Rehab experts share how they came to incorporate ergonomics for workers into their own jobs, and why others might want to do the same.
by Virginia Marshall (Halling), PT
Seven rehab experts with a wide range of backgrounds answer three questions about how and why they’ve integrated ergonomics into their professional work. Their diverse responses shed light on why all rehab professionals should consider making ergonomics part of their own repertoire.
1. How did a career in rehabilitation lead you to ergonomics?
Nancy Bellendorf, OTR/L, owner, Worksafe Therapy & Ergonomics: In college, we had a visiting therapist who performed work in industry. My interest was piqued. After a year of working in general hospital and outpatient settings, I landed a job in a work hardening center. During that time, I started doing job site visits. It was amazing to find out how often there were fairly obvious reasons (to us) why the worker was sore and there were some simple solutions to help the workers get safely back to work. I took ergonomics-related classes and continuing education to help build greater knowledge of ways to evaluate and develop solutions. I learned that safety and engineering professionals have a lot of knowledge to share as well.
Gina Sandoval, PT, DPT, CEAS III, owner, Spine Solutions Inc: I was working at the Boeing Company, which opened my eyes to the industrial rehabilitation field of physical therapy. I was fascinated by the proactive approach to preventing injuries and mitigating re-injury. Up to that point, my career focused on the reactive side of rehabilitating injuries instead of preventing them. I realized I could positively impact my community by keeping workers on the job and helping them work more efficiently. There is no better feeling than knowing a worker could keep their job, provide for families, contribute to the economy, and keep their company productive.
Alison Heller-Ono, PT, MSPT, CPE, owner, Worksite International Inc: I was interested in back safety and work injury rehabilitation. I noticed patients got hurt at work often and it seemed that employers did nothing to help avoid the injuries. With an understanding of body mechanics and work safe principles, I realized I could help both employees and employers work safer. After the ADA was first passed in 1992, I began learning about OSHA and NIOSH. The state of California wanted to develop an ergonomics standard through Cal-OSHA, and there was a focus on reducing workers’ comp costs through legislation. These factors made it clear to me that my vision to start a company focused on ergonomics would work. I was right!
Scott Ege, PT, MS, president, Ege WorkSmart Solutions PC: I worked in a large hospital-based system, in an “industrial mecca” for manufacturing. I was treating a patient who had injured his back at work and he was angry. He described his employer and work environment as “the worst ever.” He’d improve in his therapy sessions but worsen every time he went back to work. I called his employer out of frustration and spoke with the human resource manager. She invited me to come to the plant and meet with her, my patient, and his supervisor. I saw that the workstation was too low and offered some simple changes. I was able to provide my patient with more specific training on movement and body mechanics related to his job. We clarified his work restrictions. Two weeks later, he was released to full duty. He was pain-free and no longer angry. The HR manager and supervisor were grateful. Since then, I have assessed thousands of jobs.
Brian Langenhorst, OTR, CEA, industrial/ergonomics specialist, healthcare facility: As a new graduate I was hired to develop a new facility’s outpatient occupational therapy program and industrial rehab program. I trained in many of the available industrial rehab programs and systems and I started consulting with employers for the patients I was seeing in industrial rehab. But something was missing. I was not able to communicate with the employers like I wanted to. I did not yet have the engineering, human factors, and ergonomics background to complement my medical/rehabilitation background to best help my patients/employers. I started attending occupational ergonomics and human factors courses. I left healthcare and worked in the workers’ comp insurance industry as a loss control consultant managing safety and injury prevention strategies and where ergonomics was a strong focus for me. I became a board-certified ergonomist by the BCPE in 2004, which has helped me expand my current clinical, consulting, and training work.
Bryon Graulich, MSHAC, ATC, PTA, CEAS, CSPHP, Injury Prevention and Ergonomics Sr. Specialist, healthcare facility: A phone call from the hospital employee health director came in asking if we could do ergonomic assessments for her caregivers. After 10 years as an ATC and PTA in clinics and sport situations and overseeing multiple clinic sites, a new challenge was welcome. It was also a perfect way for me to investigate a question that had always been frustrating me. Why were my cumulative trauma patients making progress in therapy, but not at the rate or with the complete recovery I would expect? It was different than with my athletes and was frustrating. As an athletic trainer I was always eyes on with my patients and could see them in performance. That visual feedback helped to shape my instruction and treatment plan. Seeing clients in their work locations while performing ergonomic assessments was the missing link.
Sandi Sorum, OTR/L, CEAS I, healthcare facility: Early in my career, I worked in an outpatient rehab setting 50% of my day and work hardening patients 50% of my day. There was not an ergonomic program, but there was a need in both the community and within our health system. As the program evolved, my fire was ignited. Patient safety is a constant focus in the health care setting. Employee safety is equally important. Through collaboration with a progressive and willing employee health services department, an ergonomic program was born.
2. What does your work look like today?
Bellendorf: My work today is 80% early intervention services. The other time is spent performing job function analysis and descriptions for ergonomic purposes. Soon I will be teaming up with a Safety person at a client company to assist him with performing ergonomic assessments and developing their ergonomic program. I have good relationships established with the supervisors and engineering staff already. Hopefully this will help gain their buy-in and involvement in the process.
Sandoval: Today my company focuses on making an impact in New Mexico by providing high-quality rehab services including comprehensive return to work programs. On the prevention side, we help companies by providing on-site injury prevention, ergonomics, and up-to-date job function descriptions.
Heller-Ono: I run a successful niche consultancy focused on onsite, remote ergonomics services in office, biopharma/biotech, government, and industry. I also have a robust ergonomics training academy for corporate and professional training in ergonomics. We offer professional certificates in ergonomics process leadership, office preventive evals, chair assessment, fittings, and remote ergonomic analysis.
Langenhorst: My day is different every day. I work in a free-standing occupational health/employee health clinic managing the health and safety for 3,500 healthcare employees including a very proactive safe patient handling program, office ergonomics program, and facility-wide ergonomics program. We provide post-offer pre-employment testing for all our new hires and for hundreds of different employers. I can be found in an office setting, a healthcare setting, meat packing plant, light/heavy manufacturing, road construction, trucking company, agri-business, paper mill, brewery… to name just a few.
Ege: 100% of everything we do as a company is onsite with employers. Our services include training and awareness programs, ergonomic training and risk assessments, workplace stretching, and early Intervention. We partner with our employer clients as “musculoskeletal experts.” Our collective goal is to reduce/eliminate musculoskeletal injuries. We provide guidance using OSHA-approved first-aid intervention strategies, which includes a great deal of ergonomics. Every worker we see leads to an opportunity to promote health and safety, whether it’s through reduction of ergonomic risks or promoting awareness around movement/body mechanics.
Graulich: I have spent the past almost 20 years focusing on ergonomics, injury prevention, job function testing, safe patient handling, and safe return to work for healthcare workers. It has been the most gratifying work that I have ever done.
Sorum: At the time of my retirement in June 2022, I was working 20% in ergonomics.
3. What advice do you have for other rehab professionals who might be considering adding ergonomics to their professional work?
Bellendorf: Your knowledge of the musculoskeletal system and biomechanical processes makes you qualified. You don’t need to be an ergonomic expert. The workers will also guide you toward solutions if you engage them. Take classes and continuing education and engage the safety and engineering staff at the companies you work at. They will be happy to share their knowledge. It’s a good way to build relationships.
Sandoval: Ergonomics ties into our everyday work as physical and occupational therapists. It takes the guesswork out of return to work. It closes the gap where most employers, providers, and insurers don’t have the answers of knowing what an injured worker can and cannot do as part of their job. It expedites the return to full duty. Therefore, the worker is set up for a safe and successful return to work. I encourage other therapists to explore the ergonomic arena from a different perspective that might surprise them.
Heller-Ono: If you are interested in ergonomics as science, learn it as a science. It is objective and measurable. Learn how to analyze using valid methodologies. Invest in education and training that offers a pathway to a certificate or certification and continue to learn; don’t stop after one course or certificate. Work with a mentor who will show you the art and science of ergonomics. Practice, learn, practice, learn, and teach.
Ege: Musculoskeletal conditions are often in the top three spend categories of group health. Get to know the challenges and needs of employers as it relates to health and safety. Partner with safety and human resource professionals. We are experts in human motion and function. We understand how the body can work more efficiently. Ergonomics is about changing the work environment to better fit the worker. There are tons of free ergonomic resources available online, and the National Ergonomics Conference is being held Nov 8-10, 2022, in Las Vegas, which will be a great opportunity to find out more. Remember that the best ergonomist in any work environment is often the worker.
Langenhorst: If you like change in your workday, ergonomics is great to add to your professional work. If you would like to increase revenue, it is a great addition. If you would like to complement your clinic work as a therapist, it will assist you with addressing the true root cause of risk in your patient’s workplace vs. just treating symptoms.
Graulich: Get good training! Ergonomics is a complex field, and the saying holds true: “You don’t know what you don’t know.” Having a strong background in kinesiology, biomechanics, and therapy is a great start, but understanding elements in engineering, industry, lighting, and noise and occupational safety require solid study. Find a program that is taught by an instructor who is from a different background than yours and that will challenge you to think in a unique way. It is challenging work but very gratifying when you have a positive influence on that client’s daily work life.
Sorum: Building the ergonomic program for our health system was an incredibly rewarding experience. Helping people remain gainfully employed is what it’s all about. I will never forget Sally (name changed). She had severe rheumatoid arthritis and worked from home doing data entry. Sally had two years until retirement, and she wanted to finish out her career. She was determined to work. So, we worked through modifications and with an extremely supportive human resource department, she succeeded!
As a rehab professional reading these responses, what common denominators spoke to you? Was it frustration when workers failed to stick the landing with their progress under your plan of care? This follow-up question is for you. How can you integrate ergonomics into your current professional work, to better serve your patients and clients?
Virginia “Ginnie” Marshall (Halling), PT, is chief executive officer of DSI Work Solutions Inc. For more information, contact [email protected]