This could have been a disaster… - Specialised Health This could have been a disaster… - Specialised Health
July 26, 2016 specialisedhealth

This could have been a disaster…

spiral
We love sharing a big win, especially if it’s in Worker’s Comp. And for those folk that are working within the Worker’s Comp space on a day to day basis you’ll perhaps appreciate this a little more than others as I’d say you’ll relate to the story and could attest to the rarity of it.

We all know how much of a slippery slope the hierarchy of return to work can be. When the outcome rate of someone returning to a different employer sits at about 50% compared to the 90% chance of a positive outcome when someone is aiming to return to their current employer it obviously gives an indication of the difficulty of achieving a successful outcome once job seeking services start.

About 3 months ago we were referred a fellow’s case as he had essentially just been advised by his Specialist that since his left shoulder operation about 18 months ago, he had achieved basically all that was possible in terms of shoulder function, he wouldn’t be as strong as he used to be and essentially it was now deemed he wouldn’t be able to get back to his previous job of being a field technician (basically installing satellite dishes and other AV equipment into people’s homes). Climbing the ladders to get onto the roof would be too difficult, the T.V’s too heavy to lift, the equipment too hard to carry. You’ll need to get another job.

This is where the slippery slope starts… Well it likely started the moment the injury occurred as it takes a very supportive workplace, a very supportive GP and committed treatment providers etc to continue throughout an 18 month period of rehabilitation, graded RTW plans etc without getting jaded, losing focus and without the decline in the relationship between the worker and everyone else starting. But when the word comes that the previous job is no longer an option, the redeployment cogs start to turn and internal job sourcing kicks off. From there it again takes a very supportive employer to actively start sourcing a new role and invest the time in talking to other managers, working out other department’s budgets, “are they a good fit with these guys?, “do they know what they’re doing if we put them in that section” etc etc. It takes a lot to redeploy someone internally and prevent them from dropping even further down the rungs of the hierarchy where they have to start looking externally for another job which is where that 50% chance of a successful outcome kicks in.

Here’s where the upswing in the story starts though…

So throughout the 18 months of rehabilitation, it panned out that everything was really remaining within the whole “passive” sphere of treatment including physio, pain medication, pain management etc etc and there was never a dedicated “strengthening” component to the rehab. Sure, as an Exercise Physiologist I know that when it’s just the bursa involved in an injury to the shoulder (the fatty pad sitting under the collarbone which cushions the impact in the joint) and not a specific muscle tendon actually being injured then the shoulder still has a huge capacity to build strength as long as the pain can be tolerated. The shoulder lacks the “suspension” that the bursa usually provided but if the patient can handle the pain, they can build strength. And in this case the bursa was actually surgically removed totally from the shoulder due to the inflammation and calcification that eventuated rendering it basically useless.

So it sounds significant and probably something that you could easily be led to think wouldn’t be helped by putting someone through a gym routine, right?? Well not in this case..

The awesome Rehab Providers at IMR, based in Newtown, Sydney recognised that this key part of treatment was missing and referred the fellow across to us. The idea was that while the Specialist, GP and Physio thought this was the end of the road, hey, an EP program hasn’t been tried so let’s see where you can get them to. Long story short, after approximately 6 weeks of shoulder strength work we were starting to look at lifting overhead, pushing, pulling, reaching etc. Slowly, slowly we managed to get more and more range in the shoulder, started lifting heavier and heavier loads, so much so that we started to move BACK UP THE RETURN TO WORK HIERARCHY!! To Same Job / Same Employer! From staring down the barrel of redeployment and likely having to start job seeking for another employer very soon we had turned the ship around and were now gunning for a return back to the old role!

This is where this occurrence may not be appreciated completely if you haven’t spent a lot of time working in the Worker’s Comp environment as in my experience this just does not happen!

When he attended his next Specialist review the words from the Specialist to him were “Your strength is like chalk and cheese compared to our last review. You should be able to get back to your old job now.”

Since that appointment there’s been another 6 weeks of even further strengthening including more specific exercises, all based around nailing down everything that needs to be performed on a day to day basis in the old job. Carrying ladders overhead, lifting with one arm from the ground, holding both arms overhead to use drills, heavy carrying, we covered it all and he just continued to improve.

We’re now trialling pre-injury duties and in another 2 – 3 weeks the case will be closed. We’ll chalk it up as another positive outcome and pat ourselves on the back for helping this fellow avoid the downhill spiral that so many others unfortunately go down. Nice little bullet dodged there.

Awesome!