Initial Teacher Education (ITE) is a critical arena for advancing inclusion in Health and Physical Education (HPE). This paper reports research that is engaging with the diversity of the HPE profession and practitioners. It centres on a unique case study that critically explored the school-based professional experience of an Australian secondary HPE Pre-service Teacher (PsT) who has a hearing impairment. Specifically, to enable PST success in HPE professional experiences as defined by the professional standards for teachers in Australia and to which, PSTs' must evidence to graduate and attain teacher registration. Drawing on documentary and interview data the paper focuses on tensions identified between the bureaucratic environment of ITE and the legislation of 'reasonable adjustments' for students with additional needs. Discussion highlights the expertise that PsTs with additional needs can bring to inform institutional and sector-wide work to advance equity and inclusion in ITE. Our research shows that graduate employability of peoples with additional needs in HPE teacher education relies on the inclusive interpretation and application of the professional standards for teachers. We advocate further research to increase knowledge(s) supporting (i) the representation of people with additional needs in HPE teaching and (ii) inclusive practice in HPE ITE courses.