"I had stiffness and inflammation in my right elbow, which I thought was just part of getting older. I'd throw anyway, but sometimes I couldn't straighten my arm," says Mr. Repekta, who plays with the East Rutherford Brewers. He went to an orthopaedist, and X-rays were taken of his elbow. Mr. Repekta, also a high-level racquetball player, had valgus extension overload, an overuse injury of the elbow typically seen in people who play throwing and racquet sports. But there was more: This overuse injury resulted in posterior olecranon impingement–a condition involving two bone spurs wedged behind his elbow. For some patients, resting the arm and taking anti-inflammatory medication helps relieve posterior olecranon impingement, but in Mr. Repekta's case, the orthopaedist recommended surgery to remove the spurs and "loose bodies"–small pieces of cartilage and bone chips."My doctor didn't perform that kind of surgery, but he referred me to someone who did, Dr. Lou Rizio. He said Dr. Rizio was one of the only surgeons in the area who was doing this type of advanced surgery," Mr. Repekta recalls.

Still, the Bergen County man didn't call Dr. Rizio right away. He sat out the 2000 baseball season in hope that with rest, the condition would resolve itself. In September–the beginning of racquetball season–Mr. Repekta headed for the courts. "I woke up one morning following a game and couldn't move my arm," he says. "I couldn't straighten it."

Finding an Expert

This time, the athlete called Dr. Rizio, an orthopaedic surgeon specializing in sports medicine at University Hospital. After his orthopaedic residency, Dr. Rizio completed fellowship training in sports medicine and arthroscopic surgery at the University of Miami. While there, he participated in the care of professional baseball and football players as well as NCAA Division 1 sports teams. His advanced, comprehensive training enables him to diagnose and operate on complex sports injuries such as Mr. Repekta's.

In November 2000, Mr. Repekta had same-day arthroscopic surgery on his right elbow. "Dr. Rizio removed the bone spurs and checked for arthritis and nerve damage. Thankfully, there was none," said the pitcher. Mr. Repekta was eager to test the results of the surgery: two weeks after the operation, he was playing racquetball–with no pain. Today, he is throwing fast balls, working on a split-finger pitch, and hoping once again to earn a spot on his league's all-star team.

Serious Sports Injuries: Not Just For Professionals

Athletes like Mr. Repekta are becoming more common, and indeed, the days of the couch potato could be headed for the deep fryer. Playing fields, courts, and gyms are packed with everyone from soccer-playing preschoolers to Senior Olympians. Children are starting organized sports at younger ages than ever before, and Baby Boomers are proving that the senior years aren't necessarily sedentary ones.

All of this activity sometimes comes with a price, and not just the $150 running shoes. Sports injuries, whether due to overuse or trauma, can sideline any athlete–young or old, professional or amateur, novice or veteran. According to the National Safe Kids Campaign, more than 775,000 children are treated for sports injuries in emergency rooms each year. They can be susceptible to injury because their bones and muscles are still developing, and some young athletes adopt a "play even though it hurts" mindset for fear of letting the team down or losing their starter designation. Sometimes, children's sports injuries result from lack of conditioning, poor supervision, or the failure to use protective equipment.

On the other side of the age spectrum, the U.S. Consumer Product Safety Commission estimates that Baby Boomers experienced more than 1 million sports injuries requiring treatment in 1998 alone. As people age, their bodies tend to lose muscle mass and have tendons that are thickened and stiff, which can contribute to injury. Older athletes are more prone to heat exhaustion, tendonitis, bursitis, and lower back pain.

Whether tennis elbow or a torn ligament, sports injuries can be quite complex and, if improperly treated, end a person's participation in a sport. Sports medicine physicians specialize in the diagnosis, treatment, and rehabilitation of patients with sports injuries. Many insurance companies cover medically necessary treatment of sports conditions.

The good news is that sports medicine physicians aren't just for the elite or professional athlete anymore–they treat children, high school athletes, dancers, and the weekend league players. The same high-technology tools and advanced surgical techniques used to treat high-caliber athletes are available to all players.

"Treatment is determined by the injury, not the ability or playing level of the athlete," says Dr. Rizio, an assistant professor of clinical orthopaedics at New Jersey Medical School. "A recreation league basketball player could require arthroscopic reconstruction of the anterior cruciate ligament, while 'RICE' -rest, ice, compression, and elevation–could be sufficient for a professional athlete's mild ankle sprain."

Not all sports-related injuries require surgery, says Dr. Rizio, who notes that he presents modified activity as an option to his patients. But when an operation is necessary, he might suggest doing the repair arthroscopically, as was the case with Mr. Repekta. An arthroscope is a thin, telescope-like device with a camera that can be inserted into tiny openings to look within the body's joints. The magnified image is projected onto a television screen. With special surgical instruments adapted for the arthroscope, the surgeon can operate on certain joints, most commonly at the shoulder, elbow, wrist, knee, and ankle. Arthroscopic surgery uses small incisions and is typically a "same-day stay" procedure, but as with any operation, there's a possibility of complications, such as infection or nerve damage.

Practice Prevention

The best course for any sports participant to follow is one that prevents injury. However, in their eagerness to join in a game or in the frenzy of fitness, some athletes, well, drop the ball. "They think they don't need to warm up before they start their run or begin a game when their muscles aren't ready. This can lead to all kinds of problems," says Dr. Rizio, whose practice includes adult and children. "The wise athletes take time to stretch, listen to their bodies, and know their limitations."