The effect of manual therapy on hip joint range of motion, pain and eggbeater kick performance in water polo players

ObjectivesTo examine the effect of a specific course of manual therapy intervention on hip joint range of movement (ROM), pain, and eggbeater kick performance.MethodsSixteen junior elite male water polo players participated in the randomised crossover study. The ranges of hip joint passive and active internal (IR) and external rotation (ER), and active abduction were measured. Visual analogue scales (VAS) were used to determine hip pain. In-water performance assessment included a maximal jump height test and an eggbeater endurance to fatigue test. The intervention consisted of eight, 45-min sessions of manual therapy over a period of four weeks.ResultsA statistically significant difference between control and experimental groups was found in passive IR, ER, and total passive ROM (p<0.05). The intervention had no apparent effect on abduction ROM. Using an analysis of chosen clinical likelihood, the intervention is likely to have increased the chance of improvement in both jump height and eggbeater endurance. There was no correlation between changes in pain or ROM and change in performance.ConclusionsThe intervention resulted in improved hip ROM and is likely to have improved eggbeater performance. However, the improved performance could not be directly attributed to the improved ROM. The possible mechanisms responsible for these findings are discussed.