Challenges persist in implementing inclusive education policies, particularly in rural provinces of South Africa. The challenges are compounded by the existing imbalance in the distribution of physiotherapists where more of them are in the health sector. Physiotherapists possess the competency to assess activity limitations and provide individualised therapeutic support to people living with physical disabilities. In addition, physiotherapists understand how the classroom and school environment can be modified to maximise participation of learners. This study explored the knowledge of education physiotherapists and challenges experienced in implementing the policy to Screen, Identify, Assess, and Support learners with physical disabilities. A qualitative, single exploratory case study design using virtual focus group discussion collected data from seven physiotherapists employed by the provincial Department of Education. Data were analysed with a six-step approach to inductive thematic data analysis on ATLAS.ti version 19 software. Three themes emerged. (1) Lack of knowledge due to insufficient training, policy misinterpretation and unclear roles and responsibilities (2) Lack of support structures with regards to the School-Based Support Teams, Circuit-Based Support Teams and District-Based Support Teams. (3) Shortage of physiotherapists’ posts in special schools. Strategies like ongoing in-service training, clarification with policy interpretation, defining roles and responsibilities of physiotherapists, improving the functioning of support structures, and offering competitive incentives to attract skilled education physiotherapists are reported essential for effective policy implementation.