Ministering angels

One of the most interesting new areas of research in the history of physiotherapy surrounds the work done by masseuses during World War I.

Some of the most studied artefacts from the time are the Bliss Series of postcards held at the Wellcome Library in London.  These postcards tell us some interesting things about the way early physiotherapists used pain and vigorous treatment as a way to manage the sexual politics of the time; differentiate themselves from the ‘angelic’ image of nursing, and prove to the authorities that young women were perfectly capable of practising ethically with young male patients.

This from The End of Physiotherapy:

“WWI brought massed ranks of young men and women into close physical contact for the first time, and there were enormous concerns about the sexual tension that this might create; particularly around the use of massage as a therapy.  The need to treat men created problems for the ISTM, which had built its reputation for legitimate massage by excluding men from training and treatment.  With the advent of war, the profession’s prosperity depended on the ability of its young women to demonstrate that they could work confidently and effectively on the bodies of young men.  Ana Cardon-Coyne, Beth Linker and Joan McMeeken argue that masseuses navigated this tension by causing pain and, perhaps for the first time in any orthodox health profession, establishing dominant gendered positions over men.

“Traditional accounts of physiotherapy in the First World War tend to offer a relatively superficial narrative of the worthiness and nobility of the effort and energy brought by masseuses, but they often fail to examine some of the critically important gendered tensions that played such an important part in shaping the profession’s identity.  World War I presented some new challenges, however, because few masseuses had any experience of massaging ‘tender stumps, buttocks, and groins [which] required sensitive arrangements, and could be embarrassing for both patient and therapist’  (Carden-Coyne 2014, p. 288).  There is no doubt that the masseuses were asked to perform treatments that were, at times, exquisitely painful.  Despite what some orthopaedic surgeons like James Mennell argued, the kind of work required to break down adhesions and contracted wounds, stimulate moribund muscles and rehabilitate bodies weakened by disuse was arduous and painful.  As Joan McMeeken explains, ‘Gymnastics caused exhaustion, pain and muscle soreness, and electrotherapy was a constant source of pain, with some suggesting that modalities like faradisation were used to ‘shock’ patients out of shell shock  (McMeeken 2015b, p. 65).

“Ana Carden-Coyne describes the ‘The rough, uncaring handling of patients at the hands of doctors, nurses, and physiotherapists’ as commonplace in the treatment of soldiers and recounts the way injured servicemen felt ‘brutalised in the hands of strong women’  (Carden-Coyne 2014, p. 286).  Carden-Coyne goes on to argue that ‘men’s fear of the masseuses was well documented’  (Carden-Coyne 2014, p. 286), and that ‘Patients often loathed the gymnasium where rehabilitation exercises were conducted…Indeed, some patients internalized and thus affirmed the medical and social perceptions of them as passive, weak, child-like and at women’s mercy’  (Carden-Coyne 2014, p. 287).  Beth Linker has suggested the same, arguing that ‘physiotherapists resembled drill sergeants more than bedside nurturers’  (Linker 2005, p. 330).” (Nicholls 2017, pp.96-7).

Further reading

Carden-Coyne, A. (2014). The politics of wounds: Military patients and medical power in the first world war. New York: Oxford University Press.

Linker, B. (2011). War’s Waste: Rehabilitation in world war I America. Chicago: University of Chicago Press.

Nicholls, D. A. (2017). The end of physiotherapy. London: Routledge.

Posted by Dave Nicholls

Dr. Nicholls is an Associate Professor in the School of Public Health and Psychosocial Studies, AUT University, Auckland, New Zealand. He is a physiotherapist, lecturer, researcher and writer, with a passion for critical thinking in and around the physical therapies. David is the founder of the Critical Physiotherapy Network, an organisation that promotes the use of cultural studies, education, history, philosophy, sociology, and a range of other disciplines in the study of the profession’s past, present and future. David’s own research work focuses on the critical history of physiotherapy and considers how physiotherapy might need to adapt to the changing economy of health care in the 21st century. He has published 35 peer-reviewed articles and 17 book chapters, many as first author. He is also very active on social media, writing more than 500 blogposts for in the last three years. David has taught in physiotherapy programmes in the UK and New Zealand for over 25 years and has presented his work all around the world. The End of Physiotherapy – the first book-length critical history of physiotherapy, and written by David – was published by Routledge in mid-2017.

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