When it comes to injuries, physical therapy is a must for getting back to 100%. When someone’s 100% includes successfully completing a job that involves lifting or pushing 50+ pounds multiple times per day or repetitive and continuous movements like walking, climbing, or bending, those are instances that require a more powerful tool: work conditioning.
Physical Therapy for Injured Workers
Physical therapy uses manual techniques to increase blood flow in soft tissues and to mobilize joints, paired with exercises to increase the strength and resiliency of the body tissue. A typical course of physical therapy lasts for an average of 12-14 visits over six weeks. Treatment also includes a Home Exercise Program designed for the individual patient’s needs. The best physical therapy programs focus on function, helping patients meet specific goals that are currently painful or impossible. These are identified at the first appointment and worked towards gradually throughout treatment.
For an injured worker, there is an additional element of the functional focus: the patient’s physical demands at work. Without focusing on these work-related activities, the patient won’t return to 100% and will be at risk for further injury upon returning to work.
What is Work Conditioning?
Work conditioning is a structured rehab program implemented by a physical or occupational therapist that emphasizes full-body strength, flexibility, and conditioning elements needed to perform all physical job demands before returning to work after an injury. On an injured worker’s road to recovery, work conditioning occurs following traditional physical therapy.
On the surface, physical therapy and work conditioning can look very similar. They implement exercises and job simulation to improve strength, endurance, flexibility, and body mechanics. A key difference is the duration and volume. Most physical therapy visits are about 60 minutes, and patients are seen 2-3 times per week. Work Conditioning visits are 3-4 hours, and are five days per week.
The additional volume and duration in a work conditioning program serve to re-condition the body and build up the endurance and tolerance for job tasks that often diminishes due to time away from work.
Who Can Benefit from Work Conditioning?
The first candidates that come to mind for Work Conditioning are those with very physically demanding jobs. This could include a firefighter who needs to practice lifting, carrying, or pulling heaving weights to effectively respond to an individual in distress during an emergency, or a carpenter or bricklayer whose job involves moving and handling heavy lumber or cinderblocks for 8-10 hours each day.
However, any injured worker with a non-sedentary occupation may benefit from work conditioning prior to returning to their job. Those who lift more than 20 pounds at work or are active and not sitting at a desk throughout the work day can benefit from work conditioning if they cannot meet their job’s physical demands with the help of solely traditional physical therapy.
What to Expect in Work Conditioning Program
Work conditioning is tailored to the individual patient’s needs based on their specific injury or end goals. This often involves different hour-long “circuits” during each visit. One circuit may be focused more on cardiovascular training, and another may focus more on job simulation or replication. Formal warm-up, cool-down, body mechanics training and flexibility are part of every visit as well. No two visits are the same, and no two patients’ programs are the same. Therapists guide and monitor the patient throughout each step to ensure safety and proper progress.
Are FCEs part of Work Conditioning?
An FCE is a Functional Capacity Evaluation, a 4-hour-long assessment of the person’s physical capacity relative to the physical demands of their job. In decades past, a patient would often be sent for an FCE both before and after a work conditioning program. However, this practice is not the norm anymore. FCEs are no longer needed before work conditioning. After working with a patient for 4-8 weeks in physical therapy, the therapist already knows the individual’s capacity and the starting point for designing the work conditioning circuits. FCEs are also often not needed after work conditioning, because the result of the program is to return the patient to 100%. If a patient achieves 100% and returns to their pre-injury level of function, there is no need for an FCE.
We Can Help
Therapists at Ivy Rehab have experience and training in helping patients recover from injuries and teaching ergonomics and injury prevention. If you have experienced an injury, either on the job or off, or have a job that may expose you to a potential injury, we can help. Click here to find a location near you.
If you are an employer and have observed a common pattern of work injuries or a high rate of injuries, there are options for Return-To-Work programs such as Work Conditioning, Injury Prevention, Ergonomics, and Job Demands Analysis that can meet your needs to reduce injuries and keep your workforce healthy, happy, and productive. Contact a location near you to learn more.
Article By: Matthew Lesniak, PT, DPT, FCE-Evaluator
Matt began his PT career 13 years ago, graduating with his DPT degree from Northwestern University in 2009. He loves working with the full range of patients seen in the outpatient environment and has treated individuals from four years to 90+ years old. He believes in the importance of providing rehab plans that integrate creative exercises with manual therapy to help people meet their health and functional goals. Matt specializes in overhead athletes, runners, post-ACL injury, and industrial athletes, including Work Conditioning and FCEs. For those individuals, as with all his patients, he strives to rehabilitate and educate on joint loading and movement patterns to recover from an injury fully and to prevent future recurrence. Matt currently treats patients at Ivy Rehab in Lisle, IL.
