I’m speaking purely for myself here, but I feel that physiotherapy doesn’t really need any more quantitative research on hamstring stretching. I think we’ve seen enough evidence that pain is aversive, and that putting scores on complex conditions critically misrepresents the condition, the person’s lived experience, and the benefits of physiotherapy.
Where I feel we could definitely do with more research – particularly these days, where we are increasingly looking for ideas about how physiotherapy might need to change in the future – is research about our past.
Not just accounts of past events, although even some of this would be nice, but historical works that connect to messages about the future: why we did what we did then; what has that made possible and what has it denied; and what can it tell us about how we should change?
We need more work by people like Sarah Nettleton, whose critical analysis of dentistry was groundbreaking, or David Armstrong who took a scalpel to medicine (Armstrong, 1983; Nettleton, 1992).
Critical historians like this are few and far between in physiotherapy, but one champion of this discipline is Anders Ottosson.
Ottosson’s work on the origins of physiotherapy in the 19th century is quite exceptional. Amongst other things, he has shown that Swedish gymnastics played a major role in developing kinesiology today (Ottosson, 2010), and became the basis for medical, osteopathic, chiropractic and physiotherapeutic practices of manipulation (Ottosson, 2011). His latest work has looked at Gustaf Zander, the founder of the kinds of exercise machinery that we see in gymnasiums around the world (Hansson & Ottosson, 2015).He has work under review looking at androphobia, demasculinization, and professional conflicts in physiotherapy; scientific gynaecological masseurs; and gym-machines and the migration of medical knowledge.
In all cases, the questions posed about the history of physical therapies are directed to a better understanding of the present, and they follow a growing trend in research to explore the histories of health professional practice.
There are now well established academic chairs of the history of medicine and nursing, and major publications compiling historical works in the histories of professions not unlike physiotherapy (see, for example, D’Antonio et al, 2013; Sitzman & Davis, 2010), but so far nothing in physiotherapy itself.
It is said that ‘history is a vast early warning system’ and if this is the case, it would be neglectful of today’s physiotherapists if they failed to pay attention to the lessons of the past and left future physiotherapists with a profession that had concentrated too much on its hamstrings on not enough on its history.
Armstrong, D. (1983). Political anatomy of the body: Medical knowledge in britain in the twentieth century. Cambridge: Cambridge University Press.
D’Antonio, P., Fairman, J. A. & Whelan, J. C. (2013). Routledge handbook of the history of nursing. Hoboken: Taylor and Francis.
Hansson, N., & Ottosson, A. (2015). Nobel prize for physical therapy? Rise, fall, and revival of medico-mechanical institutes. Physical Therapy. doi:10.2522/ptj.20140284Judd, D. M., Sitzman, K., & Davis, M. (2010). A history of american nursing : Trends and eras. Sudbury, Mass.: Jones and Bartlett Publishers.
Nettleton, S. (1992). Power, pain and dentistry. Buckingham: Open University Press.
Ottosson, A. (2010). The first historical movements of kinesiology: Scientification in the borderline between physical culture and medicine around 1850. Int J Hist Sport, 27(11), 1892-1919. doi:10.1080/09523367.2010.491618
Ottosson, A. (2011). The manipulated history of manipulations of spines and joints? Rethinking orthopaedic medicine through the 19th century discourse of european mechanical medicine. Medicine Studies, 3(2), 83-116. doi:10.1007/s12376-011-0067-3