As specialists in workers’ compensation injuries and rehabilitation, ARC Physical Therapy+ has combined the expertise of some of the most recognized leaders in industrial physical therapy, rehabilitation, and sports performance to create the S.T.R.I.V.E. Work Conditioning Program. Learn more as we dive into this innovative and successful program that improves outcomes for both patients and employers.
What is STRIVE work conditioning?
STRIVE stands for Strength Training and Rehabilitation for Increased Vocational Effectiveness. As part of our STRIVE work conditioning program, ARC Physical Therapy+ collaborates with employers and patients to develop a functional return-to-work program that encompasses all the components of the job. The result? A restriction-free return to work and dramatically-improved long-term outcomes with fewer reported repeat injuries over time.
Through STRIVE work conditioning, we use the job site as the means for rehabilitation. Taking into account the unique demands of an employee’s specific job role, we design a customized solution to transition the injured area into working with the rest of the body.
However, it’s more than just determining if a patient can lift the 50-pound box. With ARC Physical Therapy +’s STRIVE program, we make sure the patient is prepared to lift the 50-pound box for eight hours a day, with safe body mechanics and in the positions required by the job. Sometimes, that means incorporating strength training, core conditioning, or cardiovascular training to improve the injured worker’s endurance and their ability to maintain safe body mechanics throughout their shift.
As a result, our patients are re-injured less frequently because they are better prepared to meet the requirements of their day-to-day job. Plus, employers get employees back to work safely and, many times, more quickly after a work-related injury. Less time off from full duty work translates to significant savings for employers and insurance carriers.
What does it look like from an employer’s perspective?
The STRIVE work conditioning program is designed to be a four-hour program for five days a week.
“I usually say that work conditioning takes people from saying, ‘I THINK I can go back to work,’ to saying, ‘I KNOW I can go back to work,’” Rich Kidwell, DPT and ARC Physical Therapy+ Regional Director, said.
When serving as an extension of the physical or occupational therapy rehabilitation and return-to-work programs, STRIVE work conditioning is appropriate for more physically demanding positions.
“It is ideal for someone that has done well in traditional PT and has reached their peak healing/strengthening for the injured body part, but cannot meet their physical job demands yet,” Nicole Grimm, ARC Physical Therapy+ Physical Therapist Assistant, said. “We are able to strengthen and condition the entire body in Work Conditioning during a 4-hour session much more effectively than you could in a 1-hour PT session.”
What can patients expect of the program?
STRIVE work conditioning helps patients with all aspects of their strength and endurance—not just rehabbing the injury.
The program is rooted deeply in exercise science, which includes: muscle grouping, muscle confusion, recovery times, multiple plane movements, cardio conditioning, functional stretching & joint mobility, and work simulation activities. The focus is on starting patients where their current abilities are and progressing them as they build up a greater tolerance.
STRIVE is designed and based on the Sports Medicine Model for injured high-level athletes. The model focuses on transitioning the injured worker, the “industrial athlete,” back to their full-speed/contact sport, or the essential physical demands of their specific job/position, through a rigorous process of conditioning with their therapist. It is the transition process from physical therapy/occupational therapy into a physically demanding environment. Similar to the high level athlete, you would not send that athlete straight from therapy back into their sport, without a safe transition process. The team trainer needs to gradually and safely ease that athlete back into their full contact/speed sport. Otherwise, that athlete is being set up for re-injury and is at risk for starting the whole treatment process over again. STRIVE work conditioning is that transition process for our “industrial athletes”. It’s hard work, but it provides the best opportunity to return to work full duty, enhance the injured worker’s livelihood and productivity, and live a healthy lifestyle.
“I tell patients that they will be sore at first, but it will give them the safest and most efficient way to get back to their job and decrease the risk for future re-injury,” Scott Jones, ARC Physical Therapy+ Director of Clinical Support Services, said.
What makes STRIVE work conditioning different from general physical therapy?
General physical therapy only targets an isolated area of injury. With STRIVE work conditioning, the focus is on whole-body strength, conditioning, and core strengthening, as well as higher-level activities related to patient job duties. Through job simulation activities, STRIVE takes into account the whole person, ensuring the injured worker can safely return to work and meet full-duty job demands in a shorter amount of time.
“Work conditioning can be very helpful in the return-to-work process for the right patient,” Thomas Samuelson, MD, an Orthopedic Surgeon at Kansas City Bone & Joint Clinic, said. “If I am working with a shoulder patient that has heavy lifting demands, I need to make sure the patient is capable of performing these job tasks, before I would feel comfortable in them safely being released from care.”
What are the benefits of STRIVE work conditioning?
Within the STRIVE program, therapists spend intensive, focused time on both the specific injury and increasing strength and endurance. Patients often see increased flexibility, improved body mechanics, boosted metabolism resulting in weight loss, and even decreased stress levels and better sleep. The program provides an increasing level of independence with recovery and continuation of self-directed rehabilitation and prevention exercises, and it gives patients a greater understanding of how and why movements are beneficial.
Patients who complete work conditioning gain confidence in their ability to return to work and progressively regain skills which allow them to safely meet their job demands. This is especially beneficial in situations where employers are unable to accommodate restrictions in the workplace. That way, it keeps patients moving toward the end goal of returning to full-duty work instead of remaining stationary at home.
“Having a patient go through a program like the one that ARC Physical Therapy+ has developed not only gives me confidence, but shows the patient that they’re capable of doing the work necessary to get back to their job,” Dr. Samuelson said. “I look at these work injuries from a big picture perspective, understanding that it’s my goal to not only fix the issue they’re coming to me for, but to ensure they don’t re-aggravate or re-injure that body part immediately upon returning to their job.”
What are the misconceptions about work conditioning?
At ARC Physical Therapy+, we want work conditioning to be a positive and productive experience for both the patient and the employer. The following misconceptions about work conditioning can, however, get in the way of utilizing this valuable resource.
■ High Cost: Many believe that the cost of work conditioning will be too high to justify the therapy. In situations where patients might otherwise be in physical therapy for more than an hour-and-a-half doing high-level activities, however, STRIVE work conditioning for four hours IS actually more cost-effective, in most situations. The value STRIVE work conditioning provides over general physical therapy in later stages of recovery is also significantly higher.
It’s very important to consider the long-term savings that occur with STRIVE utilization, vs alternatives. These long-term savings are related to a significant increase in return-to-work rates, decreased indemnity and medical costs, reduced re-injury rates, and decreased impairment ratings.
■ Re-injury: Often there is concern about re-injury during work conditioning. While re-injury is always a potential concern in any therapy or non-therapy setting, patients are carefully evaluated before beginning STRIVE. Therefore, we can identify their safe working level and set appropriate benchmarks for progress. Additionally, by referencing job descriptions and analysis, we know where the patient’s progress needs to be. So, if a patient’s job doesn’t require them to lift items overhead repeatedly, that would not be part of their work conditioning. Ultimately, the goal is to help the patient achieve a level of overall strength and endurance that may even be higher than it was before injury. Then, they are as safe as possible when resuming full job duties.
We also do not recommend STRIVE work conditioning for all patients. If the team at ARC Physical Therapy+ does not feel that it is a safe option for any patient, work conditioning will not be part of the treatment plan. If there are other medical issues at stake, we require clearance from the patient’s primary care provider before beginning the program.
■ Time in Therapy: It can be frustrating to have employees’ time tied up in seemingly endless yet necessary therapy hours. With STRIVE, however, employees can typically get up-to-speed with full job duty demands faster than if they were inactive at home (or simply doing one hour of general physical therapy). STRIVE can also be more efficient and effective than just performing modified/light duty work, as the patient is working side-by-side with a trained specialist and in a controlled environment, which allows optimal and safe progression of their physical abilities. Thus employees will be in a much better position following completion of two to four weeks of work conditioning than they would have been otherwise. And they may even be in better shape than they were before their injury.
How has STRIVE work conditioning made a difference for employers and patients?
STRIVE has been successful in helping a variety of employees. From police officers to bus drivers, firefighters, emergency response teams, truck drivers, corrections officers, landscapers, roofers, warehouse employees, nurses, and construction workers, we help our patients return to the work they love to do.
In many cases, patients have plateaued in therapy. But once they get into STRIVE, they experience a breakthrough and finally start making progress again in meeting their job demands.
“If the patient has been off full-duty work for months, has multiple injuries, or has had surgery, STRIVE work conditioning can especially be beneficial,” Danielle Garcia, ARC Physical Therapy+ Physical Therapy Assistant, said.
Some patients even take what they learn in STRIVE and make those exercises a part of a complete lifestyle change, which leads to better health overall. In turn, both the patient and employer benefit from STRIVE work conditioning.
The City of Olathe is a great example of the STRIVE work conditioning program at work.
“STRIVE has become our go to program for work conditioning, a program we trust will get our employees back to work full duty safely,” Jana Goolsby, the City of Olathe Well-Being Coordinator, explained.
“A couple of the key components we appreciate are the therapists’ dedication to understanding the physical demands of each employee’s job and how they teach the employee to sustain the strength and conditioning long-term. We have employees, who even after being released back to full duty, bring the workouts to our onsite workout facility and continue doing their program. It helps their overall well-being.”
Jana went on to offer this example, “Just recently, an employee was released back to work after back surgery, but he could only lift 40 pounds, and his job required him to lift 100 pounds. He would not be able to return to that job. We reached out to our case manager to see if he could try work conditioning before returning him to work, and she got him into ARC Physical Therapy+. After only 2 weeks, he was lifting 60 pounds and after 6 weeks, he was lifting 100 pounds safely, meeting all of the physical demands. The doctor was able to return him to full duty without restrictions. We believe this would not have happened without ARC Physical Therapy’s STRIVE work conditioning program.”
Interested in learning more about work conditioning for your employees? Contact us at (913) 831-2721 or email Tonya Knoettgen at tknoettgen@arcpt.com.
