For many physiotherapists, working in the elite sports arena is a dream job. Travel, supporting the well-being of high-performance athletes and the prestige of potentially working with a well-known club or team are all enticing factors. Furthermore, a sports physio is a crucial part of enhancing an athlete’s performance. The role entails looking at all aspects of an athlete’s life from their diet, exercise and rehabilitation to their medications and sleep routine. 

However, an increasing number of sports physios are feeling the pull and burn. Long hours, crazy work schedules, low salaries and immense pressure are just some of the challenges that physiotherapists in elite sport experience.

Kristian, a senior physiotherapist for a professional sporting team in Australia (name not disclosed for privacy reasons) was excited to move into elite sport and knew that it would open the door to further career opportunities.

“Working in elite sport is arguably the pinnacle of the physiotherapy industry and the most sought-after position for most aspiring sports physios. Being able to work with professional athletes in high-performance environments, striving to win sporting championships is an amazing opportunity”, says Kristian.

However, whilst it is a prestigious title to hold in the physio world, there are issues amongst sports physios that have seemingly gone unaddressed for too long. One of the biggest challenges that physios in elite sports are facing is the reduced level of remuneration.

“Being a physio in elite sport is one of the rare positions where you are at the peak of the industry but financially, you can earn more if you’re in a community-level private practice. The issue is that there are hundreds of physios ready to take our positions for less money and many sports clubs take advantage of this … I personally have a Bachelor’s degree, a Masters in physio and a Masters in sports physio totalling eight years of study and $80,000+ in education fees. A doctor (who works for the same club or team) will undertake similar years of study and will earn a significantly higher income than the physios also working for that team”.

Next to the subpar salaries, many physiotherapists in this realm have heard “it’s all about winning” and “play through injury” far too many times. For some, this has come to a point where they have recommended that athletes do not compete or play due to an injury and the coach has overruled their professional medical opinion.

Kristian has experienced this throughout his career and says it never ends well.

“There are occasions where an athlete of high importance is needed for an important game which may dictate the success of the season. In these instances as a medical team, it’s our responsibility to highlight the risk of playing the athlete and then it is up to the player and coach if the risk is worth taking … I have also experienced instances where a head of high performance - who in some structures outranks the medical team - overrides a medical recommendation to inform the coach that a player is available to play. Again, this always results in a poor outcome and highlights the importance for a head of medical to be on a flat structure with a head of high performance.”

This mentality has also led to many physios in elite sports feeling an immense amount of pressure when it comes to the performance of the athletes. It is a results-based world and there have been cases where the team physio has been fired due to the team not performing well enough, not to mention the toll this has taken on their mental health.

“The pressure of working in a high-performance environment, mixed with a high injury-burdened team and an unsuccessful season can result in a deterioration of mental health. I was close to being burnt out in my season working in the AFL which almost resulted in me giving up working in sport altogether”, says Kristian.

He believes that in order for sports physios to feel more supported and heard, job security and higher salaries would definitely help.

“I think there needs to be more support for physios in elite sport from an external force, independent to the sporting clubs, such as a union. We need to have job security in our contracts and more of a standardised process for how the terms of our contracts (length of contract and salary) are determined. As it stands, it is up to the individual to negotiate their worth to a general manager of a sporting club which is always going to be an unbalanced situation favouring the club”, Kristian says.

With all the challenges Kristian has faced over the years, he reiterates that at the end of the day, he loves what he does and is aware of the opportunities he has received, but he wishes working conditions were better. A similar sentiment is echoed by Shane Hayes, Sports Physiotherapist and High-Performance Practitioner.

“Sports physiotherapists in international sport involves long hours, months away from home, difficulties in relationships, extensive continued education, and the pay normally doesn’t match the amount of work. Those passionate in sports performance however should pursue it with the rewards of knowing that they genuinely help elite athletes to achieve their goals”.