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“People often envisage MSK/Sports physiotherapy to be a glamorous profession – perhaps they mistakenly imagine we spend our days running onto pitches to treat elite athletes!”  Jill Kerr

But what is the difference between working with the general public and elite athletes and how can physiotherapists ensure success?

physiotherapy for cyclists

Back to Basics

The first thing every MSK physiotherapist has to remember is to get the basics right during a clinical assessment, and focus on clinical reasoning and diagnosis. You must consider which pathologies occur in the age group you are treating and avoid jumping to conclusions or cutting the assessments short. This reduces the chance of a misdiagnosis or missing something important or serious.

Know your Sport

Elite sports physiotherapists need to gain knowledge of the common pathologies encountered within the sporting population with whom they work. This knowledge helps them to develop strength and conditioning schedules that are specific to that sport. The aim of these schedules is to prevent and reduce the risks of injury to each individual group of athletes.

Assessing Elite Athletes

When you work full time with elite athletes you quickly get to know their baseline strength and conditioning, plus you will potentially have access to video evidence of any traumatic incidents they have been involved in. This furnishes you with the mechanism of the injury and the forces that were involved, therefore giving you information about the structures potentially injured.

Assessing the General Public

In contrast, you will not normally have access to this information with the general public and therefore your questioning and clinical reasoning may be more in-depth. It’s a bit like being a detective and thinking outside the box, with each client assessed individually.

Clinical assessment is important to rule certain pathologies out as well as building a clinical impression of the injury/problem. Continued postgraduate training helps to build this skill set for all MSK physiotherapists. An accurate clinical assessment should be available to all members of the population.

MSK sports physiotherapy

Psychological Recovery

The psychological impact of injury must always be taken into account.
An elite athlete may have been training all their life for one high profile event or game and then a last-minute injury impacts on their ability to perform or compete. This can have a devastating effect. Measures need to be taken by the physiotherapist when planning their recovery. A focus on activities they can still do, and building in short and long-term goals to try to keep a positive outlook for the athlete, is an important part of their recovery.

Injury to the general public can be equally devastating depending on the nature of the injury. Therefore it is important that each physiotherapist understands how crucial their role is in helping with this aspect of their recovery. Each client is an individual with different needs and lifestyles and this should be accounted for when planning rehabilitation.

Access to Physiotherapy Treatment

Physiotherapy treatment and rehabilitation are often available daily to elite athletes and it is easy to do exercises when the physiotherapist is watching over you! In contrast, this is often much less so for the general public as resources may be limited. Therefore giving specific rehabilitation to each client and clearly explaining the purpose of each aspect is key for compliance.

In Summary

MSK Physiotherapists play an important role in getting the assessment, clinical diagnosis, treatment and rehabilitation right for everyone!

Time, litigation and resources may be different between the elite sport and the general public but a clear focus on rehabilitation, including core strength, balance, and proprioception, is very important for injury prevention and recurrence.


Jill Kerr has over 30 years experience of hands-on musculoskeletal physiotherapy and has an MSc in Orthopaedic Medicine. Jill is a Module Coordinator for SOMM’s Diploma and Advanced Courses and joint Programme Leader for the MSc in Musculoskeletal Medicine.

As a wife and mother to professional rugby players (Leicester Tigers) and also mother to a professional runner (Brooks Beasts), Jill has an excellent knowledge of the issues surrounding the assessment and treatment of elite athletes.

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