Published in Physio Matters magazine February 2010: physiotherapy had emerged as a profession by colonising ideas and practices that had existed for centuries before.
One of the joys of the summer holidays is the chance to catch up on some of the reading that has been sitting on my bedside table since last summer. And one of the books I read this year reminded me of one of the dilemmas we face in piecing together a history of physiotherapy in New Zealand. The book was Caroline Daley’s excellent ‘Leisure & Pleasure: Reshaping & Revealing the New Zealand Body 1900-1960.’ Caroline will be well known to many of you as an Associate Professor of History at the University of Auckland, and her book traces the way the body has been the source of tension between the need to develop our individual and collective strength (for King and country), and our growing desire to use our bodies for pleasure.
The book reminded me of a realisation I came to while completing my PhD thesis. I was attempting to trace the social and cultural roots of the physiotherapy profession, and realized that physiotherapy had emerged as a profession by colonising ideas and practices that had existed for centuries before. The four main tenets of early physiotherapy – massage (and manipulations), exercise, water-based treatments, and electrotherapy – had all been practiced extensively elsewhere, by other people in other cultures. So unlike radiography, physiotherapy had not emerged as a result of a new invention or discovery, but was possibly more like dentistry, because the profession had been formed to address a particular social need. In our case the need was to offer the public a “legitimised” form of touch-based therapy.
This means that to separate the practices associated with physiotherapy from those practiced by people for centuries before, we need to look at the culture of the society in which we operate. It follows then that we should no longer think about physiotherapy as an object, or a “thing”, like a book or a bicycle, because physiotherapy is, in reality, a set of social and cultural “practices”. So it may be better, and certainly more accurate, to talk about physiotherapy practices rather than physiotherapy alone.
By taking this small linguistic step we open up a space to analyse the social and cultural influences upon the profession and see it as part of a bigger historical process. Returning to Caroline Daley’s book, it is possible to draw a connection between the arrival of strongman Eugen Sandow in New Zealand in 1902-3 and the rise in popularity of the “physical culture” movement. (1) Physical culture, for its part, relates closely to our changing views of the body and how it should be used. Physiotherapy, as an agent of the state, has played a small, but significant part in this, and has benefited greatly from people’s desire to improve their bodies. Importantly, physiotherapy has always operated at the boundary between bodies at play and the rehabilitation of disabled bodies: between leisure and pleasure. Consequently there has always been a tension between physiotherapy practitioners and those offering massage for pleasure; between hydrotherapists and the spa industry; between remedial gymnasts and gym trainers.
Defining physiotherapy becomes a much more complex task when we challenge the idea that it is a “thing” with objective boundaries. But thinking of physiotherapy as a set of cultural and social practices opens up other problems too: not least the question of when we might agree that physiotherapy actually began. When we speak of physiotherapy practices from now on, do we mean the kind of practices that were born in New Zealand with the 1949 Physiotherapy Act? Or those that began with the formation of the Masseurs Registration Act in 1920 when the name “physiotherapist” was still a distant dream? Or maybe, we believe that the profession began formally with the organisation of the massage training school in Dunedin in 1913? Whichever we choose, we must accept that it will always be an arbitrary decision, since physiotherapy practices have existed for centuries across many cultures and societies. They have merely taken other names and other forms.
By David Nicholls
[1] The ‘physical culture’ movement was a response to the idea that the predominantly white, European peoples were committing “race suicide”. This idea was very popular in the early twentieth century amongst prominent eugenecists. In New Zealand, a form of this ideal lay behind the formation of the Sunlight League – an organisation committed to improving the health and vitality of the pakeha through outdoor exercise. A prominent founder of the Sunlight League was Cora Wilding, a noted early physiotherapist.
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