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.