Original researchThe volume of goal shooting during training can predict shoulder soreness in elite female water polo players
Introduction
Shoulder soreness is the most common musculoskeletal complaint for water polo players.1, 2, 3 Shoulder soreness has been associated with both the playing experience and performance level of water polo athletes.3 Importantly, athletes that have a greater level of experience are more likely to experience shoulder soreness perhaps due to greater training loads experienced in this level of athlete.3 Female water polo players experience significantly higher rates of shoulder injury than males.4 Shoulder soreness may lead to injury and as such is an important health and wellbeing issue in water polo given the stress placed on this joint during match-play activities such as goal shooting. Despite this, previous research has focussed on the incidence and pathology of the general injuries that occur in water polo and not specifically considered shoulder soreness.4, 5, 6
Shoulder soreness is commonly associated with overuse shoulder injury and is prominent in water polo players.2, 7, 8 It is believed to be the result of cumulative micro-trauma from the repetitive dynamic motions of overhead throwing and swimming.2, 7, 8 Greater shoulder soreness has been associated with increased shoulder mobility as a result of imbalances in rotator cuff muscles.9 The relative increase in dominant shoulder external rotation observed in water polo players suggests that levels of shoulder soreness would be a result of throwing actions rather than swimming.9, 10 Building on this, biomechanical research on goal shooting has indicated that the forceful throwing actions from the water expose the shoulder to greater load than land-based throwing actions such as throwing in handball, cricket and baseball.11, 12, 13 This can be explained by the reduced contribution of the lower extremity to the kinetic chain when throwing from the water as required in water polo. Less energy generation from the legs requires a greater amount of force to be produced at the shoulder when compared to equivalent land-based throwing.3 Therefore, the repetitive throwing actions in water polo combined with the characteristic water-based activities may contribute to shoulder soreness.
A greater understanding of shoulder soreness associated with throwing actions in water polo would be valuable for coaches in designing appropriate training programmes and health practitioners in monitoring the incidence of soreness in the sport. The design of current water polo training programmes are based predominately on physiological training and match-play activities with limited consideration given to injury incidence.14, 15, 16 In cricket and baseball, a high prevalence of shoulder soreness and overuse injuries has been observed in bowlers and pitchers, similar to that in water polo.17, 18 This has lead to training workload limits based on the established association between throwing and the risk of overuse injury.18, 19, 20 It has been found that greater than 75 pitches per game in baseball increased the risk of shoulder soreness and injury. Similarly, research in cricket has shown that less than 2 days rest between high volume throwing in training and games significantly increased the risk of shoulder soreness and injury to bowlers.19 Hence, information regarding shoulder soreness and the association with goal shooting volume in water polo would provide valuable insight into how to structure training and schedule games in order to optimise performance improve player welfare.
The aim of this study was to examine the incidence of shoulder soreness during water polo training with respect to the volume of goal shooting throwing actions. The objectives of this study were to define the relationship between self-reported shoulder soreness and the volume of goal shooting throwing actions and examine the rest periods between shots that were associated with increased shoulder soreness.
Section snippets
Methods
Seven participants volunteered ( age 23 years, range 18–29 years) from a squad of high performance international level female water polo athletes. Each participant wore a cap exhibiting a unique number for identification during data collection. Prior to the data collection ethics approval for Human Investigation was obtained through the national sporting institution's ethics committee (Australian Institute of Sport Ethics Committee, Canberra). The ethical guidelines followed by investigators
Results
Predictive modelling showed that the volume of shots during training accounted for 74% of the variance in shoulder soreness (R2 = 0.7430). The total number of shots taken during each training camp contributed significantly to this predictive model of shoulder soreness (p < 0.001). A total of 2234 shots were observed during both camps with 875 shots taken during the squad selection camp and 1359 shots during the team game-based camp. The average volume of shots per day during the squad selection
Discussion
The current study described the interaction between water polo goal shooting and shoulder soreness. Existing literature has indicated that despite a high prevalence of shoulder soreness in water polo, the specific activities that contribute to these symptoms are poorly understood.23 Increased shoulder soreness reported for athletes during both training camps in the current study is supported by an established association between throwing actions and shoulder soreness in land-based activities.1,
Conclusion
This study demonstrated that the volume of goal shooting increased shoulder soreness in high performance women's water polo. Shoulder soreness was shown to increase with goal shooting workload and reduced recovery time. Variance between individuals was an important predictor of shoulder soreness. The most effective way to manage shoulder soreness would be to monitor goal shooting workloads for each individual athlete. Monitoring of goal shooting workload provides meaningful information in the
Practical implications
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Shoulder soreness increased with a greater number of shots and less rest between shots.
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Athlete shoulder soreness should be monitored based on individual workload responses.
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Monitoring the number of shots athlete's take during training may provide an alternative assessment method to self-rating surveys in highlighting athletes likely to experience increased shoulder soreness.
Acknowledgements
The Australian Institute of Sport provided financial assistance during this project. Chris Barnes is acknowledged for his valuable assistance in analysing the data for this project.
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