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Work Hardening

What is Work Hardening?

Injuries and conditions that affect the musculoskeletal system can have a diverse and varied effect on an individual’s functional level.  Beyond functional limitations in the home environment, challenges often present that limit or prevent an injured person from completely and safely performing job duties.  The inability to work can have far reaching effects on both the individual who has been injured as well as their families.  

Work Hardening is an interdisciplinary, individualized, job specific program of activity with a long-term goal of return to work. Work Hardening programs use real or simulated work tasks and progressively graded conditioning exercises that are based on the individual’s measured tolerances. Work hardening provides a transition between the sub-acute rehabilitation phase and successful return to work.  Work Hardening programs are designed to improve the biomechanical, neuromuscular, cardiovascular and psychosocial functioning of the worker, which improves the chances of a successful return to their prior job.

individualized treatment

At CPT, work hardening programs are overseen by our occupational therapy team.  The initial consultation involves collaboration between members of the rehabilitation team (including OT, PT, nurse case managers and physician) and the client. This diverse interaction supports a thorough understanding of the current condition, medical restrictions in place and ultimate functional level that is required and/or expected.  This communication is essential to establish the expectations and time line for the work hardening process.

Work Hardening at CPT Involves:
  • Development of strength and endurance of the individual in relation to the return to work goal:  The demands of a specific job are considered and appropriate goals outlined.  Methods that quantify and measure strength and conditioning levels are incorporated. These may include ergometers, dynamometers, treadmills, measured walking tolerances;  commercial strength and exercise devices, free weights, and circuit training.
  • Simulation of the critical work demands:  One of the main differences between a standard rehabilitation program and a work hardening program is the specific focus on the tasks and the environment of the job the worker will return to.  Job simulation tasks that provide for progression in frequency, load and duration are essential.  Providing the opportunity to practice work related positions and motions directly builds the clients conditioning toward those tasks and allows the occupational therapist the ability to directly observe and assess the effects of those tasks on the individual.
  • Education:  A successful work hardening program not only strives to return the client to meaningful work and employment, but also educates that worker to limit the risk of future or further injury.  A work hardening program incorporates training that stresses body mechanics, work pacing, safety and injury prevention as well as worker responsibility and self-management.
  • Assessment of the need for job modifications:  The ultimate goal of a work hardening program is to return a worker to their prior job without modifications.  However, there are times when this is not fully achievable and modifications are necessary.  Through the work hardening process, the therapist will closely observe and monitor the client’s response to simulated activities and ability to safely execute them.  If modifications, such as added equipment, changes in work position or ergonomics at the work site are necessary, those recommendations can be communicated to the physician and nurse case manager.