Physiotherapy:
the backstory

Which is why Emeritus Professor Gwen Jull AO FACP (Diploma of Physiotherapy ’68, Master of Physiotherapy ’85, Doctor of Philosophy ’01) and fellow ex-UQ physiotherapy lecturers Elaine Unkles OAM (Bachelor of Physiotherapy ’65, Bachelor of Educational Studies ’75) and Prue Galley (Bachelor of Physiotherapy (Honours) ’65, Master of Educational Studies ’78) made it their mission in retirement to address the lack of knowledge about the history of their profession.

Thanks to funding from Alumni Friends through its Physiotherapy Special Interest Group account – and a lot of dedicated research – they have almost achieved their goal, presenting a history of UQ's teaching of physiotherapy at the program’s 80th anniversary celebration in 2018, and currently developing a website to formally document this history.

“So, it was an unexpected outcome of our research that we also produced a 2-part Brief history of physiotherapy in Australia in mp4 and PowerPoint formats, which is now presented to students annually, whether as an introduction or refresher to the profession.”

A timeline of UQ Physiotherapy’s history, prepared by Dr Andrew Claus in 2009, is on permanent display in the Department via wall mural and digital kiosk.

Physiotherapy: the beginnings

Physiotherapists use physical means to treat those experiencing movement disorders or suffering pain; so, it’s no surprise that massage and other manipulative techniques, water, and heat have been used across the world for many millennia. Paintings of such techniques from 4700 BCE have been found in China, with later depictions seen in India, Japan, Egypt and Rome.

Fast forward several centuries, and 1813 saw Pehr Henrik Ling (1776–1839) pioneer the teaching of remedial exercise through his 3-year training program for Sjukgymnastik (sick exercise) at the Royal Central Institute of Gymnastics in Stockholm. By 1887, the program was recognised by the National Board of Health and Welfare as a viable health practice, and by 1906, this Swedish training program as well as an English one had spread to Australia.

Frederick Teepoo Hall (1859–1909), widely regarded as one of the most influential contributors to the profession with a successful practice providing exercise, massage, manipulation and electrotherapy, was among the first lecturers. Holding honorary positions in hospitals and sporting clubs, Teepoo Hall taught medical and dental students at the University of Melbourne and initiated the discussions to establish the Australasian Massage Association in 1906 (which later became the Australian Physiotherapy Association in 1939). He was ably supported by another early advocate for the healing power of touch, Miss Eliza McCauley.

Courses were established in other states soon afterwards, but it was not until the late 1920s – partly because of the need for physiotherapists during the polio epidemic – that moves were made to establish a formal training course in Queensland. This ultimately resulted in a 3-year Diploma of Physico-therapy being established and first led by orthopaedic surgeon Dr Harold Crawford at UQ in 1938, when 16 students enrolled in the country’s first university-based program.

Physiotherapy: the need

During the first half of the 20th century, 2 world wars and countless polio epidemics expanded the scope of conditions that physiotherapists treated, leading to the development of many new techniques for facilitating movement. With skills in muscle re-education and retraining for the activities of daily living, physiotherapists became well placed to provide rehabilitation services.

Both wars brought international experts together to provide treatment for soldiers with injuries rarely seen in peacetime, while the need to care for tens of thousands of children suffering from ‘infantile paralysis’ instigated physiotherapy clinics across the country.

Physiotherapists working closely with nursing and other staff to manage children in ‘iron lungs’ was a forerunner of today’s intensive care units.

Anticipating many spinal injuries during WW2, the British Government appointed Professor Sir Ludwig Guttmann to establish a spinal injuries unit in Stoke Mandeville Hospital in Buckinghamshire, further cementing the need for physiotherapy. Sport was seen as important for patient rehabilitation. Interestingly, the Stoke Mandeville Games for injured veterans that began in 1948 became the precursor to the first Paralympics, held in Rome 12 years later. 

The 1950s saw physiotherapists develop new treatments for neurological conditions, including Proprioceptive Neuromuscular Facilitation, Bobath and Rood techniques, which were then applied more widely.

During the 1960s, ’70s and ’80s, South Australia’s Geoff Maitland MBE (1925–2010) became one of the world’s leaders in physiotherapy, having developed a manual therapy treatment approach for back and neck pain and movement dysfunction based on a comprehensive examination.

Physiotherapy: the profession

From its inception in 1906, the profession comprised both men and women, but between the 1920s and 1980s, it became predominantly female with typically lower wages – despite the Physiotherapists Union of Employees being formed in 1947 – and the requirement until 1970 to resign upon marriage if working in a hospital. Gender balance began equalising in the 1980s, however, as did salaries.

In 1976, physiotherapists became first-contact practitioners after Prue Galley presented a paper at the Australian Physiotherapy Association Conference in 1975, which opened further opportunities for practice as the profession advanced its evidence base and leadership in the rehabilitation field. Many career paths are available in private practice, sport, hospitals, rehabilitation, academia and research. A clinical career path culminating in clinical specialisation is also awarded by the Australian College of Physiotherapists.

“The scope of practice is broad. We treat persons with musculoskeletal pain (e.g. neck and back pain, osteoarthritis etc.), sports injuries, neurological conditions (e.g. stroke, traumatic brain injury, Parkinson’s disease), cardiorespiratory disorders and incontinence.

“We treat all age groups, from newborns to the elderly.”

And it’s very rewarding.

“Yes, it has been a fascinating journey,” Prue Galley said.

Elaine Unkles agrees.

“I decided after I had physiotherapy, following a fractured arm when I was 7, that this was what I wanted to do and I have never regretted that decision,” she said.

“It gave me the opportunity to teach and practise but also to learn in 3 overseas countries.

Top 5 career tips

1. Love what you do and strive to help every person who consults you.
2. Be aware that patients are individuals whose conditions rarely – if ever – present as ‘typical’: every day will be different.
3. Enjoy problem-solving and implementing individualised care.
4. Never stop learning: explore the unexpected.
5. Explore the many career paths available in physiotherapy.