Prevalence and mechanisms of injuries in water polo: a systematic review

Abstract

ObjectiveTo summarise the information available in the literature on the prevalence of injuries in water polo and injury risk factors.MethodsProtocol was registered on Open Science Framework. MEDLINE, CINAHL, Embase and SPORTDiscus databases were searched for keywords relating to water polo and injuries on 3 February 2021. References were searched for additional studies. Only original research papers in English or French were included, and studies without an injured group were excluded. A data extraction file was made based on the Cochrane Collaboration recommendations. Study quality was evaluated with the Newcastle-Ottawa scales for cohorts and a modified version for cross-sectional studies.ResultsThe initial search yielded 581 articles, with 5 more added from reference lists, but only 41 remained after removing duplicates and applying inclusion/exclusion criteria. Thirty-one articles identified the head, fingers and shoulders as the most common sites of injury. Ten articles on mechanism of injury focused mainly on the shoulder, with degenerative changes, posture, scapular alignment, strength, flexibility and overhead shooting kinematics as the main injury risk factors. Publication types included cohort studies, cross-sectional studies, and one case series.ConclusionsMost traumatic injuries affect the hands and the head from unexpected contact with the ball or opponents. Conversely, training injuries seem to affect mainly the shoulder area. Low level evidence suggests a correlation between shoulder injuries and lack of strength or flexibility as well as large volumes of overhead throwing. Further prospective research is needed to investigate risk factors for other body areas.

Injuries Affecting Intercollegiate Water Polo Athletes: A Descriptive Epidemiologic Study

“…8,26 Although less traditionally discussed, groin/hip pathology is becoming increasingly recognized as important in water polo. 5,11 Strikingly, this study found pathology of the groin/hip/pelvis/buttock to make up 50% of injuries requiring surgery, which was considerably more than the second most common site, the hand/wrist/forearm (15.4%). A total of 9 of the 13 groin/hip/pelvis/buttock injuries had the specific diagnosis of FAI, and the other 4 were described more generally as chronic joint trauma and may or may not have been FAI.…”

“…31 The longitudinal nature of an injury surveillance program has been emphasized as a critical need for understanding injuries in the sport. 5,19 To date, there has been no study to our knowledge that captures multiple years of both in-competition and out-of-competition injuries for multiple men's and women's collegiate water polo teams. This study aimed to characterize the injuries sustained by a large cohort of male and female water polo athletes from the Pac-12 Conference over a period of 5 years.…”

Injuries Among Adolescent Water Polo Players: Demographics, Evaluation, and Management

“…The repetitive overhead stress inherent to swimming has also been frequently linked to over use-related shoulder injuries such as rotator cuff pathologies and impingement [18][19][20]. In addition, player strength and flexibility as well as differences in scapular alignment have been investigated as potential risk factors for injury [3]. Among the patients analyzed in the present study, upper extremity injuries were evenly distributed between acute and chronic pathologies (15 acute and 16 chronic injuries) (Table 3).…”

“…Unexpected contact with opposing players or the ball can lead to acute subluxation or dislocation events [9]. In addition, chronic injuries, such as rotator cuff tendinopathies, may result from swimming training or overuse from throwing practice [3,[9][10][11][12].…”

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

“…Water-polo is a collaborative opposition sport that combines throwing actions, technical ball skills, explosive speed, and continuous swimming [ 1 ]. Physical contact between players and large training volumes result in water-polo being the aquatic sport with the highest incidence of injuries [ 2 ]. Injuries to the head and fingers resulting from blows and struggles between players, and overuse of the glenohumeral joint generated by constant repetitive movements during swimming and ball throwing, are the most common injuries [ 3 ].…”