Narrowing the physiotherapy knowledge-practice gap: faculty training beyond the health sciences

Distress in the care of people with chronic low back pain: insights from an ethnographic study

“…Physiotherapy’s traditional emphasis on physical and biomedical aspects of care situates the body-as-machine ( Nicholls and Gibson, 2010 ), which can constrain physiotherapists’ ability to navigate emotions and distress within clinical encounters. Historically, physiotherapy’s focus on function and dysfunction within the mechanical body was useful to differentiate it from other health disciplines and give it legitimacy and place within the healthcare industry ( Nicholls and Gibson, 2010 ; Schwab et al, 2023 ). Originally a profession dominated by women, physiotherapy first emerged as a therapeutic massage practice and later rose to prominence as a unified profession during the First World War as part of rehabilitation efforts for war veterans ( Linker, 2005 ).…”

“…Originally a profession dominated by women, physiotherapy first emerged as a therapeutic massage practice and later rose to prominence as a unified profession during the First World War as part of rehabilitation efforts for war veterans ( Linker, 2005 ). Early approaches contributed to a decontextualisation of the body, reducing it to its mechanical functions: something to be “fixed” ( Gibson et al, 2018 ; Schwab et al, 2023 ). Many aspects of these historical practices continue to define physiotherapy today, and this approach leaves little space for the consideration of distress.…”

“…Lack of philosophical/theoretical clarity and failure to consider other elements, such as power, have been suggested as possible reasons for the limited success of the biopsychosocial model in clinical practice ( Mescouto et al, 2023 ). This is also reinforced by contemporary physiotherapy education and training, where competency in procedural knowledge is considered an essential skill, while critical reflexivity ( Schwab et al, 2023 ) and attention to complexity are not.…”