Massage and medical gymnastics experienced a rapid institutionalization across Europe and North America between 1850 and 1914. This article explores how this process took place in London and Paris. Physiotherapy developed many of the hallmarks of an independent discipline during this period, including an identified corpus of manipulations and exercises, some autonomous training courses and degrees for future practitioners, and even the creation of departments within several hospitals. The article analyzes all of the processes surrounding this rise, paying special attention to the influence of the ambassadors of Swedish gymnastics (which led to the re-invention of massage across Europe), to the installation of physiotherapy in hospitals in London and in Paris, and to the practical and institutional innovations driven by nurses in England and by doctors in France.