The role of a physiotherapist in the sports environment is to work with an individual or group of individuals within a team to prevent injury, restore optimal function and contribute to the enhancement of sports performance, using sports-specific knowledge, skills and attitudes to achieve best clinical practice. The sports physiotherapists’ role is complex incorporating a range of services (see Sports Physiotherapy Competencies and Standards 2005).
The exact nature of and the extent to which physiotherapy services are expected to be provided in a team context would be determined by the service level agreement between the two parties and by the immediate availability of other trained personnel within the teams’ support staff structure such as doctor and athletic trainer.
The unique and varied context of Sports Physiotherapy places the physiotherapist in many informal professional and social situations that would not normally be encountered in the typical patient-physiotherapist relationship. This unique environment presents challenges to professional boundaries that do not exist in most other areas of physiotherapy practice.
New Zealand law
The relevant legal document pertaining to this standard is:
1. Sports physiotherapy context
1.1. As a health professional, the sports physiotherapist is bound by all legislative, medicolegal and ethical obligations regardless of the setting, location or context of practice.
1.2. A patient is defined in the sports setting as the individual receiving sports physiotherapy services or the group of people for whom the sports physiotherapist is contracted or otherwise engaged to provide sports physiotherapy services.
- This includes any member of the defined ‘group’ (team or tournament group) for which the physiotherapist has been contracted or otherwise engaged to provide physiotherapy services, regardless of whether they have been the recipient of sports physiotherapy services or not and irrespective of whether services are provided on a voluntary or paid (See Sexual and emotional boundaries standard)
2.1. It is the sports physiotherapists’ responsibility to uphold professional standards applicable to their work situation, including establishing and maintaining professional boundaries.
- A clear understanding and strict maintenance of professional boundaries are necessary in order to preserve the confidence and trust required to establish and maintain effective patient-physiotherapist relationships within the sporting environment.
2.2. Sports Physiotherapists must not exploit any patient physically, sexually, emotionally, or financially.
2.3. Sexual contact of any kind with any patient is never acceptable (Sexual and emotional boundaries standard).
The consideration of when a patient is no longer determined to be a patient is not limited to the date of discharge. A person can still be considered a current patient depending on:
- the nature of the professional consultation
- the length of the professional relationship
- the degree of dependency involved in the professional relationship
- the level of knowledge and personal disclosure that occurred during the relationship.
2.4. Sports Physiotherapists must act in a considered and professional manner during all team social activities, especially where alcohol is consumed.
3. Return to play: professional decision-making
3.1. A sports physiotherapist is under no obligation to assist a patient to return to sport following an injury if the sports physiotherapist considers the risk is unacceptable.
A sports physiotherapist must:
- inform the patient of the potential harm associated with returning to sport and advocate for the patient where the patient is being pressured into taking high levels of risk
- not knowingly facilitate a return to sport following an injury where there is a high likelihood of a severe outcome for the patient.
Refer to the Administering medicines in the absence of a doctor standard.
5. Health and safety
Sports physiotherapists must hold up-to-date competencies in basic life support and management of acute trauma situations.
6. Continuity of care
6.1. Sports physiotherapists must:
- Provide appropriate handover of patient information to relevant medical personnel to ensure continuity of care.
- Uphold professionalism in all dealings with other health professionals, particularly where there is inter-professional collaborative practice of the athlete.
7. Health records
7.1. Patients in the sporting domain should feel confident that their health information will be recorded with their consent (Informed consent standard), respectfully, with regard to their cultural needs, and be kept confidential (except where legally required to do otherwise).
- Particular care is required in relation to storage and transportation of patient records.
- Consideration to the patient’s privacy and confidentiality rights is essential in relation to any disclosure of personal health information to any third party such as coaches, managers and funders.