While water polo may seem like a summer sport, there is heavy competition during the Fall, with the men’s NCAA championships taking place in December. Given the physical nature of the sport and limited protective equipment, it’s important to be aware of the many different acute injuries that put water polo players at risk.
Acute injuries are often the result of contact with an opposing player, with the head and upper extremities being the most common areas injured. Water polo players are also at risk for many different overuse injuries given that the sport is played in the water, which provides unique biomechanical challenges to the body, especially the upper extremities and knees. The hand and fingers are vulnerable areas for acute injury, either when opposing players strike the area as they try to steal the ball, or when players attempt to block shots. This can lead to dislocations or fractures of the hand or fingers. Finger dislocations can often be reduced immediately at poolside, and if no associated fracture is present, can be treated with buddy-taping or splinting. Eye injuries are also common, ranging in severity from irritation to lacerations/abrasions and fractures. An abrasion to the can also occur from getting poked in the eye. This can be treated with topical antibiotic drops and rest until the area heals, typically within a period of a few days. Lastly, water polo players are also at risk of a ruptured eardrum if the ear is struck. This typically heals on its own with time, but given the possible damage to the inner ear from water, the athlete will often have to remain out of the pool until healing occurs.
With repetitive overhead throwing in water, which does not allow a solid base for support, a lot of stress is placed on the upper extremity to generate velocity in the throws. These actions can be responsible for causing injuries that may include bursitis or tendinopathy of the rotator cuff muscles, tendonitis of the biceps, shoulder impingement, and elbow ligament, cartilage and impingement injuries. These injuries can often be treated conservatively with rest, anti-inflammatory medications and physical therapy. The lack of a solid base in the water also places a lot of load on the lower extremities, as water polo players have to constantly tread water to stay afloat. This “egg beater” kick places strain on the muscles of the thigh and the inside half of the knee, and overuse injuries to these areas are common. These include thigh muscle strains and tendon injuries, patellofemoral pain syndrome and knee ligament and meniscus injuries. Fortunately, as with upper extremity overuse injuries, these can often be treated conservatively with rest, ice, anti-inflammatories and physical therapy.
As with injuries in any sport, the best treatment is to prevent the injuries from occurring in the first place. Overuse injuries can be prevented by allowing the body adequate time to heal, whether by taking days off during the week, or cross-training to avoid using the same areas repetitively. The only protective equipment for acute injuries in water polo is a swim cap, which can protect the ears.
Dr. David Wang is a sports medicine physician at Hospital for Special Surgery specializing in the treatment of acute and overuse injuries. His main clinical and research interests are overuse injuries, concussions, viscosupplementation injections, and the pre-participation physical exam. As a former collegiate baseball player, he also has a special interest in the care of baseball players.