Physiotherapy : The Child of Massage Therapy

In 1939 the Australian Massage Association was re-named the Australian Physiotherapy Association. There were many reasons for this name change in the context of Australian health care; distasteful connotations associated with the name ‘massage’ and the fact that the teaching of massage therapy had already been part of the University system for over thirty years in Australia and they wanted to rebrand the profession.

The real heroine for both massage and physiotherapy in Australia was Eliza McCauley, a doctor’s daughter who took an anatomy course at Melbourne University in 1890 after being convinced that massage had therapeutic benefits. Her work came close on the heels of Per Henrik Ling, the father of Western massage and the inventor of swedish massage.

The discipline of physiotherapy, up to the 1960’s was never very far away from the techniques of massage. The skills that the Universities identified as essential to applying physiotherapy to patients in Australia had been gradually drawn away from honouring the human somatosensory system and linked to strict biomechanical, reductionist medicine.

But paradigms can get blurred. This millennium has seen a quantum shift in health care. The road to wellness in the West now has many vehicles on the healing highway and I have seen several paths in Australia, Asia and in my many workshops overseas. This article outlines how physiotherapists are revisiting and relearning the techniques that the great Eliza McCauley advocated so long ago. It seems to me that the therapeutic model used by early physiotherapists is now of some interest to the modern practitioner.

My workshops around New Zealand, Austria and Norway over the past two years have attracted many physiotherapists who have been eager to learn a range of new techniques such as manual vibration and remedial techniques using thermal stones to complement their physiotherapy practices. They are not new techniques but many have been lost to the physiotherapeutic field due to machinery replacing skilled human touch. Perhaps my four years or study, research and dissection at UNSW on the Iliopsoas made me of special interest to them but it is rewarding to share insights between two therapeutic disciplines that share the same mother. There are a few lessons to be learnt from these workshop encounters;

• Physiotherapists have gone much further into scientific proof through robust research for their belief in ‘what works.’ Their therapeutic truth is built on a well-worn process of assessment, treatment and outcome based, biomechanical results, but they are finding that a number of their patients are dissatisfied.
• Patients who are in pain need to be touched. Distress is symptomatic of pain and a biomechanical approach to healing does not honour the somatosensory path to healing. Massage therapists and others who employ educated touch know that the style of touch that does not elicit pain is a powerful way to facilitate healing. Sometimes I think that European physios are more receptive to this idea as they still do use palpation to a greater extent than Australian counterparts. Palpatory literacy is a skill that excites both physiotherapists and massage therapists and presentation of our skills through educated palpation combined with sound, anatomical knowledge is the language of engagement between our two professions.
• The massage therapist who has limited anatomical knowledge relies way too heavily on metaphysics to successfully explain what they do; this language is foreign to the physiotherapist. In response, the physiotherapist who considers machinery or deep, painful palpation as ways to heal are relying mostly on placebo for success; brutality and touch are opposite healing forces for the massage therapist.

The lessons learnt across the globe while teaching physiotherapists, sometimes in the University setting, indicates to me that a profession never strays too far from their mother for too long. Eliza McCauley passion for massage therapy initiated the profession of physiotherapy in Australia and her therapeutic soul still exists in every physiotherapist. Care is common between us.

There is a role, a very strong role for palpatory literacy in therapeutic practice, whether it be physiotherapy or massage therapy. A massage therapist will gain respect from physiotherapists if they are able to communicate intelligently with them in their own language; functional anatomy. A physiotherapist envies the skills, art and freedom a massage therapists has in their experienced hands. A well know physiotherapist, my client for several years, once said to me, ‘I want your hands!’ I replied to her, ‘I want your (anatomical) knowledge.’ When I am at UNSW, in the dissection room I sometimes wonder if she ever completed a massage course to learn what Eliza knew.

Greg Morling M.Ed. DRM, Wat Bo practitioner, Dip QA
Greg has been a massage therapist for over 28 years. He has been Head of Massage for ATMS and President of the AAMT.
He is a world expert on the Iliopsoas and lectures mainly in Europe to to a broad range of therapists.
His Web page is www.academyoftactileresearch
Contact him at: [email protected]