The idea that most grabbed people’s attention during last week’s 1st critical physiotherapy course was slow physiotherapy (you can listen back to the full talk here).
Slow physiotherapy – like the slow food and slow TV movements – would be a reaction to the hyperkinetic life that we’re now all leading. But more than that, it would force us to focus more on exactly how pervasive questions of time and speed are in physiotherapy today.
Paul Virilio – the philosopher we looked at last week – coined the term dromology to refer to the study of speed and time and, especially, how speeded up our lives increasingly feel.
Virilio was concerned with the way technology had collapsed the time it takes from go from here to there, or the lag between sent and received. Once it took a week to send a letter to someone, now it takes nanoseconds. Once we had to travel halfway around the globe to hear the latest professional updates, now it’s all available at the click of a button.
Physiotherapy is particularly vulnerable to this kind of speeding up because so much of the work we do is underpinned by speed and time.
The time it takes people to do things is one of the backbones of our clinical assessments, but our focus on speed is also inherent in the way we understand bodies. Synapses, tissue repair, and functional activity are all underpinned by concepts of time and speed.
Even our understanding of what it means to be disabled is governed by time and speed. The speed it takes someone to do something is one of the main ways we distinguish the able-bodied from those needing therapy and rehabilitation.
When Virilio talks about the world speeding up, he’s reminding us that technology comes at a cost. Not so long ago people convalesced for weeks in community hospitals after having a cholecystectomy, a hip replacement or a lengthy labour. Now your in-patient stay is measured in hours rather than days, and your bed is barely warm before you are being shipped home to continue your rehab on your own.
Physiotherapists used to cherish the time they spent with their patients and gave them treatments like massage as a way to make a connection. These things took time to set up and care to implement, but they were once one of the defining features of their profession. Now therapists trumpet the values of efficiency, exercise, and activity, and seem to be happiest when everyone is in a state of restless, twitchy agitation.
A slow physiotherapy move would reject all of this and call for an approach to practice that values the slow pleasures of an enduring recovery, and the mindful connection between the therapist and their client/patient. It would oppose the 15-minute appointment and the ‘disco physiotherapy’ of the past that saw four, five and even six patients being treated at the same time, with the primary purpose being to maximise the profits for the clinician.
Slow physiotherapy would be an antidote to the anxious hypervigilence of 21st century healthcare and make us all consider different ways to assess and treat people – ways that don’t reinforce the incremental speeding up of our lives and the exponential collapsing of time.
If it works for slow food and slow TV, why not slow physiotherapy?