Sport and Exercise Medicine's Role in Rehabilitation

Musculoskeletal problems are a major, under-recognised barrier to patient recovery in rehabilitation settings. A new blog in the British Journal of Sports Medicine argues that embedding Sport and Exercise Medicine specialists into these teams can address these issues and improve outcomes.

Common issues like hemiplegic shoulder pain, osteoarthritis flares, gout, post-operative joint effusions, and undiagnosed fractures frequently accompany a patient's primary diagnosis. Pain, swelling, and restricted movement from these conditions reduce engagement with physical therapy. This can delay functional gains and potentially prolong hospital stays. A swollen knee or painful shoulder might halt progress in gait retraining or discharge planning.

Why SEM Fits the Rehabilitation Model

Sport and Exercise Medicine is well-suited for this role because it combines broad medical training with musculoskeletal diagnostic expertise. Specialists often use bedside diagnostic ultrasound and possess image-guided intervention skills. They also bring a functional, movement-focused mindset to patient care.

In practice, this allows for proportionate decision-making at a patient's bedside. An SEM clinician can assess whether pain is safe to move through, if a joint effusion needs aspiration, or if a targeted injection could improve therapy participation. The role is not to replace rehabilitation medicine, physiotherapy, or other specialties. Instead, it adds an embedded musculoskeletal skillset within the existing multidisciplinary team.

Evidence of Impact on Patient Flow

When available within rehabilitation teams, SEM input may act as a flow-enabling specialty. Timely assessment and intervention can restore engagement with therapy, reduce avoidable transfers to other hospital departments, and support safer post-falls assessments.

The blog cites a local three-month service report from 2025 at the St Pancras Rehabilitation Unit. During that period, embedded SEM input delivered specific procedures and was estimated to have avoided numerous external referrals.

The authors state that at least 31 external referrals or acute trust reviews were estimated to have been avoided over this period. They note these figures require more formal evaluation but suggest timely musculoskeletal input can meaningfully impact patient flow and system burden.

Benefits for the Multidisciplinary Team

The advantages extend beyond individual patient consultations. Rehabilitation units often include clinicians, such as resident doctors, who may have variable confidence in managing musculoskeletal presentations despite their common occurrence.

Embedded SEM input provides immediate educational value by supporting confidence in examination, red flag recognition, and the assessment of post-fall injuries. It also offers practical understanding of procedures like aspiration and injection. This educational gain persists after the individual consultation, potentially strengthening the rehabilitation service more broadly by improving baseline musculoskeletal confidence across the team.

The blog concludes that as healthcare systems face ageing populations and a greater emphasis on functional recovery, the relevance of Sport and Exercise Medicine in rehabilitation is likely to grow. The core focus of SEM is on restoring movement, reducing pain, and enabling participation, which aligns directly with rehabilitation goals. The authors, a group of doctors from University College London Hospitals and Central and North West London NHS Foundation Trusts, frame the question not as whether SEM adds value, but whether service design should evolve to make that value available where it is needed most.