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Titre : | Epidemiology of shoulder injury in sub-elite level water polo players (2019) |
Auteurs : | Andrea Hams ; Kerrie Evans ; Roger Adams ; et al. |
Type de document : | Article |
Dans : | Physical therapy in sport (Vol. 35, January 2019) |
Article en page(s) : | p. 127-132 |
Note générale : | https://doi.org/10.1016/j.ptsp.2018.12.001 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Athlètes ; Blessure ; Epaule ; Épidémiologie |
Mots-clés: | Water Polo |
Résumé : |
Skip to main content Journals & BooksRegisterSign in Download PDF Advanced Outline Highlights Abstract Keywords 1. Introduction 2. Methods 3. Statistical analysis 4. Results 5. Discussion 6. Conclusion Ethical statement Conflicts of interest Acknowledgements References Tables (3) Table 1 Table 2 Table 3 Elsevier Physical Therapy in Sport Volume 35, January 2019, Pages 127-132 Physical Therapy in Sport Original Research Epidemiology of shoulder injury in sub-elite level water polo players Author links open overlay panelAndreaHamsabc KerrieEvanscRogerAdamsaGordonWaddingtonaJeremyWitchallsa https://doi.org/10.1016/j.ptsp.2018.12.001 Get rights and content Highlights Shoulder injuries were the most common self-report and physiotherapist-report injury by sub-elite water polo players. Shoulder injuries accounted for 25% of all lost training days. The average time delay between sustaining a shoulder injury and seeking physiotherapy treatment was 10 days. Abstract Objective Investigate the patterns and circumstances of shoulder injury, in both male and female sub-elite water polo players, through evaluating the injury incidence, mechanism and subsequent training time lost. Design :Retrospective cohort. Setting Sports institute. Participants 80 sub-elite water polo players. Main outcome measures Total injury number and incidence, mechanism of injury, lost training time and time from injury onset to seeking treatment. Results For the athlete self-report data set (20092013), 218 total injuries were reported with 54 (25%) being shoulder injuries. From 2014 to 2016, 133 physiotherapist-report injuries were recorded, the shoulder accounting for 21 (16%) of total injuries. The shoulder was the most frequently injured site and accounted for 25% of lost training days. Two thirds of shoulder injuries were due to overuse (67%). The average time between sustaining a shoulder injury and presenting to the team physiotherapist was 10 days. Conclusion : Irrespective of data collection method, shoulder injuries were the most common injury for both male and female sub-elite water polo players. Future injury prevention strategies could address overuse through optimising throwing volumes, and include athlete education about injury management to determine whether reducing time delay between injury occurrence and seeking treatment improves outcomes. Previous article in issue Next article in issue Keywords Shoulder Water sports Return to sport Physical therapists 1. Introduction Water polo is a water-based contact sport that involves swimming, throwing and defending. Men's water polo was introduced at the modern Olympics in 1900, making water polo the first Olympic team competition (Smith, 1998). Despite the long history of the sport, information regarding intrinsic risk factors for injury and injury rates in both male and female water polo players is limited when compared to other throwing sports. Water polo is a physically demanding sport, in that participating athletes are required to perform bursts of sprint swimming interspersed with lower intensity swimming, (Franić, Ivković, & Rudić, 2007). Due to water polo training including a substantial swimming component, risk factors for shoulder pain and injury in swimming cohorts are often generalised to water polo. However unlike swimming, water polo players use a heads-up swimming technique to allow a clear view of the ball and opposition as well as to allow the athlete to quickly adapt to offensive and defensive play (Elliott, 1993; Miller, Evans, Adams, Waddington, & Witchalls, 2017). In contrast to swimming, the heads-up technique requires athletes to shorten their stroke and keep their elbows high, reducing their body roll and increasing the required shoulder internal rotation and abduction (Colville & Markman, 1999). Further, water polo players have the added demand of throwing, with players performing an average of 38.7 passes, 32.1 receives and 7.9 shots per-game (Dopsaj & Matkovic, 1998). Although the throwing mechanics in water polo are similar to on-land throwing sports (Feltner & Taylor, 1997; Garrett & Kirkendall, 2000) the aquatic environment requires athletes to generate throwing force without a firm base of support. The water medium reduces an athletes ability to generate a distal to proximal throwing sequence, increasing the required trunk side flexion and demand on the shoulder joint (Alexander, Hayward, & Honish, 2010). Injury surveillance is the first step to quantifying and managing injury risk. While few epidemiological studies have been conducted on water polo injury, Annett, Fricker, and McDonald (2000) found shoulder injuries to be the most common musculoskeletal injury in elite male water polo players. Although there is limited evidence for causation, risk factors for shoulder injury in water polo are likely related to the overhead demands of the sport. A recent systematic review reporting that the combined repetitive overhead demands of water polo challenge the physiological limits of the shoulder and increase players' risk of injury (Miller et al., 2017). Additionally, the higher an athlete's level of sporting attainment (e.g. elite vs sub-elite, club or novice level) and a greater number of water polo playing years, has been proposed to increase an athlete's risk of shoulder injury (Colville & Markman, 1999). Inferences made from previous literature to the sub-elite, however, have limited generalisability due to the focus on elite populations only (Miller et al., 2017). Injuries in any professional sport are the most common reason for player unavailability for training and games, and high injury rates have been shown to adversely affect team performance and success in other sports (Hägglund et al., 2013). Due to risk of chronic injury and ensuing detraining effects, shoulder injury prevention is of high importance to developing water polo players, their coaches and medical staff. It is hypothesised that shoulder injury frequency will be higher than other injuries for this population. The aim of this study was to therefore investigate the patterns and circumstance of all injuries, and shoulders in particular, in both male and female sub-elite water polo players, through evaluating the injury incidence, mechanism and subsequent training time lost. 2. Methods A retrospective and prospective cohort study of injury surveillance data, from a single male and female state-based sports institute water polo squad (20092016 inclusive), was conducted. Each of the six Australian states and two territories has a State Institute or Academy of Sport water polo team from which the national team is selected by Water Polo Australia (WPA). Athletes included in the present study are referred to hereinafter as sub-elite, as they are on scholarship at the sports institute. The included athletes form part of the wider group from which the national team is selected, but they are not currently part of the national squad. Athlete recruitment and characteristics: Access to de-identified retrospective data, collected over the five years, for all male and female water polo squad members was granted. The data was collected with ethics approval from within the sporting institution ethics committee. For players currently in the sporting institution water polo squads, the Head of High Performance invited all players to participate in the present study through email and participant information was provided. Opportunity was also provided for the researchers to answer any questions and written informed consent was obtained prior to inclusion in the study. During this eight year period, 218 water polo players (female = 128 and male = 90) were included in the study.The mean age of players included in the self-report data was 19.27 + 2.94 years for females and 20.62 + 3.73 for males. For the physiotherapist-report date the mean age was 18.79 + 4.43 and 19.82 + 3.16 years respectively. Analyses were performed for all available injury data for the study population. The study was approved by XXX. Definitions A physiotherapist-report injury was defined as a musculoskeletal condition that required the athlete to receive physiotherapy treatment. Injury burden was defined as the total training days lost due to the injury (no training), and by the number of days in modified or restricted training. Athlete exposure (AE) was defined as available training days per athlete, and injury frequency was calculated per 1000 available days. Injury incidence was defined as the number of new injuries in a specified time period (Phillips, 2000) and injury rate as the number of injuries divided by athlete time exposure (Knowles, Marshall, & Guskiewicz, 2006). Mechanism of injury was sub-categorised within two domains: onset of pain/injury; insidious or traumatic, and water polo mechanism of injury; throwing/shooting, contact from blocking ball, contact from another player, swimming, gym-work, jumping/leg work or change-in-direction. Body areas were defined by self-report into 10 categories; cervical, shoulder, elbow, forearm, hand/wrist, spine (thoracic/lumbar), hip/groin, thigh/leg, knee and ankle. The additional categories; head, upper arm, gluteal, chest, abdominal and separation of spine into thoracic and lumbar formed a total of 16 categories for physiotherapist-report data. Self-report injury data. During 20092013, 141 athletes were included in the water polo program. Injury reporting consisted of an annual injury surveillance screening session, wherein athletes completed a paper-based instrument. Athletes were required to report a dichotomous yes or no regarding having experienced a water polo related musculoskeletal injury in the preceding 12-months, for 10 different regions of the bo |
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