Quantifying the Burden of Shoulder and Hip Pain In Water Polo Players Across Different Playing Levels

BACKGROUND: Water polo is characterised by unique skills and movements with high demands of both the upper and lower limb. There is growing recognition of the problems of shoulder and hip/groin symptoms in this population. PURPOSE: To quantify the prevalence of shoulder and hip/groin pain in water polo players, and to describe how performance and participation were impacted. Secondary aims investigated whether demographic or training variables were associated with levels of symptoms. DESIGN: In-season, cross-sectional questionnaire study METHODS: An online questionnaire was distributed to all adult levels of the Australian water polo community. Participants were asked about demographic and playing history, and then specific injury history at both the shoulder and hip/groin. Each respondent completed an Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire for the shoulder and hip/groin. Point prevalence and past history were calculated, as well as a morbidity score from OSTRC responses. Risk ratios were used to determine differences between playing levels and sex. RESULTS: One hundred, fifty-three respondents completed the questionnaire (57% female). High rates of shoulder pain were reported (38.1% current, 81.2% past history), as well as hip/groin pain (33.1% current, 60.4% past history). Current shoulder pain was a risk factor for hip/groin pain (RR 1.99 (95%CI 1.27-3.12), and hip/groin pain was a risk factor for shoulder pain (RR 1.70 (95%CI 1.23-2.35). Elite-level athletes had higher prevalence (RR 1.87 [95%CI 1.01-3.46]) and past history of hip/groin pain (RR 1.76 [95%CI 1.32-2.36]). CONCLUSIONS: This is the first study to quantify high self-reported levels of hip/groin pain in water polo athletes. Such high levels may be explained by high amounts of eggbeater kick, especially during skeletal development in adolescence. Shoulder pain continues to be the most common source of injury burden in water polo. Future research should determine whether any modifiable risk factors exist that may reduce the burden of injury in this population. LEVEL OF EVIDENCE: 2b