Risk Factors for Shoulder Injuries in Water Polo: a Cohort Study

Investigation of Predisposing Risk Factors in Adolescent Male Water Polo Players

BACKGROUND

Shoulder injuries are prevalent in adolescent water polo (WP) players. Study aimed to determine whether preseason shoulder characteristics (range of motion [ROM], flexibility, and strength) and core endurance can identify athletes at risk of future shoulder injuries.

HYPOTHESIS

Shoulder characteristics, including changes in ROM (internal rotation [IR], external rotation [ER], and total), strength (IR and ER), pectoralis minor flexibility, shoulder capsule flexibility, and core endurance, would be risk factors for shoulder reinjury in athletes with previous overuse injuries compared with noninjured athletes.

STUDY DESIGN

Prospective cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

At baseline, 53 male youth WP players (mean age, 16.6 ± 3.5 years) were assigned to Group 1 (with previous shoulder injuries [G1, n = 26]) and Group 2 (without previous shoulder injuries [G2, n = 27]). ROM, flexibility, strength, and core muscle endurance were assessed preseason. After a 12-month follow-up, players were again divided into those who developed new shoulder injuries (G3, n = 27) and those who remained healthy (G4, n = 26).

RESULTS

Total of 26 players (49%) had previous shoulder injuries at baseline. At baseline, decreased pectoralis minor flexibility, IR, total ROM, and core endurance were found in players with a previous shoulder injury compared with players without a previous shoulder injury (P < 0.05).

CONCLUSION

At baseline, a significant difference was present in proposed risk factors (shoulder and core endurance parameters) between players with and without a previous shoulder injury. Shoulder IR ROM and years of experience were significant predictors of shoulder injury. Early detection of modifiable proposed risk factors may help prevent reinjury in young athletes.

CLINICAL RELEVANCE

Screening at an early age can help identify and address pre-existing injuries, support youth athletes' return to sport after a shoulder injury, prevent new injuries, and improve performance.

The Effectiveness of Shoulder Mobility and Strength Programs in Competitive Water-Polo Players

Background: Water-polo is the water sport with the highest incidence of injuries, with shoulder pain being the most common one. The understanding of risk factors and guidance on preventive measures is essential in this sport discipline. The aim of this study was to determine the effects of a specific 6-week training plan on range of motion (ROM) and joint strength levels in a group of professional water-polo players. Methods: Quasi-experimental study with a sample of 28 participants (age: 20.1 ± 2.5 years; height: 176.9 ± 6.2 cm; body mass: 74.6 ± 8.1 kg). Three study groups, which consisted of one control group and two experimental groups, were established. Two repeated measurements, pre and post intervention, were performed. During these measurements, ROM of the glenohumeral joint was analyzed both in external (ER) and internal (IR) rotation, as well as the maximal isometric strength. Conclusions: The application of a training program improved glenohumeral joint ROM. ER and IR evolve differently in both shoulders. ER improved only in the throwing arm only in the group undergoing intervention but for the non-dominant side, improvements were observed in both ER and IR, regardless of whether or not they had followed the intervention plan. No improvements were observed in either the isometric strength or contralateral asymmetries.