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Injured workers climb, dig their way back to health

Monday, Jan. 28 | By Mark Grandstaff | Google+
David Gould and Andy Dart demonstrate how firefighters use one station in their facility to simulate everyday conditions while wearing turn-out gear at Industrial Rehabilitation Services in Warrenton. Photo by Randy Litzinger
For injured workers, the road back to work can be arduous.

A work rehabilitation center in Warrenton takes that road through a back room full of pipe fittings, ladders and endless gravel piles.

Industrial Rehabilitation Services, located on Belle Air Lane in Warrenton, sets itself apart with a 6,200-square-foot facility where patients check in for eight-hour "work" days, going through the motions with workplace props while physical therapists monitor their progress.

The front of IRS's office resembles a traditional work rehab center, with a line of treadmills and free weights awaiting patients.

But in the back, it's a whole different ball game.

Ladders lean against the walls. An elevated pit holds five cubic yards of dirt for digging post holes. Cubbyholes wait for mail sorting.

The idea, said physical therapist Anderson Dart, is to smooth the transition from rehab therapy to re-entering the work force. IRS calls it "work hardening."

"It's a pretty big jump for a blue-collar worker after a back surgery, and they're going to therapy three days a week for an hour, and all of a sudden they've got to stop and go back to an eight-hour day," Dart said.

IRS does a lot of business with Virginia Department of Transportation workers and firefighters, Dart said. They also see postal and retail workers, and so their work rehab props run the gamut from full-body activity to simple, repetitive tasks that can cause injury.

The props let IRS therapists watch an injured worker's technique, which helps them suggest exercises or different motions to lessen the pain. Working with the props for the equivalent of a full workday helps patients rebuild the endurance to get back on the job, Dart said.

Some of those props, to the untrained eye, seem anywhere from Sisyphean to sadistic.

David Gould, a work-hardening coordinator, lifted a shovelful of gravel and dumped it into a diagonal slot. The slot feeds the gravel back into the pile from which it came.

While it might sound like punishment, Gould said many patients are eager to dig post holes and shovel gravel all day.

"Yeah, they're tired, they're sore, but they've done something with their day as opposed to just feeling useless," Gould said.

Many workers wrap their identities around the work that they do, he said. When an injury takes away that ability, it can shatter morale.

"Sometimes they have nothing left," Gould said.

IRS's work hardening tries to rebuild that morale. The patient gets back into the routine of waking up early, fighting traffic, working, and taking a lunch break.

Through it all, IRS therapists watch their patients, gauging their level of pain and stepping in when necessary.

"A lot of it is watching body mechanics," said Allison Carr, functional capacity coordinator.

Like "tells" in a poker game, the body has ways of compensating for and responding to painful positions, Carr said.

Therapists look out for those tells, and they also make sure their patients are acting in good faith.

People who feign injury or try to game the worker's comp system are in the vast minority, Gould said, but they do exist. IRS has been in business only since last April, but they've already encountered a few such cases.

IRS's purpose isn't to ferret out the fakers, Gould said, but some of their work props help keep their patients honest. A few of their weights are intentionally mislabeled, he said.

But most of the injured workers are eager to work, and IRS is eager to help them.

Dr. Jeff Wise, president of Blue Ridge Orthopaedic and Spine Center, said he was impressed by the task-specific nature of IRS's work-hardening program.

"This is the only facility in this area where the injured worker's job can be simulated to determine whether or not they're capable of work," Wise said.
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