‘Involved in every step’: how working practices shape the influence of physiotherapists in elite sport

Abstract

This paper examines how the medical and non-medical skills of physiotherapists enable members of the profession to become central agents in the multidisciplinary teams (MDTs) which dominate sports health care. Drawing on empirical data derived from interviews with sports physiotherapists and doctors working in UK Olympic sport MDTs, this article argues that the role and influence of physiotherapy in elite sports health care can be explained in relation to physiotherapy’s working practice traditions and the degree to which these traditions correspond to their specific patients’ demands. Drawing on concepts such as medical dominance and relative practice autonomy drawn from the sociology of medicine, the paper argues that extended time, close physical contact and opportunities for experiential learning foster physiotherapist–patient mutuality, locate the physiotherapist as an inherent part of the recovery process and lead to trusting and collaborative health care relations. The practice traditions of physiotherapy enable these practitioners to respond flexibly to the particular demands of elite sports clients, intertwining athletes’ performance orientation with physiotherapists’ treatment through blurring the boundary between health care and sports training. Physiotherapists thus become seen as ‘useful’ in the eyes of the clients who shape the demand for health care delivery in elite sport.