WORK CONDITIONING PROGRAMS HELP INJURED RETURN TO JOB

Pat Strom watched the bioscope, which displays on a moving graph how she is using her shoulder muscles when she raised her arm. The bioscope helps the patient learn how to use muscle groups without injuring the muscles.

Physical therapist Allison Keith talked with Brad Nielsen as he used the Air Dyne bicycle to strengthen and help extend the range of motion of his knees after he had knee surgery.

Returning to work after an injury isn't just a matter of getting your internal clock readjusted to your on-the-job schedule. The body also has to be retrained and reconditioned to meet work demands.

People who have been off the job for weeks or months or longer while recovering from injuries and surgery to correct those injuries may be prescribed work conditioning, a physical therapy program combining aerobics, strengthening, mobility and body mechanics exercises designed to get them strong and healthy again so they can head back to work.

"When folks are hurt, they've been down for weeks or months or more than a year," said Sam Hite, director of occupational medicine at HealthSouth Rehabilitation in Cape Girardeau. "So the body has atrophied. Work conditioning is designed to encompass total body conditioning."

Robert Sherrill, owner and administrator of Mid-America Rehab in Cape Girardeau, said work conditioning usually involves taking a person who's been fairly sedentary and getting them back in good enough physical condition to return to work, all while teaching them not to re-aggravate the old injury.

"We do a lot of education," he said, particularly with back injuries.

That education includes unlearning old habits, said Joan Stehr of Physical Therapy Associates in Cape Girardeau.

"If it's a back or neck injury, we'll talk to them about positions they may assume that can cause problems," Stehr said. "People who work at a computer tend to work in a slump-shouldered, head forward position."

Patients also learn proper lifting techniques and good body mechanics. As an example, Sherrill said, a patient who works on an assembly line may have to learn to pivot as he turns to pick up items rather than simply reaching back across his body.

Work conditioning programs include aerobic and weight lifting components as well as the education on body mechanics and techniques.

"A lot of these people are very weak and they don't have any strength or stamina," Sherrill said.

Patients may use treadmills or stationary bicycles for their aerobics, he said.

As for the weight lifting, Stehr said, most physical therapy clinics include "the same equipment you'll find at a Universal Fitness or Main Street Fitness or any of those places."

Most of the injuries physical therapists see for work conditioning are back injuries, said Pattie Ammon, co-owner of Jackson Physical Therapy.

Therapists "try and reproduce" work conditions as much as possible in terms of the type of lifting required for the task in order to teach lifting techniques, she said.

Without physical therapy, workers who have been off the job for a while run the risk of being re-injured, Sherrill said. In addition to addressing workers' physical needs, therapists also help "pump up" patients who may be nervous about having to return to work after suffering injuries.

Work conditioning is a newer approach geared toward preparing workers for light-duty type assignments. Once on those light-duty tasks, the work itself will help employees get back into condition.

Patients in a work conditioning program might go to therapy for an hour or two a day.

Work hardening, a more intense type of physical therapy, is losing popularity with some physicians and insurance companies.

"The reasoning is, if he can go to therapy for eight hours a day, why can't he come into work?" Sherrill said.

Work hardening can be more expensive than work conditioning, Hite said -- by about $100 a day -- but there is a place for it.

In work hardening, patients will actually perform a part of their job so that a therapist can assess whether they are ready to return to work full-time. For example, construction workers might build a wall to demonstrate whether they have the strength and flexibility to perform the job.