A Musculoskeletal Return To Work Of Phenomenal Measures!
If ever anyone were up for a return to work challenge, James Danos, our Melbourne-based Exercise Physiologist, would have to take the cake!
Getting someone back to their full-time hours after an injury can be challenging enough in itself… But what if full-time hours for that person meant an 86 hour work roster?
86 hours. You read that right! Not just the standard 40-50 hour return to work goal, but literally double that. It’s a good thing that James has an appetite for challenge!
Steven (name changed for privacy) was referred to our service in July last year following spinal decompression surgery for two of his lumbar (lower back) vertebrae.
Steven’s Story…
When James first met Steven, he had been off work for over a year already – with two cortisone injections, and an epidural – all of which had done little to help to resolve the pain. While the decompression surgery had improved his symptoms, he still experienced persistent lower back pain and was demonstrating some less than ideal coping strategies. As a previously busy and active young man, Steven was extremely keen to return to his work as a heavy mobile plant mechanic. But his insurer knew that they needed to proceed with caution. James was just the man to help.
With Steven’s role as a diesel mechanic came lifting and carrying loads of up to 25kg, working above his head, heavy pushing and pulling, climbing up and down benches, sustained awkward positions, bending, stooping, squatting… Basically, all the things that tend to aggravate a sensitive back! Not only this, but Steven worked 12 hour days, with a roster of 14 days on, 7 days off. Good luck James…
Steven’s employer was very clear that he wanted Steven to be physically fit for all duties prior to returning him to site, with a specialist sign-off to say that he had been cleared for work. This meant that Steven firstly needed to be able to tolerate this wide range of movements, loads, and postures, and secondly, needed the endurance to last throughout a looooooonnnngggg working week.
James and Steven worked together, starting by increasing Steven’s understanding of his pain and the factors that can influence it. He was set up with a gym program that aimed to gradually strengthen his body in ways that replicated the physical tasks needed in the workplace, with those wide-ranging movements and postures in mind. As is common with chronic pain patients, James also had to work to reduce some fear-avoidance behaviours, using breathing / relaxation exercises to help him find comfort and confidence in new and different positions.
It didn’t take long before Steven started showing an increased interest in returning to work. After plenty of discussion around the need to carefully manage the work-related loads, James contacted his specialist.
By the time the program had finished in November, Steven was completing 30-40 hours per week of tasks within his pre-disability role, and feeling great. He had been certified by his specialist as fit to return to his usual 84-hour working roster, and they were in the process of liaising with the employer to plan his return to work!
Great outcomes on a particularly challenging case. Well done James!
Author: Yolanda van Vugt
Clinical Exercise Physiologist and Content Creator at Specialised Health
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