Assessing the side effects of the ‘exercise pill’: the paradox of physical activity health promotion

The Exercise is Medicine movement, centralised in Physical Activity Health Promotion (PAHP) policy, is illustrative of neoliberal health governance that acts to sustain the population’s regular participation in physical activity (PA) through the logics of self-care, productivity, personal responsibility and choice. One way this is propagated is through the promotion of exercise as the ‘best buy’ (AMRC 2015) in modern medicine and a wonder ‘pill’ to good health (Sallis 2009a). However, the increasing reliance of PAHP policy on the Exercise is Medicine narrative to construct the healthy citizen typically conflates the categories of sport, exercise and PA, and fails to recognise the different social relations and risks each entails. Consequently, the neoliberal logics central to this narrative are more likely to create actors inclined towards competitive sport and, therefore, PAHP places populations at risk of physical injury that entail both social and economic costs. Mobilising data from semi-structured interviews, the social and economic ‘costs’ of physical injury are documented to develop a critical evaluation of the paradoxical implications of these ‘costs’ for contemporary public health promotion such as the Exercise is Medicine movement.