Physiopunk Vol 1: Physiotherapy 2.0: Necessity is the mother of innovation


Tobba T Sudmann, PT, PhD, Professor in Public Health, Western Norway University of Applied Sciences, Bergen, Norway.

The first part of the title paraphrases Web 2.0, which refers to websites that emphasize user-generated content, ease of use, participatory culture, and interoperability for end users. The eight physio sci-fi stories can be appreciated as fragments of Physiotherapy 2.0, where users are understood to be physiotherapists, co-workers, patients, citizens, or other stakeholders, who take initiative and responsibility for launching physiotherapy 2.0.

A commentary always entails a reception of the texts. My reception appropriates a reading in line with modern day reception theories, where texts are produced, distributed, read, interpretated, paraphrased, re-phrased and re-distributed in a multitude of ways on a multitude of platforms (Jensen, 2019). Furthermore, texts are always read, negotiated, and contested within a specific context, including the differences in knowledge, experience and interests the readers bring along. The eight stories prompted my curiosity and respect, and gratitude is due for the bravery exhibited by academic staff and students for making this possible. I refrain from commenting on each of the stories, but rather invite readers of my text to create their own reception of the eight stories, the accompanying paper from the staff (Maric et al.), and the four commentaries. 

The second part of the title is an idiom which captures the common denominator across the stories; there are pressing issues, needs and wants related to health in the future which call for innovative responses from physiotherapists of today and of tomorrow. Physiotherapists’ toolboxes are equipped to motivate and support our patients in building and using their change contingency. The tools most used are movement and interaction, to create bodily changes to be able to meet an unknown future. Through movement and interaction physiotherapists can affect the body from cell to society, i.e., facilitate micro plasticity, flexibility and changeability for movement and social participation – from cell to society. 

The sci-fi stories unanimously show that physiotherapy theory and practice most often stand as an individual approach to individual problems, which the student-authors find distressing. Their imagined future health needs re-route physiotherapy towards contextual and global issues, and an understanding of health as much more than a personal biological asset. Health problems are often produced at a societal and political level, e.g., the global unequal distribution of burdens (e.g., basics like clean water, enough food, and safe shelters), unequal access to health services. The sci-fi stories are more than real in their acknowledgement and anticipation of a need for a broader knowledgebase in physiotherapy, and a need for new approaches to health encounters and health measures at an individual, group and societal level.

From my point of view, a privileged vantage point in the Northern hemisphere, an answer to the student-authors calls, is to encourage physiotherapy practitioners, educators, and researchers to learn from inter alia occupational therapists, social workers, political scientists, and philosophers, who have engaged themselves in issues related to health justice and environmental activism. Occupational therapists, social workers, and human and veterinary doctors, increasingly engage themselves in collective action to better the lives of all things living, including the health of our planet. Social workers call for environmental justice (Dominelli, 2014), and occupational therapists call for occupational justice (Bailliard et al., 2020). Social injustice and inequality in health are two sides of the same coin, as is environmental awareness and human rights. Health justice increasingly engages a broad scholarship, not at least when it comes to acknowledge and act upon the understanding of how all things living are interdependent (Mackenbach, 2021; Venkatapuram, 2013). Tarazona et al. (2020) sums up the argument as “One health, one welfare, one biology”.

The physiotherapy profession has self-administered a restraint on societal engagement, and cherished “neutrality” as a euphemism for political ignorance. The students are champs at the bit – demonstrating their impatience for a physiotherapy 2.0 with a social conscience. 

Physiotherapy 2.0 will need a refurbished tool-box, and the Johari window might fit as a generic tool (Oliver & Duncan, 2019). The model is a simple matrix of familiar and unfamiliar knowledge; what is known to someone can be shared and translated by asking and listening, whereas the unknown can be explored together.

Familiar and unfamiliar knowledge. ©Copyright Oliver & Duncan 2019. Open Access article distributed under the terms of the Creative Commons Attribution Licence.

The collected stories are written by the students as individuals. I would love to see the ideas of future thinking, creativity and bravery unfold further, and would suggest that the University encouraged the students to work collectively, material, and practical with their future projects. Design thinking (Carlsen et al., 2012) and applied drama (Nicholson, 2005) might serve as inspiration, as do different well known approaches to Utopia (Nielsen & Nielsen, 2016) and future workshops (Jungk & Müllert, 1987). The Johari window can be used as part or parcel of future workshops (Alminde & Warming, 2020), were ideas, performances, and unbridled creativity and ingenuity can unfold. Playing with fiction is playing with the future, and in my view some activity and doing is mandatory for future physiotherapist. Doing something is what we do.

Tomorrows experts are probably not known to us to day, which necessitates an open attitude towards identification of available roles for physiotherapists (Pau & Hall, 2021) . Either way, future health challenges are in emergent need of social innovation and collective action for change (Moulaert, 2013). A first foot forward could be to turn our gazes and interventions from an anthropocentric towards an eco-centric approach to health and social challenges, as shown in Ramsay & Boddy’s model below (Ramsay & Boddy, 2017).

Environmental social work practice (Ramsay and Boddy, 2017:80.) Reprinted with permission from the rightsholders.

My last two cents are: “Think global, act local – Go Glocal!” (Sudmann & Breivik, 2018). Everyone can do something that make a small difference in someone else’s life or living conditions, not least present-day and future physiotherapists. 


Alminde, S., & Warming, H. (2020). Future workshops as a means to democratic, inclusive and empowering research with children, young people and others. Qualitative Research, 20(4), 432-448. doi:10.1177/1468794119863165

Bailliard, A. L., Dallman, A. R., Carroll, A., Lee, B. D., & Szendrey, S. (2020). Doing occupational justice: A central dimension of everyday occupational therapy practice. Canadian Journal of Occupational Therapy, 87(2), 144-152. doi:10.1177/0008417419898930

Carlsen, A., Clegg, S., & Gjersvik, R. (2012). Idea work: Lessons of the extraordinary in everyday creativity. Oslo: Cappelen Damm. 

Dominelli, L. (2014). Promoting environmental justice through green social work practice: A key challenge for practitioners and educators. International Social Work, 57(4): 338-345. doi:10.1177/0020872814524968

Jensen, K. B. (2019). The double hermeneutics of audience research. Television & New Media, 20(2): 142-154. doi:10.1177/1527476418811103

Jungk, R., & Müllert, N. (1987). Future Workshops: How to create desirable futures. London, UK: Institute for Social Inventions.

Mackenbach, J. P. (2021). Inter-species health equity. European Journal of Public Health, 31(2): 241-241. doi:10.1093/eurpub/ckaa224  

Moulaert, F. (2013). The international handbook on social innovation: Collective action, social learning and transdisciplinary research. Northampton, USA: Edward Elgar Publishing.

Nicholson, H. (2005). Applied drama. The gift of theatre. London, UK: Palgrave Macmillan.

Nielsen, B.S., & Nielsen, K.A. (2016). Critical Utopian Action Research: The Potentials of Action Research in the Democratisation of Society. In: Hansen, H.P., Nielsen, B.S., Sriskandarajah, N., & Gunnarson, E. (2016). Commons, Sustainability, Democratization: Action Research and the Basic Renewal of Society. London, UK: Routledge.

Oliver, S., & Duncan, S. (2019). Looking through the Johari window. Research for All, 3(1), 1-6. doi:10.18546/RFA.03.1.01

Pau, S.S.T., & Hall, A. (2021). New spaces for healthcare futures studies: Connecting existing theory to deeper participatory practice. Futures, 126: 102689. doi:10.1016/j.futures.2020.102689

Ramsay, S., & Boddy, J. (2017). Environmental social work: A concept analysis. The British Journal of Social Work, 47(1): 68-86. doi:10.1093/bjsw/bcw078

Sudmann, T. T., & Breivik, J.-K. (2018). Editorial: Special issue on community work and going glocal in Scandinavian Welfare States. Community Development Journal, 53(3): 407-423. doi:10.1093/cdj/bsy018

Tarazona, A. M., Ceballos, M. C., & Broom, D. M. (2020). Human relationships with domestic and other animals: one health, one welfare, one biology. Animals, 10(1), 43. doi:10.3390/ani10010043

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