Using Work Hardening Techniques to Accelerate Return to Work

Risk Management |
Written by Kevin Lombardo

When the unfortunate occurs and a worker is injured on the job, there’s often little that can be done to avoid missed work days and the other costs that accompany workplace safety issues. Once a worker has entered the health care pipeline, the focus must turn immediately to rehabilitation and recovery.


Absenteeism affects employers in all industries, and lost work days due to injury or illness rank among the costliest elements of the workers’ compensation cycle.


The prevalence of musculoskeletal disorders implies major risk of absenteeism for employers. MSDs often require long recovery times for the afflicted worker—research from 2012 reported that 57.5 million Americans aged over 18 had to take time following a musculoskeletal injury, for an average term of nine days per person. Those missed days come with considerable costs to employers, who are forced to hire temporary labor or simply absorb the losses in productivity until the worker can return. And too often, workers come back to the job unprepared for its physical demands, as chronic pain and diminished strength, flexibility, and coordination can impair a worker’s ability to perform at their best.

The interdisciplinary science of work hardening proposes an integrated set of training and rehabilitation programs aimed at gradually improving a worker’s physical abilities following an injury. Customizable to each individual worker’s needs, work hardening initiatives can accelerate the employee’s return to work and save potential missed work days, making it an essential tool for employers experiencing high costs from absenteeism. 

Why is Work Hardening Important?


Most workplace safety managers and risk experts are well aware of the widespread occurrence of musculoskeletal injuries across some of the nation’s largest industries. Equally important in the cost equation for employers is the time it takes for workers to return to their jobs following an MSD. Each day an employee spends out of work for rest or treatment costs an average of $2,650 for a salaried worker, and close to $3,600 per day for an hourly worker. According to the Centers for Disease Control, absenteeism accounts for some $225 billion in costs to employers each year, as productivity losses force enterprises to cover missed work or even low-quality performance by workers who have returned, known as presenteeism. 

Presenteeism somewhat eludes direct cost analysis because it is difficult to quantify, but its effects on the budget are real. When an employee is injured and returns to work before they’ve been proven ready to perform at their best, lingering health, strength, and mental factors can disrupt the employee’s ability to focus on their work. Chronic pain, another of the costliest afflictions affecting the workforce, can also result from employees rushing back to work before they’re ready. The goal of work hardening programs is to help the worker move past the obstacles they’ll face on the road to recovery so that they can return to the job and remain safe in the future.

Who Benefits from Work Hardening?

Work hardening, also known as work conditioning or industrial rehabilitation, can provide injured employees with a safe route back to normal function at their jobs. Since work hardening programs draw from several physiological, biomechanical, and ergonomic strategies, they can easily be custom-tailored to the needs of specific employees. Still, employees whose jobs include strenuous physical exertion, difficult postures, or repetitive motion will likely see the best returns from work conditioning. 

The fact is that injuries affect workers in all industries, whether they’re on the factory floor or seated at a desk. When a worker suffers an injury and is forced out of work for rest and recovery, they typically experience deconditioning, wherein the worker’s physical strength, flexibility, mental focus, and dexterity all decrease as the worker falls out of the habit of performing their job tasks. The same occurs in sports injuries—athletic trainers and sports doctors utilize similar principles from work hardening programs to get athletes back on the field.

What to Expect from DORN’s Work Hardening/Return to Work Services

Here at DORN, we employ a range of tactics to help workers recover their physical abilities as they plan to return to their jobs after an injury. A typical program lasts as little as two weeks or can extend to four to six depending on the individual’s needs, with workers attending conditioning sessions for a few hours per day around two to three days a week. Exercises focus on strength, flexibility, coordination, and endurance, gradually increasing in difficulty as the employee regains their abilities in each area. Centrally important to the work hardening strategy is a reproduction of the employee’s work environment, and at DORN we work to specialize each session for every worker’s individual needs, based on their normal job tasks and the hazards inherent to their workplace. 

Combined with PainFree treatments, coaching, and biomechanics training, work hardening programs help you maintain a healthy, wellness-focused workforce, demonstrating to employees that you’re ready to help should they ever suffer an unfortunate injury or illness. As part of a holistic wellness program, work hardening brings talent back to the team quickly with reduced light duty and promotes a healthier workplace and a stronger financial outlook.

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About the Author

Kevin Lombardo

CEO & President at DORN Companies
Kevin is Senior Executive and widely recognized thought leader in workers’ compensation and Total Worker Wellness with a focus on workplace injury prevention and on-site innovative therapy solutions.
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About the Author

Kevin Lombardo

CEO & President at DORN Companies
Kevin is Senior Executive and widely recognized thought leader in workers’ compensation and Total Worker Wellness with a focus on workplace injury prevention and on-site innovative therapy solutions.
Contact Kevin