Exercise Medicine Program Helps Man Prepare for Surgery and Reclaim an Active Life

Severe arthritis in both knees had turned nearly every step into a struggle for Nick Connavino as he made his way across the gym floor at Cleveland Clinic's Langston Hughes Community Health and Education Center.

The retired resident of Euclid, Ohio, desperately needed knee replacement surgery but first had to lose weight to reduce the risks associated with the procedure. At the recommendation of Colin Bilski, physician assistant to Cleveland Clinic orthopaedic surgeon Nicolas Piuzzi, MD, Nick came to the center hoping it would help him reach that goal.

Soon after arriving, Nick met sports and exercise medicine specialist Matthew Kampert, DO, who helped develop a comprehensive exercise medicine program. Through personalized exercise plans and technology that tracks participants' progress, the program helps people build strength, improve fitness and work toward their health goals.

It wasn't long before exercise physiologist Brad Heiss encouraged Nick to try one of the program's resistance-training machines.

“That surprised me, because my knees were killing me,” says Nick, recalling his first visit to the center in September 2023. “I started on it right away and I couldn’t do much. But by the next week, I felt better walking across the gym. I’ve been coming back ever since. This program and the team that works with me have changed my life.”

Through the program, Nick lost 40 pounds, enabling him to safely undergo his first knee replacement surgery with Dr. Piuzzi in April 2025 and his second in May 2026. Along the way, he also developed significant strength in his legs and throughout his body, which played an important role in his surgical recovery.

“Nick’s story illustrates how personalized, modern joint replacement and multidisciplinary care can transform a patient’s life,” says Dr. Piuzzi. “His two knee replacements addressed the advanced arthritis that made everyday movement so difficult, while our exercise medicine partners helped him prepare for surgery and build lasting strength. By combining surgical care with individualized support before and after surgery, we were able to help him achieve a safer recovery and get back to living more fully.”

“People who are sedentary and haven’t been exercising regularly don’t typically enjoy exercise. So, they tend to get frustrated and give up. But when we can show them evidence of the physiological changes they are making in addition to weight loss, that positive reinforcement keeps them engaged,” says Dr. Kampert. “We see that in Nick and in so many other people in the program.”

Created by Dr. Kampert, the program uses individualized exercise plans and data-driven assessments to help participants build strength, improve fitness and track their progress over time.

Dr. Kampert says the combination of technology and experienced exercise physiologists allows the team to tailor workouts to each participant's needs and adjust them as their fitness improves.

"It's about so much more than weight loss," he says. "People are getting stronger and their cardiovascular fitness is improving. When they see the results from their assessments every few months, they're motivated to keep building on that progress."

For much of his life, Nick struggled with his weight and the health challenges that often came with it.

“My mom has a picture of me when I was 1 year old. She said I weighed 40 pounds,” he says with a laugh. “Let's just say I've never been a small guy.”

Over the years, limited mobility made it challenging for Nick to stay active, creating a cycle that became increasingly difficult to break. The physical demands of his work as a truck driver only added to the strain on his body. By the late 2000s, knee pain from loading and unloading trucks had become so severe he was taking more than 3,000 milligrams of ibuprofen daily, eventually developing an esophageal ulcer.

The setbacks took a toll.

“It can get depressing when you have a lifelong problem of being overweight and have so many physical challenges,” says Nick, who estimates he has tried countless weight-loss and exercise programs over the years. “But this program is different. The data shows you exactly how you’re doing, and the physiologists are really supportive. It’s a great community of people with all kinds of backgrounds and medical conditions who don’t care what you look like. We help each other.”

For Dr. Kampert, Nick's experience reflects a broader philosophy that sustainable health improvements require more than a single intervention. Whether someone is preparing for surgery, managing a chronic condition or pursuing weight loss, the goal is to help them build strength and healthy habits that can be maintained over time.

That same evidence-based approach to exercise and performance is helping inform programs being developed for the Cleveland Clinic Global Peak Performance Center, scheduled to open in 2027. The facility will serve athletes and active individuals of all ages and abilities.

Today, Nick is enjoying an active life that once felt increasingly out of reach. He spends time gardening, finds it easier to participate in rehearsals and performances with the Cleveland Orchestra Chorus and continues his three-times-a-week workouts at the Langston Hughes Center.

Nick is also inspired by Walk of Joints—a community event in Cleveland, Ohio, that celebrates recovery, honors loved ones and supports orthopaedic research. It serves as a powerful reminder of the challenges many have overcome and freedom pain-free movement and improved mobility can bring.

“The stars really aligned for me when this care became available,” Nick says. “It’s hard work, but it’s worth it. I’m a busy guy, and my life is so much better.”