Study: Exercise Can Help Workers with Rotator Cuff Injuries Return to Work

RESISTANCE training, some of it job-specific, was successful in getting 90 percent of workers with severe rotator cuff injuries back to work, with the majority of the workers (75 percent) at their previous job. Furthermore, all but one of the 42 employees in the study (98 percent) reported satisfaction with the resistance-training program and its outcome, a study found.

Dr. Jamie Stark described this and five related studies of workers suffering work-related rotator cuff and lumbar fusion injuries at the Experimental Biology 2007 meeting in Washington, D.C. His presentations, on April 29, are part of the scientific program of the American Physiological Society.

Rotator cuff injuries involve those muscles and tendons that stabilize the shoulder and can be caused by pulling the arm out of place, by falls and other accidents. All 42 of the employees had been through surgery to repair their torn muscles or ligaments. All had already gone through weeks of traditional rehabilitation and physical therapy. However, none had been judged capable of going back to work and thus were eligible for disability and workers' compensation settlements.

This was just the patient population Stark, director of Research and Development at the Athletic and Therapeutic Institute in Chicago, and his colleagues at the research division of the Institute wanted. Nothing had worked for these patients, and the researchers figured that what would work for them also would work for employees with less severe injuries.

The injured employees attended the Institute program four hours a day, five days a week, on average for six weeks. Their daily training began with warm up, stretching, and core exercises for balance and proper biomechanics, then moved to free weight resistance training of the upper and lower body. Unlike traditional physical therapy programs after injuries, this program was a modified version of what professional and collegiate athletes do using free weights. On the third day of the week, the exercises involved less weight than the previous two days but were much more dynamic, addressing specific injury and biomechanical patterns related to the workers' previous jobs. During the last two days of each week, the amount of weight used during free weight lifting was heavier than that of the first two days of the week.

At the end of the six-week training, the workers were tested on physical function (a four hour protocol based on U.S. Department of Labor classifications of different types of work). Ninety-six percent of patients met or exceeded the physical function levels of their previous job, and 90 percent went back to work, most at their previous job. Almost all employees were satisfied with the program, and so were employers.

"We are at a new era in which we can develop standardized exercise prescriptions that produce desired, achievable functional goals," Stark said.

The researchers now seeks to test the model in a larger prospective trial of workers at varying levels of injury in order to demonstrate increased outcome efficacy with a standardized prescription and concurrently measure cost-benefit to the workers' compensation system.

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