Work Hardening/Work Conditioning

Work Hardening/Work Conditioning

January 18, 2017
At ExpressMED/BOAC, we pride ourselves on quality care and customer service. At the forefront of our concerns is the ability to get injured employees back to work quickly and to the best of their abilities. Sometimes, a typical rehabilitation program needs some intensifying and tweaking in order for the employees to truly be able to transition back to their job successfully.

It is our relationship with Apple Therapy that allows us to incorporate Work Hardening/Work Conditioning programs to our course of treatment so that your employees have the best results possible and keep your costs down as well.

What is work hardening?

(The following are excerpts from an article from Property Casualty 360)
For an injured worker who has been away from the job for an extended period of time, re-entry into the workforce can prove challenging, both physically and psychologically. Advanced work rehabilitation (level II return-to-work) programs can significantly improve the likelihood of a successful transition and help to prevent re-injury — if the right rehabilitative path is chosen.

Workers’ compensation professionals who’ve been in the field for some time are probably familiar with the terms “work hardening” and “work conditioning” as options to prepare recovering employees to return to the workforce. Work-hardening programs were first developed to prepare injured workers physically and mentally to return to full duty, while conditioning them to either handle the demands of their former job or improve physical function enough to re-enter the workforce. For the majority of cases, a work-hardening program was used for skilled laborers, such as bricklayers or construction workers, or for those with physically demanding jobs, such as firefighters who had been out of work for a year or more. The classic work-hardening program is rarely used any longer. Because so few injured workers actually need this intensive program, the costs have become prohibitive.

Work-conditioning programs currently consist of a customizable return-to-work approach that typically provides therapy for about four hours a day, three to five days a week, for up to eight weeks, and focuses on physical or occupational therapy. While work hardening uses real or simulated work activities, work conditioning uses physical conditioning and functional activities related to the injured employee’s occupation Work-conditioning programs tend to be fairly aggressive — almost like a “boot camp” — to get injured workers to the physical level at which they can perform their job duties.

Today’s return-to-work programs continue to provide the intensive retraining and conditioning to get the injured worker prepared to report back to the workplace, but in a more streamlined and focused manner than historically defined work-hardening programs. They achieve the same goal — safe and effective re-entry into the workforce — at less cost and time than previous concepts.

How can it help your employees?

Apple Therapy’s goal for each injured worker under its care is to help the worker return to full work capacity without delay.  Some injured workers lose fitness and muscle tone while they convalesce from their injury.  They will return to work faster and safely after they go through a brief intensive program of exercise, called work hardening or work conditioning. A physical therapist or occupational therapist at Apple Therapy guides the enrollee through a customized plan of graduated physical challenges. Each worker follows a unique plan based on the severity of the injury and the tasks she or he is returning to. She or he also receives coaching on ways to prevent a re-injury. A typical program is 2 to 3 hours a day, 3 to 5 days per week, for 4 to 5 weeks.

The therapist writes a report at the end of the program detailing how the worker has regained abilities to the level the job requires.  The worker her or himself gains confidence that she or he can return to work safely and productively.


Patient: Nicholas Giuffrida

Injury: Severe right pec strain

Physician: Dr. Rix

Therapist: Janet Fee, OTR/L and Chris Morash, Apple Therapy Nashua

Nick is a 38 y.o. UPS package sorter who injured his right UE after a particularly busy week at work.  NIck describes his job as pushing air conditioners up over your head for half the night.  Nick treated with Dr. Rix and participated in PT near his home.  He was referred to Work Conditioning in November, demonstrating decreased RUE strength, lifting tolerances and general endurance.  Nick demonstrated an enthusiastic and positive approach and worked hard in the program.  He mentioned he was surprised at how de-conditioned he had become.  Nick made quick gains and was lifting the required 70lbs by early December.  At his follow-up with Dr. Rix, he was released back to his job.  Excellent work “St. Nick”, as his friends call him.