Integration of sports and exercise medicine into Saudi primary care: a narrative review from family medicine perspective

Background Saudi Arabia faces dual pressures from a high non-communicable disease (NCD) burden driven by physical inactivity and accelerating sports participation under Vision 2030. Family physicians in primary health care (PHC) are central to both challenges but lack a structured framework for integrating sports medicine and exercise medicine into routine practice. Objective To define core sports and exercise medicine roles for family physicians, identify barriers and facilitators using a SWOT framework, and propose a contextualized integration model for Saudi primary care. Methods A single-author narrative review was conducted. MEDLINE (via PubMed) and Embase were searched for English-language publications from January 2000 to July 2026; Google Scholar and the official websites of Saudi governmental and sports organizations, WHO, ACSM, ADA, AMSSM, and IOC were also searched. Clinical guidelines and consensus statements from WHO, ACSM, AHA, ESC, ADA, AMSSM, and IOC were included. No formal quality appraisal was undertaken; evidence was weighted pragmatically according to study design and population relevance. Results Five core roles were identified: (1) preparticipation evaluation and cardiovascular risk screening; (2) exercise prescription for NCD prevention and management; (3) prevention of sports injuries and illness, including exertional heat illness and overtraining; (4) assessment and rehabilitation of acute, chronic, and overuse injuries; and (5) care of special populations, including youth, female, older adult, and para-sport athletes. SWOT analysis identified Vision 2030 alignment and digital health infrastructure as strengths; training and curriculum gaps as the principal modifiable weakness; expanding sports infrastructure and the NCD burden as opportunities; and geographic workforce concentration as a key threat. Conclusion The Saudi Primary Care Sports and Exercise Medicine (SPCSM) Framework is a literature-informed, not-yet-piloted proposal comprising three pillars: Workforce Capability, Service Architecture, and Health Intelligence, with phased implementation from 2026 to 2032 within existing PHC clusters. Structured integration of sports and exercise medicine into Saudi family practice appears clinically rational and potentially feasible; empirical evaluation through prospective pilot studies and stakeholder co-design is required before conclusions about implementation readiness can be drawn.