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Specific Shoulder Pathoanatomy in Semiprofessional Water Polo Players: A Magnetic Resonance Imaging Study.

Klein M, Tarantino I, Warschkow R, Berger CJ, Zdravkovic V, Jost B, Badulescu M - Orthop J Sports Med (2014)

Bottom Line: However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described.After performing a power analysis, volunteers were recruited for this study.Clinical symptoms do not correlate with the MRI findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Universitätsspital Basel, Basel, Switzerland.

ABSTRACT

Background: Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described.

Purpose: To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects.

Results: Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic.

Conclusion: The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes.

Clinical relevance: The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings.

No MeSH data available.


Related in: MedlinePlus

Water polo player in a throwing motion. Note the strong shoulder girdle muscles. A similar arm position can be observed when handball players perform a jump shot.
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fig1-2325967114531213: Water polo player in a throwing motion. Note the strong shoulder girdle muscles. A similar arm position can be observed when handball players perform a jump shot.

Mentions: Water polo is an Olympic sport where the athletes are moving in 1 medium (water) but are throwing and passing the ball in another medium (air). In both spaces (above and below the water surface), considerable work seems to be performed by the shoulder muscles (Figure 1). This could affect the dominant shoulder in a specific way by combining throwing loads and high-frequency swimming strokes. Furthermore, water polo players exhibit forced flexion and adduction movements to bring the upper body as high as possible above the water surface. This is unusual compared with other contact or ball sports where body weight is not apparently reduced because of immersion in water. Whereas swimmers continuously repeat their strokes during training or competition, water polo players change their swimming speed, direction, and stroke styles.4 In this study, a homogenous group of high-level water polo players was examined clinically and with bilateral shoulder MRI and compared with a control group of young and healthy volunteers. The aims of our study were to assess MRI abnormalities in this specific group of athletes and to correlate these findings with clinical symptoms.


Specific Shoulder Pathoanatomy in Semiprofessional Water Polo Players: A Magnetic Resonance Imaging Study.

Klein M, Tarantino I, Warschkow R, Berger CJ, Zdravkovic V, Jost B, Badulescu M - Orthop J Sports Med (2014)

Water polo player in a throwing motion. Note the strong shoulder girdle muscles. A similar arm position can be observed when handball players perform a jump shot.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555536&req=5

fig1-2325967114531213: Water polo player in a throwing motion. Note the strong shoulder girdle muscles. A similar arm position can be observed when handball players perform a jump shot.
Mentions: Water polo is an Olympic sport where the athletes are moving in 1 medium (water) but are throwing and passing the ball in another medium (air). In both spaces (above and below the water surface), considerable work seems to be performed by the shoulder muscles (Figure 1). This could affect the dominant shoulder in a specific way by combining throwing loads and high-frequency swimming strokes. Furthermore, water polo players exhibit forced flexion and adduction movements to bring the upper body as high as possible above the water surface. This is unusual compared with other contact or ball sports where body weight is not apparently reduced because of immersion in water. Whereas swimmers continuously repeat their strokes during training or competition, water polo players change their swimming speed, direction, and stroke styles.4 In this study, a homogenous group of high-level water polo players was examined clinically and with bilateral shoulder MRI and compared with a control group of young and healthy volunteers. The aims of our study were to assess MRI abnormalities in this specific group of athletes and to correlate these findings with clinical symptoms.

Bottom Line: However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described.After performing a power analysis, volunteers were recruited for this study.Clinical symptoms do not correlate with the MRI findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Universitätsspital Basel, Basel, Switzerland.

ABSTRACT

Background: Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described.

Purpose: To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects.

Results: Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic.

Conclusion: The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes.

Clinical relevance: The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings.

No MeSH data available.


Related in: MedlinePlus