Bryan Bogue, the Fire Captain with the City of Independence, Missouri Fire Department was on a medical call and needed to lift a heavy bag over a concrete wall. It seemed like a fairly straightforward task until he raised his arms and felt a tendon snap in his elbow. The pain was immediate and severe.
The next day, following protocol, he visited the City of Independence’s workers’ compensation doctor who confirmed nothing was broken, gave him a cortisone shot and told him to take it easy. Unfortunately for Bryan, rest didn’t help the pain. Eventually he was sent to a specialist who recommended occupational therapy at ARC Physical Therapy+.

Upon arriving at his first appointment he met his Occupational Therapist and Certified Hand Therapist, Jacob Lenox, and they got to work.
“I spend a lot of time educating my patients on the anatomy/physiology, handling techniques, ergonomics, modalities, and ways to prevent symptom exacerbation,” Jacob explained. “I want my patients to have a great understanding on ways to promote tissue healing at home, work, and with recreational activities.”
Right away, they were both impressed with one another.
Jacob shared what it was like when Bryan arrived, “He came in with a positive, fun personality, a sense of humor and an energy that was contagious. He was able to talk to anyone in the clinic and I truly believe other patients looked at his motivation and it made them want to get better.”
Bryan could tell he was in good hands right away, “Jacob was awesome. He’s professional and knowledgeable, really just an exceptional OT.”
Amazingly, after about a month of occupational therapy and a range of treatment techniques such as heat/ice, stretching, soft tissue mobilization, isometric/eccentric strengthening, scapular stabilization, neuromuscular reeducation, and pain-free therapeutic activities that increased his ability to perform work activities, Bryan felt 100%. He completed and passed the required Fit for Duty test and went back to work.
But a month passed and his elbow started hurting again. Simple things like putting on deodorant and washing his back became a challenge. He went back to his specialist where they found a tear in the elbow they had originally missed.
Bryan called Jacob and the two renewed their commitment to Bryan’s recovery. They spent 2 months working together, meeting several times a week for an hour at a time, focusing on range of motion and getting him to a place where he could build up his strength again and get back to work.
Jacob hated to see that Bryan was experiencing pain and unable to work, but was glad he had the opportunity to work with him again.
“Bryan is an ideal patient. He is very communicative about his symptoms and how his injury affects his function. He is a very hard worker and compliant with recommendations. His diagnosis can be tricky, but he was patient and understanding with the process. I typically see great results with firefighters and police officers. They really want to get back to work and their motivation and passion makes you love your job.”
Bryan had nothing but positive things to say about his therapist as well.
“Jacob is progressive,” Bryan pointed out. “He goes out of the way to stay up-to-date on the newest techniques and is very willing to try new things. It was a good relationship because he wants to get better and with my medical background as an EMT, I completely understand the need to be forward-thinking. I was willing to let him try new techniques on me knowing that it would make him a better OT and allow him to help more people in the long run.”
After 2 months, Bryan’s pain was mostly gone and he moved from Occupational Therapy to Work Conditioning, an individualized program designed to get people back to work. Physical Therapy Assistant Lina Jaramillo took over and worked with Bryan for 4 hours at a time, 3 times a week.
“Work conditioning was really hard,” Bryan confided. “It was a great full-body workout. I’m definitely in better shape now than before my injury.”
After a month of intense training, Bryan was ready for his second Fit for Duty test. He passed with flying colors and was thrilled to go back to work.
“During my therapy I was working, but on light duty, doing administrative work. I wasn’t allowed to be in the field. Let’s just say I was more than ready to get back to doing what I love.”

As Bryan and Jacob reflect on their time together, they had nothing but positive things to say.
“I really enjoyed working with Bryan,” Jacob shared. “I would consider him a good friend. He is the type of patient where you feel bittersweet when they get discharged: happy that they are able to get back to their daily activities but sad that you don’t get to spend 2-3 days with them a week.”
“I feel really fortunate I had Jacob as my OT,” Bryan explained. “I wish him a long and successful career. Really, everyone at ARC Physical Therapy+ is amazing. I would recommend them to anyone who needs help with recovery and getting back to work.”
If you need to get your team back to work sooner, contact ARC Physical Therapy+ at (913) 831-2721. We are the region’s foremost injury prevention, rehabilitation and return to work specialists and can help you save thousands on workers’ compensation claims each year.