Sports clinic addresses health problems before they spiral out of control
(Sept. 4, 2003)
The pain she felt simply walking finally convinced Barbara Perkins to see a doctor. For years, tennis had been her work and her passion, but she was finding it impossible to walk for even short distances. Her success on the court led to joint damage and chronic knee pain.
For help, she turned to the new Physical Activity and Nutrition Clinic, a service of the division of sports medicine in the Department of Family Medicine at the Brody School of Medicine at East Carolina University. The program is designed to guide people with medical conditions back into healthy exercise routines.
Directed by Dr. Joseph P. Garry, head of sports medicine and an associate professor of family medicine, the clinic offers medical consultation, nutrition counseling and recommendations for physical activity, including aerobic exercise, strength training, walking and sports.
"A year ago I was hurting so badly I couldn't do anything," Perkins said. Now, she said, "I'm not in pain anymore. I walked a mile around the block this morning. I'm feeling much better. I have energy again."
For some time, Garry had sought a way to reach people who, because of a medical condition, avoid exercise. They include people with early signs of diabetes, high blood pressure, risk factors for cardiovascular disease, as well as those who were overweight, suffered arthritis or had high levels of bad cholesterol.
He feared they were outside the reach of traditional medical care - not sick enough for a doctor, but heading toward problems. They needed more supervision than a personal trainer could provide and would clearly benefit from exercise and better eating.
Sports medicine at the Brody School of Medicine includes a wide range of services for competitors, amateurs, weekend athletes and families. It offers diagnosis and treatment of injuries, and advice with long-term training challenges.
For people with more serious medical conditions, the Physical Activity and Nutrition Clinic provides additional oversight, guidance and medical advice.
"Exercise and diet can lower cholesterol and blood pressure, reduce the risk of heart attack, reduce the risk of stroke, help control blood sugar and improve cognitive function overall," Garry said. "Many people are looking for ways to increase their activity, but physicians often don't have the time for in-depth assessment, counseling and recommendations for their patients. We'll try to start working with them gradually and progress them to where they are independent in their exercise and have a regimen they understand."
Those using the clinic since it began in March have included people with recurring pain from injury or arthritis, fatigue, inability to lose weight, high blood pressure, post-surgical recovery and a set of troublesome indicators known as metabolic syndrome.
Metabolic syndrome describes a condition of being overweight, having slightly elevated blood sugar, elevated triglycerides, slightly depressed HDL (healthy) cholesterol or slightly elevated blood pressure - or all of them. Metabolic syndrome has been linked to a person's likelihood of developing future cardiovascular disease.
Once enrolled, participants undergo evaluations that include blood tests, a stress test and often a resting metabolism test and body-fat composition test (performed by submerging someone in a pool of water).
The goal is to determine what a person needs to feel better, have energy, lose weight and keep blood sugars stable.
Nutrition plays an important role in performance and recovery, and Dr. Kathy Kolasa provides nutritional analysis and guidelines as part of the clinic. With a doctorate in nutrition, she is professor and section head of nutrition services and patient education at the Eastern Carolina Family Practice Center.
"Food is complicated," she said. "Unless you