Physiotherapy at the intersection between standardization and individual adaptation

Abstract

Drawing on the phenomenological tradition, contemporary physiotherapy practice may be understood as an embodied experience; one that requires standardized approaches to evidence-based examination, treatment, and evaluation while simultaneously requiring adaptation of each of these elements of practice to individual patients. Drawing on material from a study of encounters between physiotherapists and patients, this chapter addresses how the work of reconciling the needs for standardization and adaptation is accomplished in physiotherapy practice. The research approach and analysis of the material draws on a number of scholars in the phenomenological tradition, beginning with Maurice Merleau-Ponty. The study illuminated the ways in which both explicit and tacit forms of knowing are brought together in the physiotherapy encounter. Physiotherapists use explicit knowledge primarily as a framework for thinking about assessment and intervention; however, it is the inter-subjective, communicative practice of being-with-another from which the therapeutic encounter draws its power. It is this being-withanother that enables the physiotherapist to adapt abstract, explicit knowledge for the individual with whom they co-construct physiotherapy care. The study revealed how the knowledge put into play in physiotherapy depends on the sensitivity and reflective embodied knowledge of the physiotherapist, and their bodily style and developed professional skills. This is the bodily style that in some way transforms the therapist’s relation to the world, and especially to various and creative ways of knowledge translation at different moments in the process of practicing physiotherapy.