Are You Functionally Aware, When it Comes to Your Patients?

[fa icon="calendar'] Nov 13, 2020 11:30:22 AM / by Erin Norton

What can you uncover with functional awareness?

Are there ways you can help your patients that maybe you haven’t thought of?

Physical therapists do a great job helping a patient regain strength, mobility and range of motion.  Could this be taken a step further by examining how it translates to function?  Adding functional testing skills to your repertoire can give you a new perspective on treatment.

Let’s take Jim for example. After a neck surgery, his therapy had him about 80% better. During therapy, Jim explained how he had to roll massive cast iron pipes, weighing hundreds of pounds. The therapist worked to incorporate exercises to help him meet these strenuous job demands. The therapist also talked him through body mechanics and weight shifting. By the end of his therapy, his range of motion was good, he had no pain after a typical day at home and he sailed through therapy.  This was good enough for the doctor to send him back to work.  

As soon as he started back on the job Jim began making complaints about neck pain. He was re-evaluated. All looked good with his neck and he was sent back to work. Jim continued to complain about his neck although the therapist and the doctor couldn’t figure out why it would be giving him trouble. It may seem obvious to some that Jim was self-limiting.

Luckily for Jim, the physical therapist worked on site and knew Jim well enough to know there was more to this case. The therapist took her lunch break to visit the job site and record Jim performing his duties. She talked with the supervisor, who explained how they had other employees performing the same job with no complaints.  The supervisor led her to watch one of the workers with 20 years of experience.

She first recorded this experienced employee rolling the massive pipe. He looked good: standing close to the pipe, arms bent to get good leverage, efficiently flipping and rolling as required. As Jim walked out for the next pipe, the difference was quite obvious.  Jim stood further away, arms fully extended, no confidence in his movements as he struggled to get the pipe moving. Even the supervisor could see the difference in body mechanics as they watched the scene. Digging deeper into Jim’s file, it was discovered that due to various circumstances after his hire, Jim didn’t have the same initial training as other employees in this position. The supervisor then provided Jim with more comprehensive education and his neck issues evaporated.

This short visit didn’t even take an entire lunch break yet it probably prevented future injuries for not only Jim, but for other employees and new hires as well.

You may be thinking, “I don’t work onsite. I can’t just run out to a job site like this.” You may not already have a relationship with an employer, but this might provide the opportunity to build one, which could lead to more referrals and additional services, many cash-based.

A visit to the job site is not the only avenue to help your patient progress that last 20% or so. Consider having your patient video themselves doing the job and bring it to therapy. You can use the video to see body mechanics, whether at a desk or at the task that causes the most pain. Even having the patient demonstrate the activity that bothers them the most, can help you figure out how to fix any lingering issues. Body mechanics and posture awareness are areas of education that can help the patient help themselves.

Many therapists have shared that after being trained in FCEs and RTW screens, they always think about how their treatment translates to function for the patient. ErgoScience can open up this new perspective. Contact us to find out more about training in functional testing.

Topics: Injury Prevention, Return to Work, "FCE"

Erin Norton

Written by Erin Norton

Erin help clinics find the best solution to fit their needs from functional capacity evaluations, to job analysis, pre-employment screens or impairment ratings.