INJURIES IN WATER POLO

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Men's water polo was the first team sport in the Olympic games, and since then it has continued to grow in popularity. Given the combination of swimming and throwing, and that water polo is a contact sport, injuries in water polo are not uncommon. Not only do these athletes swim thousands of meters per week, they pass and shoot a ball slightly larger then a volleyball (slightly smaller for the women), at high velocities, without the benefit of a firm base of support. It has been determined that during every game, a water polo player swims approximately 1000 m of front crawl, depending on their position or role in the game. Compared with competitive swimmers who swim a single uninterrupted distance, water polo players have been documented completing 49 to 56 separate 16- to 24-m swims at high intensity bursts of energy lasting 10 to 18 seconds. These sprints are separated by 30- to 40-second intervals of legwork (mostly “eggbeater”) and occasionally 3 to 7 meter combinations of 100% intensity swim and leg work.

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THE GAME OF WATER POLO

The game of water polo often has been described as a cross between soccer and basketball. The field of play is 30 m long for men and 25 m long for women, for international play. Players do not touch the bottom of the pool during play, as depths are in excess of 6 feet, and holding oneself higher in the water than the other players gives a distinct advantage. A game clock is set for four 7-minute quarters of “stop time,” taking approximately 1 hour to complete a game. Teams are composed of six

HEAD AND FACE INJURIES

Because of the close contact among players and high ball velocities, head and facial injuries occur frequently. Closed head injuries must be evaluated and treated with the care given in other sports. Water polo is unique because the physician or trainer must rely on other players to bring the injured athlete to the pool side for evaluation; assistance that is especially important in cases where an injured player becomes unconscious, possibly without his or her teammates being aware. Time is

INJURIES TO THE SPINE

Extracting players with spinal injuries from the water is a particularly important aspect of aquatic sports, especially water polo and diving. Aquatic spine boards and neck collars should be available on the pool decks for all competitions. Although spine injuries in water polo are distinctly uncommon, prevention and preparation are definitely the best course for treating these often devastating injuries.

Because of the repetitive cervical spine rotation required for breathing in freestyle

UPPER EXTREMITY INJURIES

Undoubtedly, the shoulder is the area of greatest concern in the management of a water polo player. A great number of studies have evaluated the biomechanics and kinetics of the actual shot and the repetitive microtrauma of excessive shoulder rotation movements.1, 2, 8, 9 No other throwing athlete deals with water as his or her sole base of support, and many believe this transfers more force to the shoulder stabilizers.5 Throwing, combined with head-up freestyle, shorter, high-elbow positioned

LOWER EXTREMITY INJURIES

Swimmers, especially breaststrokers, have long complained of medial knee pain.7 Kenal reports this percentage as high as 73%.4 It has been documented that leg work accounts for 40% to 55% of the game, depending on position played and game tactics. Water polo players seldom perform the breaststroke “whipkick,” but instead the right leg rotates counterclockwise while the left rotates clockwise, in the “eggbeater” kick unique to water polo. This pattern produces an abduction and internal rotation

WOMEN IN WATER POLO

Women's water polo will make its debut as an officially recognized sport at the 2000 Sydney Olympics Games. Little research is available concerning the demands of waterpolo on women. The Canadian women's water polo team seems to have a higher incidence of shoulder complaints than does the men's team; in the near future, the authors hope to provide data comparing shoulder and hip strength and flexibility in men and women players. Presently, women play water polo with a smaller, lighter ball, in

MISCELLANEOUS

Irritation of the eyes and skin resulting from prolonged exposure to chlorine (or similar chemicals used to treat pools) is, of course, common in a sport where training sessions may last in excess of 2 to 3 hours. Unlike competitive swimmers, protective eye goggles usually are impractical for water polo players. Regular treatment with artificial tear solutions following practice and games is advisable to avoid chronic conjunctivitis. Like competitive swimmers, otitis externa (“swimmer's ear”)

CONCLUSIONS

Water polo is the only true “contact” sport of the aquatic disciplines. It combines the skills of swimming and throwing, and appeals to an ever increasing population of athletes. Women's water polo has grown rapidly in the past decade, especially with American universities and colleges offering athletic scholarships. Fortunately, major injuries are not common. Further research and documentation of injuries are certainly warranted.

ACKNOWLEDGMENTS

Special thanks go to Graham Brooks, the Canadian Men's National Water Polo Team; Heather Kaulbach, George Gross, Dave Bedford, John Csikos, Neil Muir, David Hart, and Rich Corso.

References (9)

  • J. Armour et al.

    Three-dimensional cinematographic analysis of water polo throwing

    (1998)
  • A. Giombini et al.

    Posterosuperior glenoid rim impingement as a cause of shoulder pain in top water polo players

    Journal of Sports Medicine and Physical Fitness

    (1997)
  • K. Kenal

    Swimming and water polo

  • K.A.F. Kenal et al.

    Rehabilitation of injuries in competitive swimmers. Injury Clinic

    Sports Med

    (1996)
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Address reprint requests to Joy M. Brooks, BScPT, RPT, MCPA, Canadian Knee Institute, 2863 Ellesmere Road, Suite 202, Scarborough, Ontario M1E 5E9, Canada

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Canadian Knee Institute, Scarborough, Ontario, Canada

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