and made it holy, because on it he rested from all the work he had done in creation. (Gn 2:1-3)

The second account of creation portrays God as physically shaping man and then planting a garden. “The Lord God formed man out of the clay of the ground and blew into his nostrils the breath of life, and so man became a living being” (Gn 2:7). One might imagine God digging the clay, shaping it and bending over the lifeless mass; with an expenditure of breath, God gives the lump life. God takes the man and settles him in the garden of Eden, “to cultivate and care for it” (Gn 2:15). To use an athletic metaphor, God readies creation, sets the mark, and shoots the gun. It is as if God says to the man, “Go, be fruitful, and share my love with the world.”

In the Heart of God

I can think of no better example of the delight and joy to be found in physical activity than that observed in small children. I frequently pick up my five-year old granddaughter from school; one day, as we were walking along chatting, she asked me where her new baby cousin was before she was born. In an inspired moment, I replied, “She was in the heart of God.” With a jump in her step and a lilt in her voice, she responded with all certainty, “I’m in the heart of God.” She then grabbed my hand and began skipping with abandon, pulling me along.

Through her physical movements, she was expressing a joyful awareness of the transcendence and immanence of God. In grabbing my hand, she was sharing her insight that God was both beyond and within us. With the innate wisdom and innocence of childhood, she had intuitively connected physical activity, delight, and relationship with the presence of God.

My granddaughter is still “trailing clouds of glory … from God who is our home”, as William Wordsworth (1973) wrote of the natural inclination of children to recognize the sacredness in human existence and creation. For those of us who shook off those clouds of glory long ago, it may be more challenging to recognize the sacred intent behind physical activity.

Glorify God with Your Body

Frequently, physical activity is associated with results. Whether from the perspective of organized and competitive sport, or from an individual focus on fitness, most physical activity outside of childhood is purpose-driven and results-oriented. We play to win. We work out to achieve or maintain a healthy body weight. We exercise to feel good about our self. However, the lens of faith may help us re-orient some of our attitudes about physical activity.

Created in the image and likeness of God, the human person is a divine masterpiece, and enjoys an unparalleled dignity within creation. The psalmist sings of humankind, “Yet, you have made them little less than a god/ crowned them with glory and honour” (Psalm 8:6). The human person expresses this unique relationship to God through both body and spirit. Therefore, the spiritual life of the individual cannot be isolated from the physical body. Too much emphasis on the physical side of being human may endanger spiritual growth. Conversely, severe asceticism may harm the living, clay vessel that God lovingly breathed into existence.

In First Timothy 4, Paul warned against false asceticism. Although he specifically refers to deviations from the Christian message that prohibited marriage and required abstinence from certain foods (4:3), Paul also mentioned physical training.

Train yourselves for devotion, for while physical training is of limited value, devotion is valuable in every respect, since it holds a promise of life both for the present and the future (4:7,8).

Paul may be addressing an issue of strict asceticism of the body. Or, he may be using an athletic metaphor to drive home his message, as he does elsewhere.

In First Corinthians 9, for example, Paul used an athletic metaphor in defense of his rights as an apostle. Paul wrote,

Do you not know that the runners in the stadium all run in the race, but only one wins the prize? Run so as to win. Every athlete exercises discipline in every way. They do it to win a perishable crown, but we an imperishable one. (9:24, 25)

On the surface, Paul appears to hold physical activity of little account. However, Paul’s theology is always concerned with the interface between faith and daily life. For Paul, the death and resurrection of Jesus had made all things new. The Christian was a new creation in Christ, whom Paul urged to live a life worthy of Christ. So, while Paul recognized the mortal nature and the limitations of the body, he also acknowledged the body as the dwelling place of the Spirit;

Do you not know that your body is a temple of the Holy Spirit within you, whom you have from God and that you are not your own? For you have been purchased at a price. Therefore, glorify God with your body. (1 Cor. 6:19, 20)

The human person embodies the spirit of divinity. This spirit is a gift from God given at the time of creation. In the beginning, the man and woman walked in harmony with God in the coolness of the garden (Gn. 3.8). From the beginning, the human person was wired to walk with God, to move towards holiness. Thus, physical activity has a role in sanctification, in achieving the ‘imperishable crown’ to which Paul referred. Physical activity can be thought of as a spiritual practice. Spiritual practices render us more open and responsive to dynamic activities of grace, and move us towards greater spiritual maturity (Griffith 2009).

The Road to Emmaus

“The Road to Emmaus” (Lk 24:13-26) provides a starting point for understanding the role of physical activity in spiritual formation. In the passage, two disciples are walking from Jerusalem to Emmaus, a distance of about seven miles. Along the way they encounter a stranger, the risen Jesus whom they do not recognize. The pair are struggling to make sense of Jesus’ crucifixion and death, and their own dashed hopes. The stranger elucidates the meaning of the scriptures as they relate to the Christ. When they arrive at their destination, they invite the stranger to dine, and in the breaking of bread they recognize Jesus. Once again, the pair set out walking; they return to Jerusalem to share their experience.

While there are multivalent levels to the passage, the point for us is that the physical act of walking is integral to the disciples’ spiritual development. Along the road, they experience the transcendence of God in the wisdom of Jesus. As they walk with Jesus, their hearts ‘burn within’; they also experience God dwelling in and among them. Enlightened with deeper understanding, they are able to go forth. In Christianity, as in other spiritual traditions, walking is often a feature of the spiritual journey.

Lessons from the Walking Monk

A few years ago, I had a chance encounter with a Krishna monk who was on his fourth walk across Canada. It was early one spring morning. My daughter and I were out for a run when we passed Bhaktimarga Swami (2014) walking along a back road, his orange robe flowing in the early morning breeze. Not wanting to break our stride and spoil our pace, we said “Hello”, but did not stop. Towards the end of the run, we crossed paths a second time with the ‘walking monk’, as he is known. He stopped us for directions, and we learned that he was walking across the country. A few weeks later, I interviewed Swami for a column I was writing.

For Swami (2014), walking is very much an essential component of spiritual maturation. At the core of the self,

… there is a passion to move about and pick up on all the little nuances the world has to offer. Walking brings about a lot of revelation and epiphany about the self and one’s place in the universe. You learn not to be so passionate about results. (Swami 2014)

As the disciples on the road to Emmaus had the presence of God with them in the stranger, Swami (2014) has the presence of the divine with him as he walks in the chanting of the mantra. The mantra frees the mind from focusing on “the acquisitions you’re trying to achieve”, and the tendency to wander in the past and the future. “The Absolute or the Divine is there with you in their sound … The mantra keeps the spiritual in your midst” (Swami 2014).

My own experience of walking jives with the lessons from the road to Emmaus and those of the walking monk. I have found walking helpful in keeping me grounded in the present moment, enlightening my understanding, and nurturing my spirituality.

Conclusion

The story of creation as recounted in the Book of Genesis demonstrates that physical activity is part of God’s plan for human thriving. The human person is naturally inclined towards movement, and initially intuits the unity of physical activity and spirituality, of body, mind, and spirit. Over time, we may lose this awareness as physical activity becomes more results-oriented.

A shift in thinking may help to recover the sacred intent inherent in physical activity. When viewed from a faith perspective, rather than as a means to an end, physical activity can become a spiritual exercise. It can move the individual towards greater spiritual maturity. As an aid to spiritual growth, physical activity, such as walking, can help us enter more profoundly into the heart of God who asks us to go skipping forth with joy and love.

Bibliography

Griffith, Colleen M. 2009. “Catholic Spirituality in Practice” C21 Resources.  Spring: 1-2. Retrieved from https://www.bc.edu/content/dam/files/top/church21/pdf/Spring_2009.pdf (February 2, 2019)

Swami, Bhaktimarga. 2014. From interview transcript of Louise McEwan. Trail, B.C. (September 04, 2014).

Wordsworth, William. 1973. “Ode: Intimations of Immortality.” In Major British Poets of the Romantic Period, edited by William Heath, 257-259. New York; Macmillan Publishing Company.

Author Bio: Louise McEwan (BA, BTh) is a former elementary school teacher and catechist. She has a Bachelor of Arts (English Literature) from the University of British Columbia and a Bachelor of Theology from Newman Theological College, Edmonton, Alberta. Louise was a freelance religion columnist for ten years, writing for secular media on a broad range of topics from a faith-based perspective. Although retired, she continues to contribute opinion pieces on an occasional basis. Louise lives in Trail, B.C. with her husband, Chris. She is a mother of three, and grandmother of seven.

Brent Bradford, PhD

Associate Professor, Faculty of Education
Concordia University of Edmonton

Published in the Canadian Journal for Scholarship and the Christian Faith (journal.ccscf.org) on 2 October 2019

Welcome to the CJSCF’s Special Issue that will be examining the relationship between wellness-related topics and the Christian faith. For as long as I can remember, physical activity, and often times as a result, physical recovery, have been an important facet of my life. In my youth, I spent countless hours in hockey arenas throughout BC’s Kootenay region and northwest USA developing my hockey and team skills with my childhood buddies. These early experiences led me to continue to play organized competitive sports such as hockey, baseball, and soccer throughout my school years and into early adulthood and, with reduced competiveness, into my 30s and 40s. It was during those formal learning years spent practicing, competing, reflecting, recovering, celebrating, etc. that afforded me incalculable opportunities to develop knowledge, skills, and attributes related to discipline, sportsmanship, resilience, and one of my most cherished (but, often times challenging) characteristics – competitiveness.

That said, one constant has endured as a primary element in my life. This constant has been my faith in God. It was during my formal learning years in elementary school that I became a servant to God. And to this day I continue to dedicate myself to living out His plan through physical activity and sport with their accompanying threads of spiritual, physical, social, and emotional development.

Competing with Teammates
National Champion University of Alberta Golden Bears, 1999

Jogging along a Beautiful Nature Trail with my Son (Kane, 3 Years Old), 2016

Engaging in Service. As part of my faculty-related service, I choose to serve on the Canadian Centre for Scholarship and the Christian Faith Executive Committee. As a component of this committee work, I wanted to help establish a section in the Canadian Journal for Scholarship and the Christian Faith that focuses on the relationship between wellness-related topics and the Christian faith. This led to the initial step of organizing this Special Issue. Over the past several months, I have been surprised by the richness of focus this topic continues to receive around the world. It is, for example, exciting to see the work that has continued through Athletes in Action (see Table 1). Further, I had no idea there was a group of scholars engaged in the Christian Society for Kinesiology, Leisure, and Sport Studies (see Table 1). This new contact has led me to become a member, to prepare a presentation for an upcoming conference, and to collaborate with scholars interested in exploring the relationship between wellness-related topics and the Christian faith.

In addition to these organizations, I was introduced to scholars such as Dr. Brian Bolt (Professor, Calvin University), author of Sport Faith Life (see Table 1). Dr. Bolt is interested in sharing the “love of sport and how it intersects with Christian faith in our everyday lives” (see Table 1). I look forward to reading Dr. Bolt’s book in the near future. Further, while working on this Special Issue, I was introduced to outstanding work and messages from the contributing authors: Louise McEwan; Dr. Diane Wiese-Bjornstal; Dr. Colin Pennington; Lacie Webb; and Dr. Marc Apkarian. It was through this guest editorial process that I was encouraged to reflect on my own life experiences and how faith in Him has remained a constant. As you read through the articles, I invite you to reflect on the importance of faith, in whatever form it resides within you, and how it connects to your daily life.

Table 1: Related Resources

Special Issue (2019). First, I would like to extend a big appreciation to the peer reviewers who volunteered their time throughout the review process. Beginning with a Special Column, invited contributor Louise McEwan, a former elementary school teacher, catechist, and freelance religion columnist, explains how physical activity can be viewed as an aide to our spiritual journey. Sharing her story about communicating with the ‘walking monk’, Louise lends thought to how physical activity is a gift from God and is part of His plan for human thriving. Dr. Diane Wiese-Bjornstal, a professor and certified mental performance consultant, introduces a religiosity-adapted version of the integrated model of psychological response to the sport injury and rehabilitation process as a conceptual framework for research concerning religiosity within sport injury prevention and care. Dr. Wiese-Bjornstal raises the issue that although the role of religiosity seems to be largely positive in preserving and promoting athlete health and well-being, future research might examine potentially negative aspects of religiosity relative to sport injuries. Dr. Colin Pennington, a scholar interested in teacher socialization and physical education teacher training, shares how physical educators are afforded opportunities to meet goals beyond physical- and health-related objectives, including positive moral socialization. As part of his work, Dr. Pennington offers a brief review of Muscular Christianity along with historical origins of church-based physical education. Lacie Webb, a physical therapist passionate in medical mission trips, and Dr. Pennington offer their insights into research exploring the intersectionality between faith, spirituality, and physical recovery. As part of their message related to preventative medicine, Lacie and Colin point to research stating that patient religious and spiritual practices and beliefs become powerful factors in coping with serious illnesses, making ethical treatment choices and end-of-life care decisions. Dr. Marc Apkarian, an Associate Professor involved in both youth and adult ministry opportunities at church, discusses attributes and characteristics of physical fitness and how each aligns to a figurative counterpart in the Christian faith. Marc extends his message through a number of examples in which strength, endurance, and flexibility are depicted throughout books of the Old and New Testaments.

As stated, the intention with this Special Issue is to provide opportunities for readers to reflect on the relationship between their own wellness practices (e.g., physical activity, physical recovery) and their faith. And, it is hoped future contributions to CJSCF will include a local, national, and international flavour while raising global-level queries and broadening horizons of thought possibilities related to wellness and the Christian faith. I extend an invitation for all readers to become CJSCF contributors. As a member of the Canadian Centre for Scholarship and the Christian Faith Executive Committee, I invite you to explore your understanding of the relationships that can exist between wellness-related topics and the Christian faith.