Fly-In Fly-Out (FIFO) work is a cornerstone of Australia’s mining, oil, gas and construction industries, offering attractive pay but demanding hours and work. This line of work can take a serious toll on the body and mind, from long shifts, repetitive tasks and harsh conditions to extended periods away from family and support systems. Injuries are common among FIFO workers, yet traditional rehabilitation models don’t always fit into the unique schedules these roles require. When recovery clashes with work rosters, rehab progress can stall, leading to prolonged pain, reduced function and even reinjury. That’s why customising physiotherapy around FIFO work patterns is so important. With the right approach, physiotherapists can help FIFO workers recover faster and return to work safely and confidently.

FIFO (Fly-In Fly-Out) work offers financial incentives but comes with unique challenges. With rosters typically ranging from 2:1 to 4:1 (weeks on versus weeks off), FIFO life demands workers perform in intense conditions: often for 12-hour shifts, seven days a week, in remote environments with limited health resources. Here are some of the challenges that come with it:

• Physical Load: Repetitive manual tasks, heavy lifting and prolonged static postures are common, increasing the risk of musculoskeletal injuries such as lower back strain and shoulder and knee pain.
• Fatigue and Sleep Disruption: Shift work, poor sleep environments and extended hours can lead to chronic fatigue, which impacts recovery time and the body’s ability to heal.
• Environmental Stress: Harsh weather conditions, dust, noise and vibration from machinery further add to physical stress and strain on the body.
• Limited Access to Healthcare On Site: While some sites may offer basic health services, physiotherapy is often unavailable, making it difficult to treat minor issues before they escalate into significant injuries.
• Psychosocial Stressors: Isolation from loved ones, social disconnection and the mental load of being away from home can heighten stress and delay recovery, especially when dealing with an injury

In physically demanding FIFO roles, injuries can jeopardise long-term employment and quality of life. Whether it's lower back pain from repetitive lifting, rotator cuff injuries from overhead work, or joint strain from long hours on hard surfaces, FIFO workers face a range of musculoskeletal issues that require targeted and timely care.

Delays in treatment can allow minor niggles to turn into chronic conditions. Early assessment and intervention, even via telehealth, can prevent this and support a safer, faster return to work.

One of the biggest challenges in supporting FIFO workers through rehabilitation is fitting treatment into their unpredictable and inflexible schedules. Standard rehab models, based on weekly appointments and consistent routines, simply don’t work for workers spending weeks at a time in remote regions.

• On-site rehab strategies need to be simple, portable and time-efficient:
• Self-guided exercise programs: Tailored exercise routines can be delivered via app or PDF, focusing on injury-specific rehab exercises and general conditioning.
• Portable equipment: Tools like resistance bands, spiky massage balls and foam rollers are easy to pack and useful for mobility and strengthening routines in small spaces.
• Telehealth check-ins: Scheduled video consults with a physiotherapist allow for exercise progressions, form correction and injury monitoring while on-site.
• Micro-sessions: Short bursts of activity (5–10 minutes) that can be done before or after shifts to help maintain mobility and circulation

Rest and recreation (R&R) weeks offer an opportunity for focused rehab.

• In-person physiotherapy sessions: Hands-on treatment, re-assessment, and exercise upgrades can be done while workers are at home.
• Gym-based strength and mobility training: Structured programs that target injury-specific strength deficits, imbalances, or range-of-motion restrictions.
• Education and technique refinement: Physiotherapists can work with patients to refine lifting techniques, posture and other movement patterns relevant to their job tasks.

In the world of FIFO work, where isolation, long hours and rotating rosters are the norm, technology has become an essential bridge between workers and their healthcare providers. For physiotherapists, digital tools offer powerful ways to maintain continuity of care, monitor progress remotely and empower FIFO workers to take control of their rehab journeys.

• Video consultations have become a game-changer for remote workers. Physiotherapists can:
• Assess movement and function via video
• Progress or adapt rehab programs based on worker feedback
• Troubleshoot flare-ups or new symptoms in real time
• Offer education, motivation and emotional support

Apps like PhysiApp and TrackActive allow physiotherapists to:

• Deliver personalised rehab programs complete with demo videos and instructions
• Set reminders and track patient adherence
• Update exercises as progress is made, even between rotations
• Collect feedback and pain scores to guide clinical decisions

Smartwatches and fitness trackers can assist with:

• Monitoring sleep quality
• Tracking physical activity levels and step counts
• Heart rate variability and stress monitoring

FIFO workers are the backbone of some of Australia's most demanding industries, but the intensity of their schedules and environments presents real challenges when it comes to injury recovery. Traditional rehab models often fall short in these settings, where time, distance and routine are anything but predictable. That’s where tailored, flexible physiotherapy comes in. By customising rehab to align with rostered rotations, leveraging technology for remote support, and addressing both the physical and mental demands of FIFO life, physiotherapists can help workers recover more effectively, wherever they are.