Return to Work: More than the Physical

Working as an allied health professional in the workers compensation and injury management scheme, it can be a complex system with many moving parts and involved parties. I can imagine it may be daunting for some injured workers, particularly those who have never sustained an injury before and suddenly they are liaising with insurers, doctors, specialists, employers, surgeons, allied health professionals, workplace rehabilitation providers and the list goes on. However, from my perspective, often more involved parties who are specialists in their area lead to better outcomes for the injured worker particularly those with complex claims.

An important lesson I have learnt is that return to work as an outcome is multifactorial. Return to work cannot be predicted only by the physical presentation or medical diagnosis of the injury, we need to be aware of biopsychosocial flags and how they may impact recovery. I think one of the biggest mistakes we can make as exercise physiologists is to look at the injury in isolation and adopt a linear model of; patient, intervention, outcome. This just doesn’t work.

Often the biggest barriers to return to work are;

  • Injury characteristics and injury beliefs.
  • Work place relationships and job satisfaction.

So how do we overcome these barriers? Building a good rapport in the initial assessment and early phase of the exercise programme is key, as is taking a comprehensive patient history and completing a thorough assessment. We also administer a standardised risk stratification tool early on. We can then categorise the information we have gathered using the flags model below.

The Flags Model:

Once identified we can then look at how to address the barriers to recovery. As exercise physiologists, often we can reduce some of the barriers presented by providing education on realistic recovery timeframes, building exercise self-efficacy, helping to establish a self-management routine and improving physical function for example. Sometimes flags that are raised may need to be referred on to other specialists such as psychologists, workplace rehabilitation providers or pain specialists who will work concurrently with us to achieve patient outcomes. We can help to identify, communicate and facilitate this multidisciplinary approach when required and approach the recovery of the injured worker in a holistic way.

For more information or to discuss further contact Absolute Balance on 9244 5580 or email


Lisa Wallbutton (BSR, MClinicalExPhysiol(Rehab))

Accredited Exercise Physiologist (AEP) (ESSAM)