While the global burden of musculoskeletal conditions is well recognised within physiotherapy, far less attention has been given to the disproportionate impact experienced by Indigenous Peoples. 

Despite the profession’s central role in prevention, assessment and rehabilitation, Indigenous musculoskeletal health has remained relatively overlooked within physiotherapy contexts. 

In response, a recent series of articles in the Journal of Orthopaedic and Sports Physical Therapy, ‘Moving Forward Together’, brings this issue to the forefront, aiming to advance collective understanding; critically reflect on current efforts across physiotherapy clinical practice, research, education, and allyship and advocacy; and identify priorities for future action.

The development of the ‘Moving Forward Together’ series began a couple of years ago, after a conversation between one of the lead authors, Associate Professor Ivan Lin, and Assistant Professor Clare Ardern, the editor-in-chief of the journal, about the lack of literature on Indigenous musculoskeletal health published in physiotherapy journals. 

‘Ivan did what he does best – he linked us all together and asked if this was something we’d be interested in working on as a group,’ says Dr Brooke Conley. 

The collaboration was led by Brooke, Ivan, Jane Linton, Associate Professor Robyn Fary and Dr Rachel Toovey (see below for more about each of the lead authors), who reached out to their networks in Australia and internationally. 

‘It was initially going to look like the background paper and provide a general overview of musculoskeletal health for Aboriginal and Torres Strait Islander Peoples and ways to improve care and outcomes. 

Then we had the idea to make it global and to expand the scope to include all aspects of the physiotherapy profession – clinical practice, research, education, and allyship and advocacy. 

We really wanted to have widespread change and not just focus on one area of physio, acknowledging that we work in many different spaces,’ Brooke says. 

‘A strength of the series is that it was Indigenous-led and grounded in our ways of knowledge sharing. 

Also, I’m particularly proud that it’s a majority Indigenous authorship project and that we’re spotlighting the work of Indigenous leaders and allies around the world who are doing great things in these spaces.’ 

The ‘Moving Forward Together’ series was a collaboration of both Indigenous and non-Indigenous Peoples from Aotearoa/New Zealand, Australia, Canada, Fiji and Samoa. 

At the heart of the series is a four-fold purpose – it aims to ‘deepen [physiotherapy’s] collective knowledge’ of musculoskeletal health in Indigenous Peoples; ‘reflect on current initiatives… across clinical practice, research, education and allyship/advocacy’; ‘explore future directions… to advance the profession’; and, ultimately, ‘contribute to positive change for Indigenous Peoples’ seeking healthcare. 

While the initial article (Conley et al 2025) provides an overview of the series and the need for a holistic, strengths-based view of musculoskeletal health that reflects an Indigenous world view, the subsequent articles each focus on one of the four aspects mentioned – clinical practice (Lin et al 2026), research (Linton et al 2026), education (Fary et al 2026) and allyship and advocacy (Toovey et al 2026) – with the final article a call to action across each of these areas (Conley et al 2026). 

The authors say that above all, they wanted the series to build interest and provide information and resources to support physiotherapists to continue their learning in this area. 

Jane says, ‘Often people feel a bit unsure about how to bring it up and talk about it and this provides a summary to open conversations up and get people to think differently.’ Each article identifies different levels where change is needed, from the level of the individual – whether clinician, researcher or educator – to that of the organisations surrounding them and healthcare systems overall. 

In particular, the article on allyship and advocacy focuses on the roles of individuals (both Indigenous and non-Indigenous), organisations and policymakers (Toovey et al 2026) in supporting physiotherapists to drive change. Rachel says, ‘We intentionally had two aims for the allyship and advocacy paper. 

There is a lot of discussion about what allyship means across different contexts. 

It was first important for us to discuss and conceptualise what we mean by allyship and advocacy in Indigenous musculoskeletal health. 

Second, we wanted to provide practical and clear guidance to physiotherapists, organisations and policymakers on what they can do to reflect these concepts.’ 

They have taken an approach that, like many Indigenous cultures in Australia and internationally, focuses on storytelling to impart ideas. 

Each article includes a story explaining and conceptualising the link between the topic of the article and its connection to Country (see info below). 

In addition to her research leadership and contributions, Jane also designed artworks that were included in several of the articles. ‘It was nice to have the opportunity to develop some of the graphics for the articles. 

It’s a different way of learning and taking in information. 

We thought that might be helpful for some readers and make it a bit more interesting.’ 

Robyn says the metaphors developed in Jane’s artwork for each of the articles are a key part of the series. 

In the article on advancing education (Fary et al 2026), she describes the education ecosystem as a rainforest, with the older trees nurturing the younger seedlings as they grow. 

‘The lovely drawing (figure) that Jane did for the education article really captures the interconnectedness between all the levels, reflecting Indigenous ways of being.’ 

In addition to Jane’s artwork, several other Indigenous artists contributed original artworks to convey key messaging throughout the series, including Talah Laurie, a Gumbaynggirr and Yaegl woman from Australia, whose artwork Layers of Country is in the first paper (Conley et al 2025); Louise Potiki Bryant, a Kai Tahu, Kati Mamoe and Waitaha artist from Aotearoa/New Zealand, whose artwork Te Ngahere (The Forest) is in the final paper (Conley et al 2026); and Tashina Makokis, a Nêhiyaw artist from Canada, whose artwork Call to action is also in the final paper. 

The lead authors found the process of developing the series inspiring, noting that everyone who contributed was keen to be part of it and that the participants learned a lot about each other’s cultures. 

‘Especially as a non-Indigenous author, it was an extraordinary privilege and a great experience with lots of learning,’ says Ivan. 

Ultimately, the authors want to empower readers to take what they’ve learnt on board and to become part of the efforts to transform musculoskeletal care for Indigenous Peoples. ‘It’s reframing the narrative for Indigenous health and Indigenous Communities. 

We are telling a lovely story of how there’s so much strength in Indigenous cultures and if we embrace that, positive changes can happen. There’s lots to learn for everyone in the way that Indigenous People do things,’ says Jane. 

References. 

The stories behind the series 

Challenging the stereotypical approach for physiotherapy journals, each article in the ‘Moving Forward Together’ series contains a story that explains and conceptualises the link between the topic of the article and the Indigenous world view, with illustrations and figures. 

The first article in the series sets the scene, explaining some of the terms used and introducing the five lead authors. 

Using the Aboriginal and Torres Strait Islander term ‘Country’ as a metaphor for Indigenous musculoskeletal health, it provides a short explanation that highlights the need to look at musculoskeletal health holistically – a concept shared across the different Indigenous cultures represented in the series – and with a strengths-based lens. 

Each of the following articles uses an aspect of Country as a metaphor. 

Clinical practice is likened to the rocky cliffs – solid, sheltered and needing to provide an environment of safety and stability. 

Research is a whirlpool, where there is ongoing movement and where ideas form and swirl; education is an interconnected ancient rainforest – a thriving ecosystem where knowledge grows and Communities thrive; and allyship and advocacy are represented by the wind, connecting diverse landscapes and symbolising change. 

The final article encourages physiotherapists and the profession to bring all the elements together to move forward.

Meet the authors 

Adapted from ‘Moving Forward Together: transforming physical therapy to improve Indigenous Peoples’ musculoskeletal health’ (Conley et al 2025). 

Dr Brooke Conley APAM is a Ngiyampaa woman, physiotherapist and vicechancellor’s senior research fellow based at RMIT University in Naarm/Melbourne, Australia, on Wurundjeri Country. She has research expertise in musculoskeletal conditions, with a particular focus on improving outcomes and care for Indigenous Peoples. 

Dr Robyn Fary APAM, a proud descendant of the Gunditjmara People, lives and works as a teaching and research associate professor at Curtin University on Whadjuk Noongar Country in Perth, Australia. She has many years of combined experience as a musculoskeletal physiotherapist in clinical practice, education, research and leadership. 

Jane Linton is a Gumbaynggirr woman living on Country on the north coast of New South Wales, Australia. She has over 20 years of clinical experience as a physiotherapist in the public health system. She is a PhD candidate at the University of Sydney, with a special interest in improving access to healthcare for Aboriginal people with musculoskeletal conditions. 

Dr Rachel Toovey APAM is a settler- Australian physiotherapist and academic with British ancestry. She lives and works at the University of Melbourne on Wurundjeri and Bunurong land in Naarm/ Melbourne in so-called Australia with her two children. Rachel has worked with Indigenous colleagues, patients and community members across physiotherapy clinical, education, advocacy and research contexts for more than 15 years. 

Dr Ivan Lin FACP is an Australian non- Indigenous Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2021) and researcher who lives on Yamaji Country in Jambinu/Geraldton, coastal Western Australia. He works for an Aboriginal Community Controlled Health Service and is an associate professor at the WA Centre for Rural Health, University of Western Australia.