On 29 July 1948, as the London Olympics opened, 16 patients in wheelchairs lined up with bows and arrows on the grounds of a hospital in Buckinghamshire. The doctor who organised that small contest believed it was the start of something much bigger. He was right.
A ward nobody wanted
Before the 1940s, a broken spine was close to a death sentence. About 80 per cent of people with a spinal cord injury died within three years, most of them from infected pressure sores or urinary infections, according to the Australian Paralympic Committee's history of the Paralympic movement. Those who survived usually lived out their lives as dependants in the care of relatives or in homes for the "incurable".
In September 1943 the British government asked a German-born neurosurgeon, Dr. Ludwig Guttmann, to set up a spinal injuries unit at Stoke Mandeville Hospital, north-west of London. It opened on 1 February 1944 with one ward and 28 beds. Guttmann later described spinal injury as a field that medicine had abandoned, and he set out to prove that it did not have to be that way.
The refugee doctor
Guttmann was born in 1899 to a Jewish family in Tost, Upper Silesia, then part of Germany and now Toszek in Poland. As a young volunteer at an accident hospital in 1917 he met his first paralysed patient, a coal miner with a broken back, who died within weeks. He later wrote that the picture of that young man stayed fixed in his memory.
He trained as a doctor and became a leading neurosurgeon in Breslau, now Wrocław. After 1933 Nazi laws drove him out of his university post, and he went to work at the city's Jewish hospital, becoming its medical director in 1937. In early 1939, with help from the Council for Assisting Refugee Academics, he reached Oxford with his wife and their two children. He continued his research there until the call came from Stoke Mandeville.
Turning every two hours
Guttmann's first revolution was on the ward. He identified pressure sores and urinary infections as the main killers and attacked both. Nurses turned every patient in bed every two hours, day and night, whether the patient was awake or asleep, and he was known to make unannounced visits in the small hours to check. He replaced crude bladder surgery with careful catheterisation under strict hygiene. Physiotherapy and occupational therapy were compulsory, and patients learned carpentry, clock repair and shoemaking, sang in choirs and put on plays.
His aim was to give people back their whole lives, not just to keep them alive: to build strength and confidence and send them back into work and society. The results were dramatic, and his methods spread to other hospitals in Britain and then around the world. Sport was part of the cure from the start. It built upper-body strength, but Guttmann believed it also restored something harder to measure, a sense of self-respect.
“The most depressing and neglected subject of all medicine.”Ludwig Guttmann, describing spinal cord injury before his work at Stoke Mandeville, Australian Paralympic Committee, Paralympic History
From archery on the lawn to Rome
On the day the 1948 London Olympics opened, Guttmann held his first competition for wheelchair athletes: 16 injured servicemen and women taking part in archery. He called it the Stoke Mandeville Games and repeated it every year. In 1952 a team of Dutch ex-servicemen came over to compete, and the event became the International Stoke Mandeville Games, the first international sports competition for athletes with a disability.
Guttmann dreamed of a disability equivalent of the Olympics. In 1960 the games were held in Rome alongside the Olympics, with about 400 athletes from 23 countries. They are now recognised as the first Paralympic Games. The movement kept widening. Winter Games began in Sweden in 1976, and over time events were opened to athletes who are blind, have amputations, cerebral palsy and other impairments. In 1989 the International Paralympic Committee was founded to govern the movement, and since 1988 the Summer Games have shared the Olympic host city and venues.
Guttmann was knighted in 1966. When he died in 1980, the games he had started on a hospital lawn were held across the world.
Who it reaches today
At the Paris 2024 Paralympic Games, around 4,400 athletes competed in 549 medal events across 22 sports, with a record number of delegations, more than 160, according to the International Paralympic Committee. A record number of them were women, close to 2,000 or about 45 per cent. The IPC noted that this near parity had been reached just 64 years after the first Paralympics. Three national teams made their debut: Eritrea, Kiribati and Kosovo.
The ideas Guttmann pioneered in medicine reach even further. His approach of regular turning, careful bladder care and active rehabilitation was taken up by spinal units around the world, and a life-size bronze statue of him now stands at the National Spinal Injuries Centre at Stoke Mandeville. A hospital for neurorehabilitation in Barcelona, the Institut Guttmann, carries his name. In 2019 a small museum, the National Paralympic Heritage Centre, opened at Stoke Mandeville Stadium to tell the story of where it all began.
Beside the Olympics, not behind them
The International Paralympic Committee explains that the word Paralympic joins the Greek "para", meaning beside or alongside, with Olympic. The Paralympics are the parallel Games, two movements side by side. It is a fitting description of what Guttmann achieved. He took people whom medicine had written off and showed the world they belonged on the same stage as everyone else.
The next Summer Paralympics will be held in Los Angeles in August 2028. A new generation of athletes is already training for it, in a world that expects people with spinal injuries to live, to work and to compete. That expectation is Ludwig Guttmann's legacy, and it grows with every Games.
People in this story
Sources & further reading
- Paralympics History: Evolution of the Paralympic Movement, International Paralympic Committee
- Paris 2024: Record number of delegations and females to compete, International Paralympic Committee
- The world's first spinal unit, Australian Paralympic Committee, Paralympic History
- How Nazi persecution of a Jewish doctor led to Paralympics, and a revolution in treating spinal injury, The Times of Israel
- Ludwig Guttmann, Wikipedia
- World Abilitysport Games (Stoke Mandeville Games), Wikipedia
Researched from the sources above and checked against them. Spotted an error? Tell us.
Tikkun olam in action. This is part of tikkun olam, the Jewish idea of repairing the world, and every one of us can add to it.
