Purpose

Underwater rugby (UWR) is a team sport in which the player and ball move in three dimensions. The goal is to get the ball into the opponent's basket, which is placed underwater, and the ball may only be moved underwater. Athletes require a high degree of strength, endurance, speed and coordination. Intense physical contact and effort during tackles can sometimes lead to acute or chronic injuries or overuse disorders. A scientific review of sport-specific injury patterns in UWR is not yet available. Therefore, the current study aims to provide conclusions on injury patterns or injury risks of the sport, to present possible consequences of accidents and to provide a basis for subsequent prevention measures.

Methodology

Since 11/2020, athletes of different performance levels have been surveyed via online questionnaire (SurveyMonkey) about training habits, current or past injuries, and chronic complaints that have occurred in the context of UWR. The questionnaire (n= 55 to 111 questions depending on the number of previous injuries) included: general and health-related data (n= 10 questions), training habits (n=15 questions), information on chronic complaints (n=9 questions), and acute injuries (n=21 to 77 questions). The Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire was used to evaluate chronic overuse injuries.

Results

So far 51 active athletes (Ø 39,4 years; Ø 179cm/82kg; male: 38, female 13) were included in the current study. On average, the respondents had been practicing UWR for 15.4 years. The performance level was: 1st national league: 19x (of which 8 were national team athletes), 2nd national league: 24x, state league: 2x, no league: 6x. The sport-specific training workload (UWR) was Ø 2.1 hours per week, with additional swimming training for 21 of the participants. Additional strength training or endurance training was reported by 21 and 29 of the respondents, respectively. Previous acute injuries with a break from training and/or a visit to the doctor were present in 77% of the athletes (mostly hand/finger, ear (ruptured eardrum, hearing loss) or cervical spine injuries). These injuries occurred predominantly in training (73%) with 58% of the players being in possession of the ball at the time of injury. Chronic complaints were reported by 44% of the participants, mainly in the wrist (48%), finger and cervical spine (33.3% each), shoulder/clavicle (29%), and ankle, knee, head/face (19% each). In the "Overuse injury Questionnaire", 61% stated that they had participated in training in the past week without complaints, while 21% were able to train fully despite complaints. 16% of all respondents were limited in their training due to complaints and 2% had to take a break.

Conclusion

The present study on athletes of different performance levels analyzes the distribution of injuries in UWR for the first time. Leading injury regions are hand/finger injuries, ear injuries and cervical spine injuries. The knowledge gained can help to establish prevention concepts in the future (e.g. training programs for wrist stabilization, prohibition of reaching into the opponent's fingers or tightening of rules regarding head/neck contact).