Living with Chronic Pain

What Is Work Hardening?


Work hardening is a specific type of rehabilitation designed to help injured employees return to work. It is a multidisciplinary program with the goal of meeting physical, functional, and emotional or psychosocial needs, as well as any job-specific needs. Work hardening involves working with a physical therapist, occupational therapist, psychologist, or vocational specialist. It may be especially beneficial for employees in labor-intensive professions, such as firefighters, police officers, construction workers, healthcare providers, electricians or plumbers.

A work hardening program typically begins with an assessment of the individual’s functional abilities. This may include evaluation of the ability to walk, climb stairs, bend and rotate, lift and carry objects, perform pushing and pulling activities, squat, kneel, utilize gross- and fine-motor skills, and other activities as required by the individual’s occupation. The individual’s aerobic capacity, core strength, and joint strength may also be assessed.

Based on these assessments, a four- to eight-week program is tailored to the individual’s needs. Activities that may be part of a work hardening program include the following:

  • Stretching and strengthening exercises
  • Cardiovascular exercises
  • Mobility conditioning
  • Work-simulation tasks
  • Training in proper body mechanics
  • Instruction in stress management techniques
  • Treatment for anxiety or depression
  • Individual or group therapy sessions

Work hardening programs typically involve a significant time commitment, requiring several hours of activities per day, several days per week. This helps build the individual’s endurance and helps reinforce positive behaviors, such as regular attendance.

Work hardening programs can help individuals successfully return to work with a reduced risk of recurrent injury or pain. They can also help prevent chronic or permanent disability that may otherwise affect injured employees.

Additional resources used for the creation of this article include the Journal of Orthopaedic and Sports Physical Therapy and Robbins Rehabilitation West.

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