89 Physical therapies in common

Perhaps the most radical idea put forward in this book is for physiotherapists to relinquish their claim to the physical therapies, and actively work to ‘return’ them to ‘the commons’. I will explain what I mean by the commons shortly, but I should first say that if we accept that physiotherapy is now only one, and an increasingly de-centred, way for people to engage in the physical therapies, then any claim to be ‘returning’ them to the people are already spurious. Physiotherapy never really owned them in the first place. No profession could ‘own’ therapies that have been used by civilisations since the dawn of humanity. But, as Sarah Nettleton has pointed out, ‘the development of biomedicine and the associated hegemony of the medical profession’, caused a significant decline in healing systems and therapies that had been marked by much more diversity and permissiveness prior to the 19th century ^[1]. And physiotherapy has been a notable beneficiary of this, as it enclosed some of the most stable and marketable forms of physical therapy and claimed them as its own.

The idea of ‘enclosure’ is a powerful metaphor here. Prior to the Industrial Revolution in Europe and North America, large areas of land were open, allowing people to move freely, graze herds, grow crops, and store supplies. These commons began to be lost in a series of enclosure acts that began in the early 1600s, eventually putting nearly seven million acres of land in the UK alone, into the hands of private interests. As well as fuelling early capitalist market economies and changing rural landscapes, the theft of the commons also disturbed customs and traditions that had defined the social order since the Magna Carta and the Charter of the Forest;

‘Standing for the traditional practices of commoning which included mutual aid, neighbourliness, and mixed economic welfare, the Charter of the Forest was quietly forgotten with the rise of capitalism and the proletarianization of the common people, the enclosures movement, the renewal of slavery, and the rise of the Atlantic colonies. Under the yoke of the new economic principle of commodification and privatization, the common people were demonized (women gathering in the forest became witches) and criminalized (men taking from the land became thieves and pirates) ^[2].

The commons, then, refer to anything that belongs ‘neither to the human law nor to the divine’ ^[3], and today includes, ‘land, water, air, digital commons; our acquired entitlements (e.g., social security pensions)’, as well as ‘languages, libraries, and the collective products of past cultures’ ^[4].

‘Community gardens, food sharing, forms of credit, shared spaces/transition towns, coastal marine commons, community forests/open spaces, seed saving/sharing, commons-based peer production, Creative Commons, free software, innovation commons, peer-to-peer music sharing, shared grid electricity commons ^[5].

Indeed, consider anything that you would not want taken from you, only to be sold back to you for someone else’s private gain, and anything that you would not want the state to regulate, including your freedom of movement, your cultural heritage and genetic legacy, your dignity and ethical principles, your education and ideas, beaches, forests and streets, your sport and leisure, your ability to make your own everyday arrangements and to help the people closest to you, and you have a sense of why the idea of the commons has been ‘one of the most important focuses in social theory within the last decade’ ^[6].

This shift has happened, in large part, because of our sense that the manifold challenges of the future, now demand new (old) thinking ^[7]. People have become increasingly aware of the costs of replacing mutual co-dependence and solidarity with competition, autonomy, and human exceptionalism, and how much these costs fold directly into our health and wellbeing.