Reduced shoulder strength and change in range of motion are risk factors for shoulder injury in water polo players

Andrea Hams, Kerrie Evans, Roger Adams, Gordon Waddington, Jeremy Witchalls

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Objective: To determine whether pre-season shoulder ROM and strength can be used to identify athletes at risk of future shoulder injury. Design: Prospective cohort. Setting: High performance sports institute. Participants: 76 sub-elite water polo players. Main outcome measures: Mean pre-season shoulder internal (IR) and external rotation (ER) ROM and strength values compared by gender, dominance and prospective injury status. Results: 14-dominant shoulder injuries were recorded. There was a significant difference (p = 0.05) in total ROM difference (TROM) between the prospectively injured and no injury groups (−17.2°(30.4);-0.8°(13.3)), and dominant side ER strength (11.7%(2.4) vs 14.5%(2.8), p = 0.03) and IR strength (16.5%(3.0) vs 21.6%(4.9) as a percentage body weight (PBW) were also significantly different (p ≤ 0.03). Separate significant associations were found between future episodes of shoulder injury and; dominant shoulder TROM difference of ≥7.5°(OR 3.6,95%CI 0.8–16.0), ER strength as a PBW≤12.5%(OR 5.2,95%CI 1.0–27.9), and IR strength as a PBW≤16.8%(OR 13.8,95%CI 2.2–88.0). Conclusion: Pre-season dominant TROM difference, and reduced shoulder IR and ER strength relative to body weight were significant predictors for future shoulder injury. Although further investigation with a larger sample size is required, achieving optimal values on these measures may reduce future episodes of shoulder injury in water polo players.

Original languageEnglish
Pages (from-to)231-237
Number of pages7
JournalPhysical Therapy in Sport
Publication statusPublished - Nov 2019


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