So, you have a patient with a work-related injury. He has finished the prescribed course of outpatient physical therapy, but his Return-To-Work Screen revealed that he doesn’t have the physical ability to do his job. No problem, just put together some exercises he can do for a few hours each day and call it work conditioning. Easy, right?
Well, not exactly. Not if you want your patient to receive the maximum benefit from this program.
There are three common mistakes therapists often make when developing work conditioning programs.
- Not progressing the patient
- Not providing adequate feedback to the patient
- Not communicating with the case manager
The number one most common mistake made by, both young and experienced, therapists is not progressing the program. Often a therapist will start the patient at a weight he/she can handle safely but fail to proactively progress the patient as soon as the additional weight can be handled safely. Understandably, you want your clients to be as independent with the program as possible - after all, they will be doing their job tasks independently. And it’s easy to lose track of what someone’s doing if they’re working “semi” independently. But as a therapist, you can’t be so hands-off that your patient stays at the introductory weight. Patients won’t know when it’s safe to progress themselves.
In addition to progressing weights, the patient may need to work on maintaining non-materials handling activities – like bending, squatting, reaching, kneeling, standing, climbing stairs, walking etc.
Without proactive progression, your patient will likely benefit somewhat from a work conditioning program - just because they are moving and exercising, instead of being sedentary. But they won’t achieve their goals as effectively and efficiently, as they would if you were proactively progressing the program.
In our Industrial Athlete Mastery Series we teach a systematic method for progressing your patient from his starting point to the return-to-work requirements in the time frame specified.
Another common mistake is not providing enough feedback to the patient. Part of the beauty of work conditioning is that the patient is semi-autonomous. You can set them up with exercises and you are relatively hands off. But that doesn’t mean you “set it and forget it.” You still have to make sure the work conditioning patient is staying on task, maintaining a pace that is similar to their work, and using proper body mechanics and lifting technique.
This is an opportunity to change your patients’ old work habits to ones that are more ergonomically sound. It’s a chance to educate them on safe work practices for protecting their bodies over the long haul. Teaching body mechanics and lifting often requires multiple instances of re-enforcement – as well as building the strength, flexibility, coordination and balance needed for safe work practices.
Learn the most effective ways to provide feedback to the patient in our Industrial Athlete Mastery Series.
The third most common mistake in work conditioning is not communicating with the case manager or adjustor. For any patient with a work-related injury, you need to send regular progress notes to the case manager and/or insurance adjustor. If something isn’t quite right, you need to pick up the phone and call them. Timely communication is greatly valued and appreciated and will be a reason you get additional referrals in the future.
For instance, if the program is not progressing as quickly as should, let the case manager/adjustor know before the sessions are over. That way they can request more work conditioning, if needed, and get it approved in time to prevent a gap in treatment.
You should also communicate with the case manager or adjustor if you identify ongoing behavioral issues, like the patient being chronically late or not working during the session. The case manager or adjustor must be made aware of these issues so they can determine how to best help the patient.
Learn the most effective ways to communicate with your referral sources in our Industrial Athlete Mastery Series.
In summary… Implementing work conditioning in your clinic is a great service to help the injured workers get back to work if they need a little extra help beyond acute physical therapy. But it must be implemented correctly so patients receive maximum benefit.
Become the expert… If you are interested in in diving deeper, the ErgoScience Industrial Athlete Mastery Series includes four courses designed to help clinicians:
- navigate the workers compensation system
- feel more confident about RTW recommendations,
- deal more effectively with patients who demonstrate self-limiting behavior,
- develop progressive work conditioning programs
- incorporate functional testing into treatment of patients with work-related injuries, and just better understanding the work comp system
- increase their work comp referrals,
Check out our Industrial Athlete Mastery Course Series today.
