Daily Editors' Notes

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Elizabeth Newman, McKnight's Senior Editor
Elizabeth Newman, McKnight's Senior Editor
What do professional athletes, teachers and healthcare workers have in common?

In addition to being in professions with a lot of pressure, they're all putting lots of pressure on their knees.

As more long-term care facilities expand into offering rehabilitation services, it's no surprise that joint replacements, often for the knees, offer solid business. But that business isn't as desirable when it becomes a necessity for more and more direct care workers.

Healthcare workers, in the best of circumstances, have to be on their feet more than an office worker and may need to lift residents on a regular basis. There's also the shifting age demographics, with more and more employees working into their 60s, and increasing their risk of wearing out their bodies.

But there's another aspect, which may be apparent to anyone who has walked the halls of a hospital or long-term care facility: Many nurses are overweight or obese. That's backed up by studies, including a 2008 Journal of the American Academy of Nurse Practitioners analysis that found that out of close to 5,000 registered nurses, more than 50% were overweight or obese.

That has a huge impact, no pun intended, on knees.

And knee replacement is not necessarily the perfect solution. Putting aside whether more healthcare systems will follow Tennessee's BlueCross BlueShield example of bundling joint replacements,  there's some question of whether our focus on replacement surgery as a standard is going to change. For one, as a New York Times article notes, up to 30% of patients may not see improvement post-surgery.

That brings us back to weight loss, and low-impact exercise. Even a loss of 10 to 15 pounds can do wonders, physicians in the NYT article advised. If you are a long-term care administrator, it's worth investigating wellness programs that would work for your facility. Even a modest walking program, or gym subsidy, may result in employees losing weight and putting less pressure on their joints.

Another important point: stressing the importance of good shoes. For some, this may mean orthotics, for others it means simply not using a worn-out pair of footwear. 

Finally, if someone is headed toward a knee replacement, look at a study from the University of Louisville around “prehabilitation.”  It found that even light resistance training and flexibility exercises helped quicken recovery time.

There is no magic bullet for helping all employees keep their joints in good shape. But there is also no excuse for not being proactive on knee preservation.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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