DEAN SENSUI / DSENSUI@STARBULLETIN.COM Pearl Harbor's Sports Medicine and Reconditioning Team Center can provide same-day injury treatment for Navy, Marine and Coast Guard personnel. Prior to its inception, injured personnel could wait as long as 90 days before they'd receive proper treatment. Petty Officer Tommy Fisher, a corpsman, checked out EN1 Larry Rafanan for a knee injury last month.

Navy revamps
injury care

Hawaii's new center for sports
medicine and reconditioning
reduces treatment time

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By Gregg K. Kakesako
gkakesako@starbulletin.com

On July 29, Petty Officer Roynes Dura, a boatswain's mate on the cruiser USS Port Royal, injured his back while pulling a line when the warship was tied up at a Pearl Harbor pier.

Within three days he was being treated at Pearl Harbor's new Sports Medicine and Reconditioning Team Center for his back injury.

Navy Lt. Beth Greenway, one of two physical therapists at the clinic, said this hasn't always been the case. "In the past an injured sailor would have to see his primary care physician, who would then refer him to a physical therapist or a sports medicine doctor. That could take as long as 30 days."

Lt. Cmdr. Debra DeLeo, director of Pearl Harbor's SMART clinic, said the idea now is to see the patient as quickly as possible to find out what the injury is so treatment can begin immediately.

"In some cases," said DeLeo, a Navy nurse for 14 years, "treatment can begin the same day the patient sees his primary care physician."

Pearl Harbor's SMART center is the first of its kind for the Navy where sports medicine doctors and physician therapists are located in the same facility. The center has been in operation since July 3 in a building that once housed the base's library.

Although a first for the Navy, similar centers have existed for the past 10 years on Marine Corps bases, beginning with the first one at Camp Pendleton in southern California.

The center's main goal is to focus on managing injuries and educating patients on ways to prevent any future injuries. There are seven areas in the clinic, each devoted to a different aspect of treatment. The largest area is the combined evaluation and reconditioning area. The clinic has averaged 30 consultations a day and 20 new patients since it opened.

The SMART center's one-stop treatment concept brings under one roof sports medicine trained doctors, physical therapists and technicians and has on-call specialists in orthopedics and podiatry.

DeLeo said 95 patients were treated during the first three weeks after the center opened last month. The highest percentage of injuries was because of leisure sports at 35 percent, followed by mandatory physical readiness training at 33 percent.

Of the injuries seen, 25 percent were knees and 22 percent were back injuries. She also pointed out that not only those people who are "out of shape" get injuries. Her data showed that 25 percent of those injured exercised daily, 53 percent exercised three times a week, 11 percent exercised once a week and only 8 percent rarely exercised.

In the past, 8 percent of the patients had to wait more than three months before being treated at a physical therapy clinic, DeLeo said.

"If the injury was acute, the patient would end up at an acute care center and a consult would get set up for someone to diagnose the injury," said DeLeo. "Then the patient would have to wait for someone to contact them for treatment. If an (orthopedist) sees them, then they would put in a consult for therapy. In the meantime, the original injury is not being treated."

The new Pearl Harbor clinic has substantially reduced the waiting time, with 48 percent of patients seen within three to four days of an injury and 10 percent are seen the same day. The statistics show 90 percent of patients are enlisted and 89 percent are male. So far the results have been positive: Twenty-eight percent of the patients returned to full duty within five days of their injury.

"We're going to give them the tools," said DeLeo. "We're going to educate them. We're going to motivate and encourage our patients to own their own injury. The whole point is education. We teach them about what happened, why that particular limb or body part did what it did and how to prevent it from happening again."

The idea also is to pinpoint if there are any significant areas at the base where the injuries are occurring and then "we can notify their command to see if something can be done to correct them," said Greenway.

"We really want the patients to take ownership of their injury," DeLeo added. "The idea is to make them as much a part of the treatment as we are."

Physical therapy sessions include ice and electrical and ultrasound stimulation.

Besides being able to set casts and splints, the 12-member clinic also does foot examinations and recommends the best workout and running shoe a sailor or Marine should buy.

"We have to run all the time and we want to make sure they buy what is best for them," DeLeo added.

Although specially geared to return sailors and Marines to duty quickly, DeLeo said the center does offer physical therapy services to dependents.

"Our goal mainly is to decrease the number of loss work hours," DeLeo said, "and get people back to full duty and provide them with the treatment that will get the best outcome."

The clinic is open from 7:30 a.m. to 4 p.m. Monday through Friday, except on Thursdays, when it closes at 11:30 a.m. for training.