Backmen & Bonesetters: A Rural Occupation

My great-grandmother, Leonora Weeks, winning a 100 mile endurance event in 1938.

The origin of osteopathy: ‘bone-setting’ and horses

The earliest historical reference to the practice of manipulative therapy in Europe, dates back to 400 BCE: nearly 2,500 years ago. However, there is strong evidence of the use of manual therapeutic procedures in ancient Asia, to be at least 4,000 years old. That’s 1,500 years before Hippocrates.

Osteopathy has strong historical linkage with the ancient indigenous craft of ‘bone-setting’. Indeed, the development of orthopaedic medicine in the UK, along with most manual therapies, has is roots firmly in bone-setting.

Physical or manual therapy for animals can trace its documented origins in the UK, back to at least the early 20th century, however it is thought Native Americans used to use manual manipulative medicine to treat their horses. This area is a field of growth due to increasing awareness and recognition, by both horse-owners and the medical community – brought about by a flourishing scientific evidence-base, which has matured in recent years.

There a long history of ‘bone-setters’ in Britain and (the ‘fear cnámh’ or bone-men) of Ireland: where the art and skill of bone-setting was and still is passed down the generations. Originally practiced in rural settings, the ‘fear cnámh’ or bone-men of Ireland, were and still are mostly from a farming background, who originally practiced bone-setting with their horses, before treating people.

Much of the bone-setter’s skill has been inherited and enriched upon by Still’s (the founder of osteopathy) osteopathic philosophy and application of manual techniques. Thus many bone-setters techniques are inherently being used in osteopathy and other manual therapies today, however 4 to 5 years of rigorous university masters level degree training and statutory regulation, accompanied by a strong scientific evidence-base and unified philosophy, distinguishes bone-setters of the past from osteopaths of today.

Frances’ late grandfather and grandmother driving cart.

It is acknowledged that some form of manual manipulative therapy was and still is widely practised in many cultures and often in remote worldwide communities such as by the Balinese of Indonesia, the Lomi-Lomi of Hawaii, in areas of Japan, China and India, by the shamans of Central Asia, by sabodors in Mexico, by bone-setters of Nepal as well as by bone-setters in Russia and Norway.

In the western world, osteopathy shares a strong historical linkage with the the Roman and Greek ‘skeleton men’ and the ancient Egyptian ‘men of the hands’. There are written descriptions of manipulative manual therapy by Hippocrates, who in Periarthron described various manipulative techniques. Such descriptions are reproduced down the centuries; they appear in the writings of the Roman physician Galen and in Arabic medical texts.


Osteopathy is a statutorily regulated (regulated by law) primary healthcare (first point of contact/doesn’t need referral) profession, which has been practised since the 1870s. Osteopaths are established members of the primary health care (PHC) community and are increasingly working within the NHS. The British Medical Association’s guidance for general practitioners (GP’s) states that doctors can safely refer patients to osteopaths.


Inherited cart or trap, from Frances’ grandfather. The one he used to drive most often. It is going to be featured on BBC Two ‘The Repair Shop’ to be revitalised.

Osteopathy is a safe and effective means of diagnosis, treatment, prevention and rehabilitation of a wide range of musculoskeletal disorders (MSDs). A consultation with an osteopath includes a thorough case history and physical examination: assessing muscles and joints and observing movements. Orthopaedic tests and diagnostic clinical procedures, such as taking blood pressure, are also used to inform the diagnosis and to assess whether referral for further medical investigation is necessary. Treatment is based on manual mobilising and manipulative procedures and massage-type techniques, tailored to the individual patient and reinforced by guidance on diet, lifestyle and exercise. It is not just about backs!

Rural France, late 19th century.

To qualify, an osteopath must study for four to five years in order togain an integrated-masters of osteopathy (M.Ost). This is similar to a medical degree, but with greater emphasis on musculoskeletal medicine. The degree includes more than 1,000 hours of clinical experience and training in osteopathic techniques.

By law, osteopaths must register with the General Osteopathic Council (GOsC). The title ‘osteopath’ is protected by law. It is an offence for anyone to call themselves an osteopath if they are not registered.


Osteopaths approach to patient care is informed by Evidence-Based Practice (EBP), the Biopsychosocial (BPS) model and the Clinical Guidelines, Standards of Practice and Code of Ethics, produced by the General Osteopathic Council (GOsC), the NHS; National Institute for Health and Clinical Excellence (NICE) and the EU.

All registered osteopaths abide by the standards for fitness to practise set by the Health Professions Council (HPC) and the osteopathic practice standards set by the General Osteopathic Council (GOsC), which sets and promotes high standards of competency, conduct and safety.

I like to think I have inherited my family’s ‘horsey heritage’. My great-great-grandfather, George Burton (above with family), was Head Coachman and Groom on two of the great north Norfolk estates, Felbrigg and Gunton.

Sarah “Crazy Sally” Mapp (died 1737) was an English lay bonesetter, who gained fame both by performing impressive bone-setting acts in London.

Commonly treated conditions include: back ache, neck strains and whiplash, migraines and headaches, changed to posture in pregnancy and pre-menstrual symptoms, sports injuries, digestive problems/IBS, jaw and facial pain, repetitive strain injury (RSI), ‘frozen’ shoulder, rheumatic and arthritic symptoms, respiratory problems, ‘trapped’ nerve, muscle spasm. Osteopaths’ patients include the young, older people, manual workers, office professionals, pregnant women, children and sports people.

Those practising in the UK carry out more than seven million consultations every year with around 30,000 people currently consulting osteopaths every working day. Today, osteopathy is practiced in over 80 countries.

Anyone addressing themselves as an equine osteopath, should by law, have a degree in osteopathy and be registered with the General Osteopathic Council. 


Put simply, osteopaths use manual, ‘hands-on’ techniques to help remove tensions and restrictions in the body. Using a wide range of gentle, long-lever, rythmic manual techniques such as deep tissue massage, joint mobilisation, stretching and high-velocity low-amplitude thrust techniques, the goal of the osteopathic consultation is to evaluate the quality of physical movement on a local and general level and to restore mobility to restricted areas; be it joint or muscle.

Through mobilisation, massage and manipulation osteopathy can also help relieve inflammation – the bodies cardinal response to injury; encourage blood flow to and fluid drainage from the affected area, helping to dissipate swelling and inflammatory fluids and thus helping to reduce pain and joint stiffness.

Treatment works by improving the ‘fluid health’ of the area – facilitating optimum transportation of oxygen and nutrients to the injured tissue(s) thus promoting the repair process that is, healing.

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