Do the International Competencies of the Sports Physical Therapist need Updating?

“Can you remember what you were doing on your birthday in 2005?”

A simple question can take you a long way back. A lot can change since then.

In 2005, the International Federation of Sports Physical Therapy (IFSPT) published the Sports Physiotherapy for All project (SPA)¹ which defined four key Roles and 11 Competencies a sports physical therapist should have, setting the standards for international education ever since. The aim of this international perspective is to reflect on the IFSPT competencies of a sports physical therapist and explore the need for an update.

The SPA project defined a sports physical therapist as a health care expert practicing at a Master’s level and having “extensive knowledge and skills that demonstrate critical reasoning, flexibility, creativity, independence and leadership” as described by the Scottish Credit and Qualifications Framework Level 11.¹ The SPA project identified the 11 competencies of a sports physical therapist as injury prevention, acute intervention, rehabilitation, performance enhancement, promotion of safe active lifestyle, lifelong learning, professionalism and management, research involvement, dissemination of best practice, extending practice through innovation and promotion of fair play and anti-doping practices. Across all identified competencies, the sports physical therapist uses an evidence-based approach and embodies the values of professionalism and ethical practice in caring for "athletes of all ages and abilities, while ensuring a high standard of professional and ethical practice".

This international competency profile was implemented in many national health care systems,^2,3 has inspired many professional, academic and life-long learning educational programmes^4,5 and guided international sporting organizations in defining the roles and responsibilities of sports physical therapists in high performance environments.⁶ So let’s hope a lot of good things have happened to you since 2005. However, like most good things, they do not come without challenges. We would like to take the opportunity to share some of the existing challenges for the global sports physical therapist community and see how we might turn these into good things together.

As a healthcare specialist, sports physical therapists should be aware of international perspectives on health care and reflect on how these affect their specific role. However, there is diversity in different education and health services globally. The CANMEDS framework,⁷ an internationally referenced competency-based model, describes the roles and competencies of healthcare professionals, specifying seven roles that should align with sports physical therapists’ roles. The International Olympic Committee Medical Commission provides guidelines for the roles and responsibilities of sports medicine professionals, including sports physical therapists.⁸ Similarly, the World Physiotherapy Education Framework⁹ provides a comprehensive and flexible approach to physiotherapy education, including an important focus on the global perspective, technology and life-long learning. While the World Health Organization (WHO) describes the importance of physical activity and health inequities, with wide disparities in the health status of different social groups.¹⁰ The WHO is also counting on all sports physical therapists and healthcare professionals to tackle the most important health challenges ahead and to continue to promote physical activity as an important part of a safe and active lifestyle. All together, these international perspectives urge us to reflect on our current sports physiotherapy competency profile accepted in 2005 and consider how this should evolve to meet contemporary needs.

From the clinical perspective, sports physical therapists are faced with the challenge of staying up-to-date with the latest evidence and developments in their field in order to provide the best quality care to their patients. This includes staying current on injury-specific rehabilitation, injury prevention and return-to-sport protocols, as well as advancements in movement analysis, motor control, and performance. With new research being published regularly, sports physical therapists must continuously review and critically evaluate the latest evidence to apply in their clinical practice. In addition, they must be willing to reflect and adapt their approach based on new findings. While evidence is growing, exposing the end-user to new perspectives on load, performance, health and wellbeing, we remain challenged as health professionals, to design tailored strategies for monitoring and protecting the health of our athletes and patients. A growing body of evidence highlights the importance of the cultural component in patient-centered care, whereas pain science provokes us to discuss “cure versus care” all the while respecting a growing complexity in ethics in sports. Within this growing complexity, should we differentiate between the sports physical therapist in a clinical environment and the sports physical therapist on the field of play? In their role as managers and communicators, sports physical therapists should show leadership skills towards patients and athletes, individually and in a team. So, what competencies still define a sports physical therapist, and how can these competencies protect both the athlete and the physical therapist?

I don’t remember what I did on my birthday in 2005, I am planning my next.

We all share the passion for sports physical therapy. We are all proud to be part of the global sports physical therapy community and the IFSPT, which continues to engage its member organizations in developing the sports physical therapy competencies together.

It is now time to update the competencies of a sports physical therapist to ensure contemporary practice. The IFSPT will be organising a new Delphi study and focus groups or interviews with stakeholders to facilitate an updated set of competencies for the sports physical therapist. Having an updated standard of competence to aspire to, physical therapists, globally, will have a possible career pathway to aim for.