Background Unpredictability, time constraints and having to constantly adapt to new situations characterise modem physiotherapy practice such that everyday clinical situations can be seen to have no easy and unambiguous solutions. Physiotherapists' practice has not yet been explored in the U.K. and their voices not yet heard, as they cope with increasing workloads in the day to day realities of busy hospital departments and their continuing professional development needs. Methodology and Design An eight months in-depth investigation into a team of NHS physiotherapists' construction of their day to day practice, viewed from a social constructionist stance, was carried out. The chosen paradigm for this study was ethnography as it embraces the importance of context related to time and the person. Analysis and Findings A systematic analysis of coding, categorising and identification of themes was carried out. All observations with the participants were followed up from a reflexive stance in the quest for a co-constituted account. Four main building blocks were identified as major contributors to the construction of the team's practice: the team's relationships with their patients, their negotiation and meaning of their food activities, their use of humour and their response to the visit from the inspectors from the Commission for Health Improvement. The institutional hierarchy and the demand for leadership skills in the senior therapist were the most potent parameters of the team's practice arena. Conclusions Contrasting themes have been presented as a way to explain the everyday world of this team's practice. The senior therapists had to manage the differing requirements of training the juniors alongside their own expectation of excellence. Propositional and craft knowledge have to complement each other more and critical reflexive dialogues are a powerful vehicle to achieve this, but the bi-annual rotations put this potential at risk. Hierarchical stances within a department can 'blur' issues by deflecting the juniors' expertise.