Dr Alicia Rayner FACP didn’t plan on becoming a musculoskeletal physiotherapist. In 2013, the Curtin University graduate was set to start a sports physiotherapy master’s program— until it was cancelled. 

‘I’d told everyone I was moving to Melbourne. I just remember crying in my room,’ Alicia says. 

‘They said the course didn’t have enough people, but I could switch to the musculoskeletal master’s program if I wanted.’ She did. 

The pivot exposed gaps in her knowledge but became career-defining. ‘I realised I’d been avoiding a lot—neuro testing, pins and needles, anything tricky. I didn’t know what I didn’t know.’ 

The challenge was energising. 

‘Suddenly physiotherapy became even more fun. It was exciting being able to figure things out rather than not knowing why things were working or not.’ 

She completed the Master of Musculoskeletal Physiotherapy at the University of Melbourne in 2013, then the Master of Sports Physiotherapy in 2016 at La Trobe University. 

‘I still wanted to work in elite sport,’ she says. ‘But I found musculoskeletal work more interesting. You’re hunting for one diagnosis that will change everything rather than just getting someone back to training.’ 

She worked with Cricket Victoria, the Melbourne Stars and the national rugby and hockey teams and was team physiotherapist at the 2018 Commonwealth Games. 

‘I loved the acute management—being on the pitch, running on when someone was injured. It was thrilling.’ 

Her early work in women’s cricket was formative. 

‘During the first season of the Women’s Big Bash League, players were training before dawn and after work and receiving $1000 for the whole competition. They were elite athletes with part-time support.’ 

Resources were sparse. 

‘There was one physio, practising 10 or 15 hours a week. The athletes were elite but the set-up wasn’t.’ 

Change was coming. 

‘My second year was when the AFLW started. You could feel things shifting but it was still a fight to get access to facilities.’ 

Eventually, Alicia craved more complexity. 

‘I wanted to help people think differently—not just manage symptoms but figure out why things weren’t improving.’ 

In 2020, she began the two-year specialisation training program (STP) through the Australian College of Physiotherapists. 

At this time, Alicia was based in Carnamah, a Western Australian town of 400 people, running a pop-up clinic at the local GP centre. 

‘It was only meant to be for six months, just a break from Melbourne. But it got busy, so I stayed. It was easy to concentrate on the STP in Carnamah, to block off time to study or to travel to meet other specialist physiotherapists.’ 

COVID-19 also helped her focus. 

‘I started the STP in the second week of lockdown,’ she says. 

‘No weddings, no sport, no distractions. I could study every weekend without missing out.’ Alicia tutored, taught in Geraldton and joined weekly online catch-ups with fellow registrars. 

‘We’d talk through the latest research and discuss complex cases or our understanding of conditions. It kept me going.’ 

She obtained the credential of Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2022). 

‘The final examination weekend was stressful but the rest—I loved it. You wouldn’t do it if you didn’t.’ The STP changed her perspective and confidence. 

‘If a doctor disagreed, I used to assume I was wrong. Now I back myself and I justify my thinking.’ 

Feedback, she says, equates to belief. ‘If someone gives you an hour of feedback, it’s because they see potential.’ 

The process made her more objective. 

‘You would get a lot of feedback on how to improve. You can’t change 20 things at once. I’d pick two things to focus on and think “What should I work on now and what needs to wait?” I still do that. There are always ways to improve but I try to choose one thing a day, not everything at once.’ 

She also overcame self-doubt. 

‘I used to think everyone else knew more. Then you hear someone like Dr Anne Daly FACP say she kept waiting for an email saying, “We made a mistake; you didn’t pass.” And she’s a superstar. You realise everyone feels inadequate.’ 

After two years in Carnamah, the Western Australian native moved back to Melbourne. ‘I still wanted to support the regions. But I needed separation from my small town—space to reset and not be “on” all the time. I would go to the cafe and end up chatting to patients while my coffee went cold.’ 

Today, Alicia runs a specialist physiotherapy practice and visits regional areas for complex cases. 

‘It’s for any physiotherapy practitioner stuck on a case. I help with the pointy end, the complex cases that haven’t responded to anything, where the local physiotherapist has done a great job but needs more targeted assessment. It’s usually in areas like headaches or complex regional pain syndrome, which are a bit less common.’ 

Only 13 specialist musculoskeletal physiotherapists work clinically in Victoria, says Alicia, far fewer than the 50-plus in Western Australia. 

‘The specialist role and what we have to offer is still not visible enough,’ Alicia says. 

To improve access and visibility, she cofounded Victorian Specialist Physiotherapy. ‘Most people don’t even know specialist physiotherapists exist. If you Google persistent pain, you’re more likely to get a surgeon or pain physician.’ 

She sees visibility as key to progressing the profession. ‘People fall into the gaps when they can’t find help. We need to be easier to find. Being accessible is not about being the best physio in the room. It’s about making sure patients can access the right help, at the right time.’ 

She credits the STP for elevating her career. ‘It’s opened doors I didn’t know existed—especially because I’m not a researcher. If you’re bored or want more, start thinking about it. But if you think you know everything, you’re not ready.’ 

Supporting the next generation of physiotherapists is a key part of her work. She teaches at La Trobe University and RMIT, supervises master’s students and tutors for the APA, including mentoring registrars undertaking their specialist fellowship. Mentoring, she says, is part of the responsibility that comes with specialisation. 

‘The registrars are the ones who will shape where physiotherapy goes next. My role is helping them get there.’ 

As she guides others, Alicia remembers the moment that sparked her interest in physiotherapy. 

‘I was seven and at a local footy game. My dad said “No girls in here” as he pointed to the change room. I just wanted to smell the Deep Heat and see how they were treating the players.’ 

Today, she’s proud to be leading the way in. 

Want to forge ahead with your career? Go to australian.physiotherapy/college or email acp@australian.physio for more information.