Top Three Mistakes in Work Conditioning

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.

1. Not progressing the patient
2. Not providing adequate feedback to the patient
3. Not communicating with the case manager

The number one most common mistake made by both experienced and inexperienced therapists is failing to progress 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-material 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 Workers Comp 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 techniques.

This is an opportunity to change your patients’ old work habits into 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. In the ErgoScience Worker’s Comp Mastery Series courses, you’ll learn the most effective ways to track progress and provide feedback to the patient.

The third most common mistake in work conditioning is not communicating with the case manager or insurance adjuster. For any patient with a work-related injury, you must send regular progress notes to the case manager and/or insurance adjuster. If something isn’t quite right with patient cooperation or progress, 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 allowed treatment 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.

We teach the most effective ways to communicate with your referral sources in our Worker’s Comp Mastery Series.

In summary... Implementing work conditioning in your clinic is a great service to help injured workers get back to work if they need help achieving functional goals beyond acute physical therapy. However, this service must be implemented correctly so patients receive maximum benefit.

Become the expert... If you are interested in diving deeper, the ErgoScience Worker’s Comp Mastery Series includes four courses designed to help clinicians:

• navigate and better understand not only what is involved in the workers' compensation system but, just as importantly, who is involved.
• feel more confident about RTW recommendations and know when to offer them to occ health physicians
• deal more effectively with patients who demonstrate self-limiting behavior
• develop progressive work conditioning programs based on functional tasks
• incorporate functional testing into treatment of all patients
• increase work comp referrals by identifying the major workers’ comp players in your area and giving them the information your competitors can’t.

Check out our Worker’s Comp Mastery Course Series today to become the preferred work comp provider in your area.