Background Athletes in low socioeconomic communities generally present with poor health outcomes as compared to those in privileged communities. A high prevalence and risks of sports-related injuries have been reported among runners in under-resourced communities. These have a negative impact on their quality of life and level of sports participation.

Objective To develop a community-based rehabilitation implementation framework for sports-related injuries among runners in under-resourced communities, using South African communities as an example.

Design The Delphi technique was used in building consensus on the appropriate framework.

Setting The study was based in South Africa.

Participants Sport medicine experts (including sports physicians, physiotherapists, biokiniticists, sports therapists, psychologists, nutritionists/dieticians, podiatrists) in treating and rehabilitating sports-related injuries were recruited to participate.

Main Outcome Measurements The questionnaire was then sent to participants to make comments and rate each item using a four-point Likert scale.

Results 19 experts participated in the study: 3 physicians, 5 physiotherapists, 2 sports therapists, 2 biokineticists, 2 podiatrists, 2 dieticians, a d 2 psychologists. 10 were females and 9 were males of which 13 were aged 36–55 years. All experts were based in South African with 11 – 20 years of clinical experience. The Delphi process yielded four core framework items. These were: 1) the establishment of transdisciplinary rehabilitation teams, 2) upskilling of available clinicians, their assistants, and trainers, 3) implementation of a community-based rehabiliation programme at low-level/no-cost and 4) referral of cases to secondary/tertiary institution for further intervention.

Conclusions Consensus was reached for a comprehensive rehabilitation framework aimed at addressing the specific needs of athletes in under-resourced communities where rehabilitation services are scarce. A further study to test the feasibility of the agreed-upon framework is underway.