Introduction

Physical therapy is a health care specialty focused on restoring, maintaining, and improving movement and strength in order to improve quality of life. In the present day, it is a well recognized and respected aspect of the healthcare field; many thanks to Mary McMillan during World War I. World War I (1914-1918) served as a turning point in modern medicine, specifically in rehabilitation services. Physical therapy emerged out of this time of crisis, of not only the war, but the influenza pandemic of 1918. The US military began recruiting and training “reconstruction aides”, the earliest physical therapists with goals of rehabilitating soldiers. The most notable of these was Mary McMillan, who served as a pioneer in the field of physical therapy, eventually earning herself the title of the  “Mother of Physical Therapy”.  Despite her role, she is often overlooked in the field, almost serving as a missing voice, overshadowed by her male counterparts in the field. This chapter explores how World War I catalyzed the professionalization of physical therapy, the role the missing voice of Mary McMillan played in shaping the field, and how it connects to the study of STS.

Connection to STS

STS is the study of science, technology, and society and how they relate to each other. STS combines the three disciplines into one, focusing on how each discipline influences the others. It uncovers how science and technology may work together or differ, in order to help society to evolve, and how in turn society drives the evolution of science and technology. In relation to physical therapy and its evolution during WWI, the societal need for recovery due to injury from the war led to the development of a new scientific field, physical therapy. From the development of physical therapy, society benefits as people were able to better recover from injury, surgery, or other medical conditions. This also drove the invention of new technology such as blood flow restriction (BFR), laser therapy machines, ice machines, and so many others that assist in recovery. As technology develops, physical therapy becomes more effective, and society is benefited, as each aspect grows, the others grow as well, demonstrating the connection between physical therapy and the study of STS. A focus of STS is highlighting missing voices, those who were overlooked or forgotten in the history books. In this chapter these missing voices are those of the reconstruction aides who were mostly women and the “Mother of Physical Therapy”, Mary McMillan.

Topic Information

WWI’s Influence on Physical Therapy

Before WWI broke out in the United States, orthopedic surgeons were training physical education graduates in their offices, all of their schools had taught them massage and corrective exercises, some later specialized in these areas. Once the war broke out, surgeons realized that surgery was not enough to mend the injured limbs of thousands of soldiers, hence the importance of physical therapy became clear. In the US, 800 women, typically the physical education graduates or nurses, volunteered to become reconstruction aides in WWI and 275 of them joined the American Women’s Physical Therapeutic Association (D.A. Nicholls, 2021). They were trained as reconstruction aides, many by Mary McMillan who taught classes in Portland, Oregon, and by 1919 physical reconstruction services were available in 53 Army hospitals throughout the US. Many of the reconstruction aides found the work so rewarding they wanted to continue after the war, during Mary McMillan’s final year in the army the idea for the AWPTA was created. When the reconstruction aides were discharged from the war, letters were also sent to determine interest in the association. After much work, even publishing a book, the AWPTA was formed, and Mary McMillan was elected as the first president (R. Eldar, M. Jelić. 2003). From here, physical therapy continued to grow, moving to China among other countries, and was expedited even further when WWII began.

Mary McMillan’s Impact

Mary McMillan, the “Mother of Physical Therapy”, yet still a missing or hidden voice, often overshadowed by her counterpart the “Father of Physical Therapy”. Figure 1 shows an image of Mary McMillan from a 1919 newspaper. Mary McMillan was the founder and first president of what is now known as the American Physical Therapy Association. A title she earned through her accomplishments in the field of physical therapy, fueled by a desire to help those suffering due to the loss of her sister and mother. Mary was born to Scottish parents in Massachusetts, when she was 4 her sister passed away due to tuberculosis, then a year later her mom passed away. She then moved to England to live with her aunt, where she studied physiology, massage therapy, and rehabilitation exercises. Mary saw it as her destiny and calling to help physicians in the areas of anatomy, physiology, and muscle movement in America. Before WWI Mary provided massage and exercise therapy for orthopedic patients at a children’s hospital in Boston, before the “physical therapy” field even existed in the United States. During WWI, Mary was the first physical therapy aide sworn into the US army, making her the United States First Physical Therapist. Mary McMillan was a member of the US Medical Corps, working as the Chief, then Supervisor of Reconstruction Aides at Walter Reed General Hospital in Washington, DC (A. Simmons, 2025). At Walter Reed, she worked to sell the ideal of physical therapy to the doctors, taught physical therapy students, and made a medical textbook – Massage and Therapeutic Exercise – still in print today . Her next accomplishment was creating a national physical therapy organization, originally American Women’s Physical Therapeutics Association with goals of standardized physical therapy practices and providing professionally trained therapists for hospitals and clinics. Now known as the American Physical Therapy Association, with over 100,000 members and a national leader in PT practices, research, and education (P. Ruth, 2021). After accomplishing such feats in the US, Mary set her sights global, living in China for 11 years establishing their first physical therapy training center. Unfortunately, World War II broke out as she was attempting to travel home to the US, she was captured and taken to a Japanese prisoner of war camp, where somehow she still managed to practice physical therapy. She created a camp hospital, and had her own PT shop in camp. She was released when she fell ill with pneumonia, and passed away 16 years later due to metastatic melanoma, caused by long hours of overexposure during the camps (M. Elson, 1964).

WWI Pandemics: Influenza and Polio and their Outside Influence

Polio and Influenza, two major pandemics that served almost as bookends to WWI. Before the war the rise of polio epidemics was a great contributor to the growth of physical therapy. Polio is an infectious disease that could cause severe muscle paralysis, often treated by splinting and casting limbs, with bedrest. This led to extreme muscle weakness and reduced flexibility. Mary treated this weakness and decreased range of motion through massage and exercise therapy before it was even established as “physical therapy”.

Post-war, the 1912 influenza pandemic, commonly known as the “Spanish Flu” was one of the most severe pandemics in recent history. Overlapping with the end of the war, many reconstruction aides wound up serving as nurses to those soldiers who had been infected with the flu, in fact some reconstruction aides even ended up passing away as results of becoming infected with flu. While originally physical therapists were determined to distinguish the profession from that of nurses, these events blurred all such distinctions (B. Linker, 2021). This set the precedent that physical therapists won’t only work with those injured, but also those affected by diseases, still applicable in current times, facing pandemic such as COVID-19.

Conclusion

Physical therapy has become a well known medical field throughout the world, many thanks to the efforts of reconstruction aides, led by Mary McMillan during WWI. Mary McMillan was educated in England, originally applied her knowledge and skills to Boston’s Children’s Hospital, focusing on regaining muscle loss in polio cases, before physical therapy was even an established field. She then joined the US army to educate 800 reconstruction aides, most women, on post injury and surgical rehabilitation. After the war, these women formed the AWPTA, eventually evolving into the APTA. The physical therapy field only grew from here, widening with the influenza pandemic, introducing the field to China, and taking off further during WWII.

References

Eldar, R., & Jelić, M. (2003). The association of rehabilitation and war. Disability and Rehabilitation, 25(18), 1019–1023. https://doi.org/10.1080/0963828031000137739

Elson, M. (1964, December 1). Legacy of Mary McMillan . Physical Therapy and Rehabilitation Journal. https://academic.oup.com/ptj/article/44/12/1067/4629052

Linker, B. (2021, January). Physical Therapy in the Time of Pandemic: Then and Now . Oxford Academic. https://academic.oup.com/ptj/article/101/1/pzaa184/6061976

“Mary McMillan, from a 1919 newspaper” by Unknown Author is licensed under Public Domain, CC0

Nicholls, D. A. (2021, September). Physical Therapy’s Hidden History. Oxford Academic. https://academic.oup.com/ptj/article/101/9/pzab151/6366308

Ruth, P. (2021, September 22). Early Markers of a 100-Year Journey Toward the American Physical Therapy Association Becoming an Ethically Grounded Societal Presence: An Ethicist’s Reflection. Oxford Academic. https://academic.oup.com/ptj/article/101/11/pzab240/6447083

Simmons, A. (2025, November 27). 10 things you didn’t know about Mary McMillan, Mother of Physical Therapy. Practice Promotions. https://practicepromotions.net/mary-mcmillan/

AI USE AcKNOWLEDGEMENT

This chapter was created with the assistance of AI tools such as Gemini 3 Flash and Microsoft Copilot – GPT 4 to find sources that fit the goals of this chapter, create a rough outline, and provide grammatical help. They both provided sources from Oxford Academic that added value to the chapter. The research was compiled and written without any assistance.

Google. (2026). Gemini 3 Flash [Generative AI chat]. https://gemini.google.com

Microsoft. (2025). Copilot (GPT‑4) [Large language model]. https://copilot.microsoft.com