Sport as rehabilitation

New approaches to physiotherapy

What made the spinal injuries unit at Stoke Mandeville truly distinctive was the introduction by Guttmann of sport as a means of rehabilitation. Dot Tussler, one of the longest serving physiotherapists at Stoke describes it thus. "Sport was used as an integral component to the rehabilitation programme and provided the means to develop strength, balance and coordination for newly injured patients. The added benefit of socialising and competition through the medium of sport was an opportunity for both staff and patients to learn and develop new skills. The presence of a weekly sports club in the spinal centre attended by both staff and patients enhanced the interaction and use of sport and confidence building."

Photo:Stoke Mandeville pool, 1956

Stoke Mandeville pool, 1956

photo NSIC

"Guttmann knew that exercise could be boring, but that archery, for example, would make maximum use of upper body muscles; so the patients would do archery. All patients were encouraged to learn to swim – and most of them enjoyed feeling less disabled because of their weightlessness in water. The pool was built by 1954. It became a very programmed approach to exercise. Patients were expected to get up and dress themselves and then do archery, swimming, table tennis  physio and occupational therapy  during the day. It had a lot to recommend it; it encouraged discipline and self-belief and competitiveness." Brom, physio

"The sports movement was hugely important to Guttmann; he knew that sport can make an amazing difference to the life of a person with a spinal cord injury. It aids rehabilitation. It decreases the need for long term healthcare and medical treatment because of the healthy lifestyle. It restores independence enabling people to undertake everyday tasks more easily including dressing, transferring in and out of their wheelchairs to the car, bath and bed. Finally, it motivates disabled people by giving them new goals and increases confidence and self belief." John Silver, Doctor

Photo: Illustrative image for the 'Sport as rehabilitation' page

Photo:Original Christmas card, Joan Newton

Original Christmas card, Joan Newton






Not exactly seasonal, but the fact that this summer archery scene was used for the hospital Christmas card in 1948 does suggest the importance that was being given to sport.


"They got in wheelchairs, and they had shortened sticks, and a disk for the puck, and they went up and down an empty ward hitting this puck. It was played against the physiotherapists, and later against the local football clubs." After some players received minor injuries in the fierce competition, polo was replaced by basketball, just as furious a sport but with less risk of damage." Joan, administrator

Photo: Illustrative image for the 'Sport as rehabilitation' page

photo NSIC

Spectator Sports

Photo: Illustrative image for the 'Sport as rehabilitation' page

photo Joan Newton

"The man using binoculars was a patient watching one of the wheelchair games in the late 1940s. You can see other spectators in their chairs in the background. But he has been brought out in his bed to watch because for some reason he couldn’t yet use a wheelchair; possibly he was still recovering from pressure sores, so we wouldn’t have been able to take him of his packs." Joan, nurse


Photo:Stoke Mandeville bowling green, 1966,

Stoke Mandeville bowling green, 1966,

photo Margaret Maughan

"Back then we would spend all our time with other sports people and you would all support each other. It was smaller scale and everything was taking place around the same arena so you would go and support all your other team mates. And back in the clubs you all did a variety of sports and met people who did a range of other sports. Now everything is split up by sport, by association or club and everyone meets separately so you don’t meet anyone outside your specialism. Of course the standards have improved by leaps and bounds – but at the loss of a certain camaraderie that we had back then." Margaret, patient

Photo: Illustrative image for the 'Sport as rehabilitation' page

photo Wheelpower

"I remember when I had first learnt how to do archery and was feeling really pleased because I had just taught myself how to use a bow right-handed. Guttmann came up and said, “Now, you ‘vill do it ‘ze other way.” He wanted to make me use the bow left-handed, the hard way, because he knew that would make me use more of my upper body muscles. He was always watching each patient individually like that.” Sally, patient


"I was so tied and strapped up that I couldn’t find a way to hold the arrow!"

"After three months at Stoke I felt at home.  I had learnt to wash myself and shave and I was pushing myself around in a wheelchair having learnt how to put my thumbs into the spokes; and then there was the sport. It was really strange in this wheelchair world, meeting all the others, seeing the paraplegics flying around the wards at great speed in their chairs. As a quadriplegic they started me out on archery. They had to tie my body to the back rest of the chair to support it; then they strapped the bow to the left hand; then they strapped a hook to my right hand; at the end of it I was so tied and strapped up that I couldn’t find a way to hold the arrow! So I tried table tennis instead and I learnt how to spin the ball and that became my world." Rainer, patient


"In those days the relationship between the hospital and the stadium was close and symbiotic in comparison to the more separate and independent organisations they are today. The sports department in the hospital was run by Harry Metcalfe, a very enthusiastic remedial gymnast. He made every physiotherapist aware of the events that were occurring at the stadium. In those days Stoke Mandeville hosted, 3 years out of 4, the International Stoke Mandeville Games, there was the annual National Games and various other events that also took place. During the 2 weeks of the International Games limited annual leave was available to the physiotherapists due to the need for them to assist at the event.  I can still recall the instructions for what to wear for the Archery tournament and the correct procedure for marking, scoring and removing arrows from the targets... On the stadium car park there would be all these cubicles for the international visitor: banks, telephone booths, taxis, coaches, cafes, souvenirs etc.,. I can vividly remember thinking ‘Why do I need to travel around the world, when the world is actually travelling around me?’" Dot, physiotherapist

Photo:Physiotherapist and patients with medicine balls.

Physiotherapist and patients with medicine balls.

photo Wheelpower

Dot Tussler

Dot Tussler started at Stoke Mandeville in 1982 and is now one of the longest-serving physiotherapists working at the hospital. Read the full interview with Dot below.

This page was added on 23/03/2011.

If you're already a registered user of this site, please login using the form on the left-hand side of this page.