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Changing the playing field - the growing role of a Sports and Exercise Physiotherapist

Photo: Australian Physiotherapy Association
From professional athletes in world famous teams, through to a 10 year-old who sprained her ankle playing netball, or an 80 year old with a sore back from bowls, Sports and Exercise Physiotherapists are dedicated to helping injured athletes return to their chosen activity.

“At the end of the day, the most satisfying part is seeing your athlete return successfully to their chosen sport and achieve their own goals,” says Australian Physiotherapy Association Sport and Exercise group Chair Holly Brasher.

“Whether it be a gold medal, a grand final win or a start in the local fun run, they are all just as important to the next person.”

A Sports and Exercise Physiotherapist has expertise in musculoskeletal complaints that are commonly found in athletes, those who exercise and in those to whom physical activity is important.
“We work in sport and with exercise,” says Ms Brasher.

“We work with sporting teams but also the general public in private practice.

“Traditionally, I guess you could say Musculoskeletal Physios would concentrate more on spinal conditions and Sports Physios on more peripheral conditions but there is a huge overlap in what we both do.”

In Australia, Sports and Exercise Physiotherapists have recently changed their name to include the word “exercise” to represent the modern way they treat people.

“We use exercise as an important facet of our treatment and rehabilitation in the aim to return our sport/office/home athletes to sport, work or life. 

“Activity and exercise is a fundamental core feature of what we do as Sports Physios.”

For Ms Brasher, it was a love of sports that lead her to study physiotherapy, and eventually spend most of her career working with sporting teams. 

“I have worked in Rugby, Netball, Running, Hockey, Rowing and AFL. I have also managed athletes—from local young sporting children to professional athletes.”

As a Sports and Exercise Physiotherapist, it’s important to not only understand the types of injuries that athletes suffer from, but also what skills they need in order to return to their chosen sport.

“A long distance swimmer who has injured their shoulder will require different rehab compared to a golfer or a volleyball player," says Ms Brasher. 

“Their level of competition also plays a role, as well as athletic age, stage of competition, past injuries and position in teams—to name a few.

“All these things come into play when we are considering how to map out a player’s return to sport.”

Over the years, the role of a Sports and Exercise Physiotherapist has grown to include things like exercise planning, monitoring, reporting, and evaluating.

“With the growing evidence base that ‘exercise’ is a primary/essential component in proactive risk minimization (prevention) programs across many health topics, we now also work in the area of prevention and load management.

“We use exercise as the main variable we manipulate to intervene and manage musculoskeletal injury in the sporting context.

“This can depend on the sport you are working with. Most sports have common injury types, for example, netball injuries are likely to be ACL injuries, soccer and AFL are more likely to elicit groin pain, swimmers will be more prone to rotator cuff injuries, runners; patellofemoral pain, rowers; rib stress fractures, cricketers; lumber stress fractures, and so on.

“Young athletes may present with growing ailments, such as severs disease, while ageing athletes often present with overuse injuries such as tendinopathies.”

Sports and Exercise Physiotherapists treat all musculoskeletal complaints, as well as manage acute injuries such as sprains, strains, fractures, dislocations and concussion.

According to Ms Brasher, the biggest difference between a Sports and Exercise Phsyiotherapist and a general physio would be their role at sporting events.

“As a Sports Physiotherapist who is required to attend to an injured athlete whilst playing, we need to be able to identify injuries, act quickly and cope with a lot of external pressures in often difficult environments.

“Our increasing role in sporting teams also now includes looking at risk profiles and injury prevention.”

While the position is indeed rewarding, it’s not without its challenges.

“Dealing with athletes’ (often unrealistic) expectations about recovery times, working as part of a team with coaching and management staff, aligning prognosis and rehab into in-season training schedules, and dealing with life threatening emergencies such as spinal cord injuries and cardiovascular events.

“The hours can often be insalubrious. If you don’t want to work weekends, late nights and accept out of hours calls; don’t consider it! It won’t work.”

Overall though, Ms Brasher says she wouldn’t have it any other way.

“What other job can you get paid to stand in the sun, watching sport and helping your team get through games and win competitions? 

“This is the glory side of being a Sports and Exercise Physiotherapist and you often don’t see behind the scenes where the physio has been up all hours treating players before their match.

“It’s not all roses but it’s still pretty good!”

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.