Getting ready to go back to work

Specialized physical therapy programs are helping injured workers return to work with little to no limitations thanks in part to resourceful therapists who use everyday items to simulate work activities.

Industrial rehabilitation takes physical therapy a few steps further by incorporating job-related activities during therapy. They can range from simple repetitive motion exercises to climbing in and out of a semitrailer for drivers, moving riverboat cables for barge workers and lifting road signs for Missouri Department of Transportation employees.

When someone is injured on a job, the company loses a worker to the recovery process, thereby losing some productivity. Industrial rehabilitation ensures that when workers return to the job site, they pick up where they left off.

"That's the ultimate goal," said Matt Rubel, a physical therapist with Mid-America Rehab. Mid-America Rehab has a truck cab, ladders and a boat suspended on springs to help different workers practice for the return to work. Other physical therapy facilities have barge cables, ratchets, bricks and cinderblocks for patients to move in order to build their abilities after an injury.

"If we don't have the exact things they have to lift," Rubel said, "We try to simulate it through boxes or some type of device."

Larry Lizenbee, a Missouri Department of Transportation employee, lifted a road sign as physical therapist Matt Rubel observed at Mid-America Rehab in Cape Girardeau.

Rubel said imitating the actual motions and movements of the job is crucial to a successful return.

"That way whenever they're put back to their regular job, hopefully we've trained the right muscles they need, and we've gotten the flexibility they need to do their job," he said.

Rubel split industrial rehabilitation into four categories: employment testing, work conditioning, work hardening and functional capacity evaluations.

Employment testing is often used as a tool for hiring capable workers, but can be used as a baseline for returning to work after an injury.

"If you have a baseline test, that will allow us an objective measurement," said Jeff Thieret, physical therapist and coordinator of the industrial rehabilitation program at Saint Francis Medical Center.

If an employee does get hurt, he said, the therapists have something to refer to showing the worker's original abilities. That measurement is helpful whether it comes from a professional assessment or a personal knowledge of the patient.

Jacob Pattengill, a physical therapist at HealthSouth Rehabilitation Center, recently helped Lee Pattengill, his father, through a knee rehabilitation program that included work conditioning and work hardening.

"I knew what his prior level of [activity] was, and I knew what we needed to get it back to," Jacob Pattengill said.

Lee suffered a ruptured patellar tendon in January while working maintenance at Noranda Aluminum Inc., in New Madrid, Mo. The injury requires surgery as soon as possible and usually has a recovery period of five to seven months.

After his surgery, Lee was confined to a wheelchair for six weeks, underwent light physical therapy and in April started work conditioning. He returned to full duty activity in the beginning of July.

"I'm slower," Lee said of his current shape. But he said he can do everything his job needs him to do, like climbing ladders, moving heavy equipment, changing bolts and crawling on the ground.

A work conditioning program usually precedes work hardening. The activities are not as specific, and it may consist of general weightlifting, flexibility and body mechanics education like proper lifting techniques.

Work hardening uses different lifting and carrying exercises and more of the job-related simulations, Rubel said.

Daily tasks provide the basis for the rehab program. Centers usually get input from employers as to what the job demands of an employee, and they go from there.

Todd Wasilewski, a physical therapist at Southeast Outpatient Rehabilitation, said bigger cities have entire physical therapy centers devoted to industrial rehabilitation. Southeast has a job simulator with different attachments that mimic real-life motions, but still incorporates real tools.

"We simulate the job as best we can if we have the materials," he said. "That's the ideal."

charris@semissourian.com

335-6611, extension 246