Increased Prevalence of Concussion in Collegiate Water Polo Goalkeepers.

Objective: To investigate the epidemiology of sport-related concussion in collegiate water polo players and compare the risk of concussion between goalkeepers and field players.

Design: Retrospective chart review using injury surveillance data from July 2016 and June 2022. Descriptive statistics, χ2 and Fisher exact tests, and pairwise comparisons using false discovery rate-adjusted P-values were used for statistical analysis.

Setting: Pac-12 conference collegiate water polo teams.

Participants: Ninety-six Pac-12 athletes from 4 men's and 5 women's water polo teams, with a total of 124 identified concussions.

Independent variable: Player position (goalkeeper vs field player) and location of injury (practice vs competition vs not sport related).

Main outcome measures: Prevalence of sport-related concussion by player position and location of injury.

Results: Goalkeepers experienced a significantly higher proportion of sport-related concussions than field players (26.2% vs 16.0%, P = 0.005). Most concussions in goalkeepers occurred from ball-to-head contact while most field player concussions were because of contact with another player. There was no significant difference in the number of concussions suffered in practice compared with competition.

Conclusions: Collegiate water polo goalkeepers face a higher risk of concussion than field players, particularly from ball-to-head contact. Current safety protocols may be inadequate for goalkeepers. Future research should examine the effectiveness of protective headgear and modified practice equipment in mitigating concussion risk, potentially leading to rule changes.