Sometimes, the right environment makes all the difference in rehabilitation. For Donna (name changed for privacy), that environment was her own home.
Donna experienced a workplace accident which caused a spiral fracture with several millimeters of bone overlap in her left wrist. She was placed in a cast for 7 weeks but fast forward several months and her recovery was not going to plan. Donna was experiencing persistent pain and stiffness in her wrist, terrible grip strength and a lot of ongoing discomfort and pain in her shoulder. She avoided using her hand for everyday movements, taking a protective approach with everything that she did. Her occupational physician suspected signs of early complex regional pain syndrome and emphasized that active engagement in rehabilitation would be crucial to her recovery.
Referral to Exercise Physiology
Donna was referred to our Exercise Physiology service 6 months after her injury, still struggling with pain, weakness and poor mobility in her wrist, hand and shoulder. Her sleep was disrupted due to pain and mental ruminations, which – combined with significant deconditioning – had her feeling fatigued and struggling to concentrate.
Donna worked in an active role at a busy post office. Her role involved lifting and carrying packages up to 20kg, sorting and maneuvering parcels, sliding pallets and repetitive tasks such as scanning and data entry. At the time of being referred, she had returned to working 30 hours per week on light duties but she was fearful of exacerbating her pain and was continuing to avoid using her hand whenever possible.
To ensure a sustainable return to work, she needed to regain both the strength and the confidence to use her left wrist at work. While she was receiving onsite physiotherapy 1-2x per week, her fear-avoidance behaviours, pain and reduced range of motion were holding her back.
Her Case Manager knew that she needed more support to keep her progressing and thankfully, they thought of us.
The Turning Point
Auckland based EP Natalie began a six-week exercise program based at Donna’s home. The program focused on hand, wrist and shoulder mobility, functional retraining, strength and pain management education. As Donna progressed under Natalie’s guidance, things started to fall into place.
Natalie arranged to have the necessary exercise equipment delivered to her house. Without the need to travel to a clinic or gym, Donna was able to focus on her exercises in a safe, comfortable and familiar environment. She engaged with every session, approached her exercises with consistency and diligence and began using her injured hand actively rather than avoiding movement out of fear or guarding.
Natalie worked alongside the other rehab professionals involved in Donna’s rehab, visiting the worksite for case conferences with the occupational physiotherapist and Donna’s manager. This allowed her to see for herself the physical requirements of Donna’s role and tailor the exercises to meet the specific demands.
Donna’s Case Manager remarked, “This is the most engagement we have seen from her in her whole rehab journey!”. Being able to access rehabilitation from the comfort of her own home was the turning point that allowed Donna to build trust in the rehabilitation process. With this trust came commitment, consistency, and progress.
Bringing It Home
Fast forward another three months and Donna has gone from strength to strength!
By progressively building her mobility, strength and confidence, Donna is now safely lifting up to 16 kilograms and working toward the full 20 kilograms required for her role.
She has returned to the majority of her duties, working 40 hours per week and has the stamina to complete almost 10,000 steps per day on the job. Perhaps equally importantly, she remains diligent and engaged with her rehab exercises, showing the difference that it makes to meet people where they are.
At the end of the EP program, the occupational health physiotherapist sent our EP, Natalie a message:
“Just wanted to say thank you again for the work you have put into supporting Donna’s recovery and RTW. I have really seen a difference in Donna’s function and confidence since starting her programme with you. Hopefully we are on the final stretch towards Donna achieving her FRTW in the next few weeks, and a lot of this is down to the work she has done with you.”
Why Home-Based Rehab Works
Donna’s story highlights why home-based exercise physiology can be a game changer, especially for clients facing complex injuries, fatigue or anxiety. We love taking clients to local gyms or getting them into the community but when fear of movement or pain is a limiting factor, bringing rehab into the comfort of their home removes many of the barriers to engagement. It increases feelings of safety, allows the individual to integrate rehab exercises in their everyday life and encourages more active participation in the program.
For Donna, this was exactly what she needed to feel supported, build trust and engage fully in her rehab .
With the right environment, the right guidance and strong collaboration, clients like Donna can finally start to move forwards with confidence.
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