Fit to work: Training and occupational rehab keep workers safe and healthy on the job

Monday, January 17, 2011
Chris Johnson completes an occupational therapy routine at Saint Francis Medical Center on Friday, Jan. 7, 2011. Johnson, a renovation and construction worker at Saint Francis Medical Center, will soon return to work after about three months of therapy to strengthen muscles and increase range of motion in his arm after undergoing rotator cuff and bicep reconstruction surgery in October (Kristin Eberts)

As a renovation and construction worker for over 30 years, Chris Johnson is used to manual labor and knowing how to avoid being hurt on the job. But on the morning of July 10, while working with a cable release dumpster system, the cable released so suddenly that Johnson sustained a severe shoulder injury. He had reconstructive rotator cuff surgery and partial bicep reconstruction on Oct. 3, and has been doing occupational therapy at Saint Francis Medical Center ever since.

"At first we just worked on trying to get my mobility and range of motion back," says Johnson of his therapy, which has included cable stretching and weight lifting. "Almost until three weeks ago, I couldn't raise my hand over my head all the way. Now I almost have my mobility and range of motion back. It's at about 85 percent. Strength is what we're working on now."

Johnson hasn't been able to work, but hopes to return part-time this month. Before getting the OK from his doctors and therapists, he will have to complete return-to-duty tests simulating his work responsibilities -- like carrying heavy buckets, climbing a ladder, pushing and pulling with a pressure gauge, and lifting from the ground up and the waist up.

"The idea is to evaluate them not just in the office, but to dynamically test people in order to get a secure idea that they can do the job safely," explains Dr. Dennis Straubinger, an occupational medicine physician at Saint Francis. "Instead of guessing, we test them to a standard. If they don't make the standard, we advise what they can do to make the standard."

In addition to helping injured workers like Johnson, occupational medicine is important for testing employees' health and wellness before they are officially hired for a job.

"The goal is to allow the companies to hire healthy people, not people who are going to be their next workman's comp claim," says Straubinger, adding that more companies are beginning to see the value in conducting post-offer evaluations of their employees. "The most cost-effective way to deal with workman's comp is to prevent the claim and prevent the injury," he says.

Straubinger tests each patient's cardiovascular health, vision and hearing, orthopedic and musculoskeletal issues before sending them on to dynamic testing, which, depending on the job, may include repetitive movements, climbing through portholes, running on a treadmill and more.

Dr. Thomas W. Marsh, director of Southeast Occupational Medicine, adds that a mental health evaluation is also an important part of post-offer testing.

"We want to ensure that a person is safe and on effective medications as necessary, and that any underlying problems will not get in the way of accomplishing the job," he says. "If it does, then we suggest accommodations that can be recommended. A lot of what we do is oriented toward making sure a person is not going to have problems doing the job in any capacity."

Mid America Rehab, with locations in Cape Girardeau, Perryville and Ste. Genevieve, Mo., offers outpatient physical therapy for injured workers, post-offer testing for potential employees, work conditioning, sports medicine and even on-site education programs about how to avoid workplace injuries, from proper posture and lifting techniques to ergonomic analyses. Mid America's functional testing program, WorkSTEPS, is the largest employment testing company in the country, with more than 1,000 testing facilities in 48 states. "When an employer wants to hire someone, the offer of employment is made and they are referred to us to make sure they're safe to do the job," says Bob Sherrill, director of the Cape Girardeau facility. "We screen their medical history, verify they don't have a current condition that would put them at risk of injury if hired, perform cardiovascular testing, check their range of motion and strength, and perform dynamic strength testing and job-specific testing to make sure they're safe to do the job. By verifying someone is safe to perform the essential functions of the job, we save employers a lot of money on work-related injury costs."

And Sherrill, like Straubinger, believes therapy and work screening is a quickly growing field of medical care.

"Physical therapy has grown in popularity over the years, as it is one of the most cost-effective ways to recover from an injury or surgery and to prevent future complications from a lack of range of motion or strength," he says.


Back injuries are the most expensive workman's comp claim against companies, says Dr. Dennis Straubinger, occupational medicine physician at Saint Francis Medical Center.

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