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Dr. Guttman and the Paralympic movement

queenslanders_in_the_australian_team_for_the_1984_summer_paralympics_in_stoke_mandeville

Sir Ludwig Guttman – the ‘father of the Paralympics’ – is credited as the man responsible for founding the Paralympic Games and the Paralympic movement as a whole.

Early years

Born on 3 July 1899 in Tost, Germany (now Toszek in Poland) into an Orthodox Jewish family, Guttmann started studying medicine at the University of Breslau in 1918 after being turned down for military service on medical grounds. He took his MD degree in 1924 and then worked with Europe’s leading neurologist Professor Otfrid Foerster until 1928, when he was invited to start a neurosurgical unit in Hamburg.

After a year, Guttmann returned to Breslau when Foerster asked him to return as his first assistant. He remained there until 1933 when the Nazis forced all Jews to leave Aryan hospitals. As one of the leading pre-war neurologists in Germany, Guttmann became neurologist to the Jewish hospital in Breslau before being elected Medical Director of the hospital in 1937. 

In 1938 Guttmann defied the radical laws specifying that Jewish doctors could only treat Jewish patients and gave orders that any male person entering the hospital should be treated. His career would no doubt have suffered as a result but thanks to his growing international reputation, he had a number of offers to work outside of Germany. Together with his wife, Else, and two young children, the Guttmanns fled Germany and, desite speaking no English, headed for England, at first settling in Oxford. Guttmann busied himself with various research projects and for a while worked at Radcliffe Infirmary and St Hugh’s College Military Hospital for Head Injuries. 

By the early 1940s, as war progressed, the Government were preparing themselves for an influx of paralysed servicemen and decided to open a special spinal ward to cater for casualties. In 1943 Guttmann was asked to become Director of the new unit, the National Spinal Injury Centre at the Emergency Medical Services Hospital at Stoke Mandeville, Buckinghamshire. He accepted the post on the condition that he was free to implement his own theories on how best to treat patients, with no interference. 

The National Spinal Injury Centre

The new Spinal Unit was opened in early 1944 with Dr Guttmann at the helm. It had fewer than 30 beds and, initially, was very poorly resourced. However, the medical need was clear – within six months the unit had almost 50 patients.

At the time, treatment for paraplegics in England was still rudimentary and Guttmann was dismayed by what he found. Care for patients was merely palliative and most prognoses were terminal. More often than not the injuries themselves were not life-threatening, it was other complications such as bed sore and urinary tract infections which posed the biggest dangers. Morale amongst staff was rock bottom.

Guttmann singlemindedly set about transforming the treatment and making the Stoke Mandeville spinal unit a success, throwing out the fatalistic care regime, challenging negative staff and insisting that patients fight back. He began by copying a regime that a Dr. Munro had introduced in the US in the 1930s, which was to regularly move patients to avoid the build up of pressure sores and infections developing. Then, crucially, he introduced the idea of rehabilitation and physiotherapy as medical treatment. 

Rehabilitation

Guttman was a great believer in the power of sport to change lives, seeing it as an integral method of therapy for those with a physical disability to help them build physical strength and self-respect. Patients at Stoke Mandeville were engaged in physical and skills-based activities to keep them active – and social. Woodworking, typing, clock and watch repairing workshops were set up in the hospital and sports such as archery, which improved mental well-being as physical strength, were introduced. The first sport promoted by Guttmann as rehabilitation was a hybrid form of wheelchair polo and hockey which was initially played informally on the wards against physiotherapists before evolving into a proper team game. A decade later and sport was completely integrated into the hospital routine, both for its therapeutic and rehabilitative value and as a way of encouraging competition among patients.

The birth of the Paralympic movement

Although sport for athletes with an impairment has existed for well over 100 years (the first sport clubs for the deaf were already in existence in Berlin in 1888) and the earliest recorded wheelchair games in the UK took places as part of a ‘Gymkhana’ for staff and patients at the Royal Star and Garter home in Richmond, Surrey in 1923, it was at Stoke Mandeville that the first established wheelchair games began.

On 29 July 1948, coinciding with the opening ceremony of the London Olympic Games, Guttman organised an archery contest for World War II veteran patients with spinal cord injuries - the ‘1948 Wheelchair Games’. 16 patients (14 men and two women) from Stoke Mandeville and the Star and Garter Home for Injured War Veterans in Surrey (where a special paraplegic ward had been set up in conjunction with Dr. Guttman) competed against one another for a Challenge Shield. The Star and Garter Home won and were presented with the cup, marking the first recorded competition between disabled athletes and the moment that the Paralympic movement was born.

The Stoke Mandeville Games go international

Following the success pf the first event Guttman decided to make it an annual spectacle, and it soon became known as the ‘Stoke Mandeville Games’. More teams and more sports were added to successive games – in 1949 six teams competed and ‘wheelchair netball’ (later wheelchair basketball) was introduced. Over the years, as word spread about the games around different spinal hospitals in the country, more participants took part and the number of sports on offer increased.

The first international competition at Stoke Mandeville occurred in the summer of 1952 when a small team from the Military Rehabilitation Centre at Aardenburg in the Netherlands competed against a number of British teams. In 1953 a team arrived from Canada, by 1954 there were Australians, Finns, Egyptians and Israeli teams competing. By 1956 there were 18 different nations participating; a forerunner to today’s Paralympic Games. This was also the year that the Stoke Mandeville Games were presented with the Fearnley Cup by the International Olympic Committee (IOC) for outstanding contribution to the Olympic ideal.

The 1957 Games was the first where all continents were represented and in 1958 the competition for the British team was such that a national Games had to be held prior to the main International event in order to select the team.

The 1955 International Stoke Mandeville Games

Becoming the Paralympic Games

By 1960 the possibility of holding the games outside of Britain for the first time, and somewhere other than Stoke Mandeville, was discussed. As the Olympics were being held in Rome that year, Guttman saw no reason why the International Stoke Mandeville Games could not be held their either. Now considered the first ‘Paralympic Games’, although still called the International Stoke Mandeville Games, they were held for the first time in the Olympics venue immediately after the Olympic Games. The XVII Olympic Games ended in Rome on 11 September 1960 and just one week later 400 athletes representing 23 nations assembled for the first overseas International Stoke Mandeville Games. In Rome, athletes shared the same accommodation and venues as their Olympic counterparts. A precedent had been set.

From 1960 it was the intention that the annual International Stoke Mandeville Games would continue to take place at Stoke Mandeville, except in the Olympic year when the Games would take place in the Olympic host city or country, although this was not always the case. The Japanese were keen to host the Stoke Mandeville Games following the 1964 Tokyo Olympic Games but this experience this experience was not repeated in the 1968 Mexico Olympics, when financial constraints and accessibility issues prevented then taking place. Instead Tel Aviv stepped in to host them. The 1972 Wheelchair Games were held at Heidelberg, near to the 1972 Olympic host, Munich and in 1976 Montreal hosted the Olympics and Toronto the Paralympics. However in 1980, the Olympics host, Moscow, refused to host the Paralympics and instead they took place in Arnhem in the Netherlands. In 1984 disagreements and financial issues meant that the venue fell through, so although Los Angeles was the Olympic host city, Stoke Mandeville had to step in to host a separate Games.

Initially Guttman was adamant that the Stoke Mandeville Games would only be open to those with spinal cord injuries, but this changed in 1976 with the addition of two new classes; athletes with a visual impairment and athletes who were amputees. This has since been broadened further. This year also saw the introduction of specialised racing wheelchairs. The 1976 Toronto games were the first to use the title ‘Olympiad for the Physically Disabled’ when the International Stoke Mandeville Games Foundation (ISMGF) and the International Sports Organisation for the Disabled (ISOD) combined to create a single event. 1976 also saw the first Winter Paralympic Games in Sweden. Despite these improvements, the Games were still not always considered an equal or ‘parallel’ to the Olympic Games. 

The 1980s – a pivotal decade

The 1980s saw a rapid growth in the Paralympic Movement. Relations between the ISMGF and the IOC became more friendly and led to more collaboration. The 1988 the first games officially titled the ‘Paralympic Games’ took place shortly after the end of the Summer Olympics in Seoul, Korea. The link between the Olympic Games and the Paralympic Games was firmly established in 1989 by the foundation of the International Paralympic Committee (IPC), the global non-profit governing body, and since the 1988 Summer Games of Seoul and the 1992 Winter Games in Albertville, France the Paralympic Games have been twinned with their Olympic counterparts and taken place in the same cities and venues as the Olympic Games.

The word ‘Paralympic’ derives from the Greek preposition ‘para’ (belong or alongside) and the word ‘Olympic’. It means that the Paralympics are the parallel Games to the Olympics and illustrates how the two movements exist side-by-side. 

The number of sports within the Paralympic programme and the number of athletes competing continues to grow. After a struggle to receive recognition as the true equal of the Olympic Games, the Paralympics now exist alongside and continue to push boundaries. From humble beginnings in Stoke Mandeville, the Paralympic Movement is a growing sporting phenomenon and a lasting legacy of Sir Ludwig Guttman which shows no signs of slowing down.

Dr. Guttman’s legacy

Not only the ‘father of the Paralympic movement’, but also an important figure in the development of treatment of spinal injuries, Dr. Guttman became President of the ISMGF and also founded the British Sports Association for the Disabled in 1961. In the same year he also became inaugural President of the International Medical Society of Paralegia (now known as the International Spinal Cord Society) and was editor of the society’s journal.

Guttman received the OBE and CBE from the Queen and was knighted when he retired in 1966. He continued to travel and lecture all over the world on spinal injuries and it was he who spear-headed conversations with the IOC over the use of the term ‘Olympic’. Sir Lugwig Guttman died on 18 March 1980 of heart failure following an earlier heart attack. Although he did not live to see his work realised his work continues through the National Spinal Injuries Centre at Stoke Mandeville and through the Paralympics. His advancements in the treatment of spinal injuries revolutionised the field and his work continues to influence physicians the world over. 

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