Return to work after MSK injury: a practical guide

A good return to work after a musculoskeletal (MSK) injury is rarely a single moment — it's a managed process. Done well, it gets someone back safely and keeps them there; done badly, it leads to relapse and repeated absence. The difference usually comes down to timing, evidence and coordination.

Why does return-to-work go wrong?

The most common failures are returning too soon to full duties, returning with no adjustments, and decisions made on subjective self-report rather than what the person can actually do. The longer someone is off, the harder return becomes — so the goal is a timely, supported return, not a delayed, all-or-nothing one.

What makes a return-to-work plan work?

• A phased return — reduced or amended hours and duties, stepped up over time.
• Objective evidence — a functional assessment of what the person can safely do now.
• Clear adjustments — changes to the task, workstation or schedule, agreed in advance.
• Shared ownership — employee, manager and clinician aligned, alongside the GP's fit note.
• Monitoring — checking how the return is going and adjusting, rather than assuming.

Who is involved?

A fit note from a GP can advise that someone 'may be fit for work' with support. Occupational health translates that into workable adjustments. The employer implements them. When those three work from the same information — instead of separate email threads — returns are faster and safer.

ReVive supports return-to-work with objective functional evidence and a shared, consent-based plan that employee, employer and clinician agree in one place. It supports and assists clinicians; the fitness-for-work decision stays with them.