Work Hardening

Work hardening/conditioning is a sub-field of Industrial/Occupational medicine. When conducted by trained therapists, is geared toward returning injured workers to some level of beneficial work. Clients typically begin with general strengthening and conditioning and progress with their resistance and duration. Clients generally begin with 2-3 hours per session and progress towards 8 hours of occupational rehabilitation with the goal of returning to work. The patients, that can’t return to the same occupation, can often find other occupations involving less hours or different capacity / different job demands. 

Work hardening programs are designed to improve work capabilities / job tasks and is not designed to treat the underlying problem; therefore  treatments aimed to decrease pain or improve flexibility are typically not used with this program. Traditionally, a work hardening program is initiated after the patient has completed a standard physical rehabilitation program.

The American Physical Therapy Association (APTA) defines work hardening as, “a highly structured, goal-oriented, individualized intervention program designed to return the patient/client to work. Work Hardening programs, which are multidisciplinary in nature, use real or simulated work activities designed to restore physical, behavioral, and vocational functions. Work Hardening addresses the issues of productivity, safety, physical tolerances, and worker behaviors.” (APTA, 2005)

A typical course of work hardening would include weekly/daily progressions of strengthening, conditioning, material handling, and dynamic tasks. A typical intervention will include two plus hour sessions, three to five times per week for the first week. Weekly, clients are encourage to participate an additional hour plus of intervention so that by the sixth week, the client has demonstrated the ability to partake in 7-8 hours of physical activity replicating or exceeding occupational/work tasks.