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Work Hardening

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Dear Dr. Caraotta,

I injured my disc at work when lifting an air conditioner and was off work for three months. The company doctor is recommending work hardening, but he has to wait on the approval by the insurance company. Could you please explain what is work hardening and how could this help me? John.


Dr. Caraotta's Response:

Work hardening is a general term for conditioning a person to the type of job that was being performing prior to an injury. Patients are enrolled in a programs that are specifically designed to mimic activities that are encountered in the work place.

Along these lines, some physicians will use the patients work place as a 'work hardening' type of program by easing a patient into their position by having them work less hours or varying their tasks throughout the day.

In addition to work hardening, when a person has a significant musculoskeletal injury, it is wise to have the postural (kinetic chain) evaluated. That entails making sure a person does not have postural attitudes that need to be corrected through stretching and strengthening that could prevent them from further injury.

It is also important not to overlook the strength and flexibility of adjacent body parts. For example, a person with tight hamstrings will be more prone to low back injuries, and a person with over developed chest muscles are more prone to upper back problems.

After undergoing a work hardening program, and returning to work, it is sometimes wise to test the waters. Gradually building up to the pace that you had prior to the accident is wise. If your job entails performing the same type of activities that precipitated the injury, make sure that you are cautious with those activities and request help with lifting and bending when you feel you can compromise your health status.

Of course, a few common sense suggestions such as continuing with prescribed flexibility and strengthening exercises, along with communicating to your employer any activity that appears to aggravate the prior area of injury will help minimize the possibility of recurrences.

Sincerely,

Dr. Jacob G. Caraotta