Article Text

Download PDFPDF
Physiotherapists as detectives: investigating clues and plots in the clinical encounter
  1. Birgitte Ahlsen1,2,
  2. Anne Marit Mengshoel2,
  3. Hilde Bondevik2,
  4. Eivind Engebretsen2
  1. 1 Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
  2. 2 Department of Health Science, University of Oslo, Institute of Health and Society, Oslo, Norway
  1. Correspondence to Birgitte Ahlsen, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, University of Oslo, Institute of Health and Society, Oslo N-0130, Norway; birgitte.ahlsen{at}


This article investigates the clinical reasoning process of physiotherapists working with patients with chronic muscle pain. The article demonstrates how physiotherapists work with clues and weigh up different plots as they seek to build consistent stories about their patient’s illness. The material consists of interviews with 10 Norwegian physiotherapists performed after the first clinical encounter with a patient. Using a narrative approach and Lonergan’s theory of interpretation, the study highlights how, like detectives, the therapists work with clues by asking a number of interpretive questions of their data. They interrogate what they have observed and heard during the first session, they also question how the patient’s story was told, including the contextual and relation aspects of clue production, and they ask why the patient’s story was told to them in this particular way at this particular time. The article shows how the therapists configure clues into various plots on the basis of their experience of working with similar cases and how their detective work is pushed forward by uncertainty and persistent questioning of the data.

  • health care education
  • philosophy of health care/health care
  • physiotherapist

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors BA and AMM planned the study. BA conducted the observations and interviews and drafted the paper. BA, AMM, HB and EE have contributed in the analysing process and in developing the paper as a whole. BA submitted the paper and is responsible for the overall content of the article.

  • Competing interests None declared.

  • Ethics approval Norwegian Social Science Data Services.

  • Provenance and peer review Not commissioned; externally peer reviewed.