Effect of Thrower's Ten Exercise Program on Shoulder Flexibility, Stability and Strength in Water Polo Players

Context: Studies have shown that the thrower's ten rehabilitation program is effective in the prevention and rehabilitation of injuries in overhead throwing sports. However its effect on water polo sports is still unknown.

Objective: To investigate the effect of thrower's ten (T10) exercise program on shoulder flexibility, stability and strength in water polo athletes.

Design: Randomized controlled clinical trial. Setting: Middle East Technical University swimming pool and training facilities.

Intervention(s): T10 group were given thrower's ten exercises 3 times per week for 10 weeks, each exercise being 2x10 repetitions. Athletes in the control group were not given any additional exercise to their weekly water polo training.

Main Outcome Measure(s): Before and after the exercise, the upper extremity internal and external rotation strength of the athletes was measured with isokinetic dynamometer, the shoulder stability was measured with the closed kinetic chain upper extremity test (CKCUEST), and the shoulder flexibility was measured with the help of the shoulder joint internal and external rotation motion flexibility test.

Key Words: Thrower's Ten, Water Polo, Stability, Flexibility, Strength

Before starting the study, individuals were informed about the purpose of the study, the test protocols to be applied and the program.

Individuals who met the inclusion criteria were randomly allocated into two groups named T10 (n=24) and Control (n=26) in a single blinded manner using a computer-based online site called "Random Lists". Three separate evaluation tests were administered before and 10 weeks after the start of the study.

Individuals in the T10 group underwent T10 exercise program with a physiotherapist or trainer for 10 weeks with 3 sessions per week and at least 1 day between sessions. Individuals in the control group were followed up for 10 weeks as they continued their weekly team training without being actively subjected to an extra program., After the inital evaluations were completed in the T10 group, exercises were started 1 week before the study and the exercises were taught. Elastic resistance band in the appropriate color to be used in the program were determined based on 70% difficulty according to the OMNI scale.

The athletes participating in the study were evaluated twice in total, at the beginning and at the end of the study. Sociodemographic data including age, weight, height, gender, BMI and dominant side were collected. Shoulder strength of the participants was evaluated with an isokinetic dynamometer in 90° abduction with external and internal rotation force test at angular velocities of 60°/s and 180°/s in two different ways. Upper extremity stability of the participants was evaluated by closed kinetic chain upper extremity stability test (CKCUEST). Shoulder internal and external rotation flexibility of the participants was evaluated with the shoulder joint internal and external rotation flexibility of motion test.

Eligibility Criteria:
Inclusion Criteria:

* Being a licensed athlete in a professional water polo team and actively participating in competitions
* Be between the ages of 10-25.
* Both genders

Exclusion Criteria:

* Having suffered an injury in the last 6 months
* Have any orthopedic, neurological, cardiovascular or any other health condition that prevents working in the last 6 months.
* Have a body mass index of 30 and above.
* Having undergone orthopedic surgery