Sport
Water polo is swimming, throwing and wrestling in deep water: short bursts of sprinting and grappling every few seconds, the eggbeater kick to stay high, and shots thrown from a floating base. It has the highest injury rate of the aquatic sports, mostly cuts, bruises and sprains from contact, and concussion is common, including in goalkeepers hit by the ball. Shoulders and hips carry the overuse problems.
This guide covers what water polo asks of your body, the common injuries, and World Aquatics' safety rules (caps with ear protectors, nails, bleeding, water depth, lifeguards and medical teams) as of February 2026. It sets out the dryland strength training that has raised throwing speed in trials, conditioning and tapering, shoulder and hip care, teeth and ears, concussion and water safety. It includes a poolside warm-up and a dryland workout, with a 3D demo of every move; swimming technique and swim training are on our swimming page.
Bursts of under 15 seconds come with under 20 seconds between them, and elite women changed what they were doing every 6.2 seconds. The Compendium of Physical Activities lists water polo at 10.0 METs (metabolic equivalents), an estimated value.
At Olympics and world championships, 14.1 injuries per 100 players, most often cuts and bruises to the head and sprained or dislocated fingers and hands, and 57% from contact with another player.
Of 153 adult players, 38.1% had shoulder pain and 33.1% hip or groin pain at the time of a survey. No shoulder programme has been tested on injuries in water polo.
Concussion was the commonest single diagnosis in US college water polo, and a higher share of goalkeepers than field players had one, mostly from the ball.
World Aquatics requires caps with ear protectors, fastened under the chin, nails cut short, bleeding players out of the pool, water at least 2 m deep, and lifeguards and medical teams trained in water rescue at its events.
Source 5
Twice-weekly strength training for 18 weeks raised throwing speed, strength and sprint swimming in elite men, and a 6-week pre-season block raised throwing speed by 11 to 17%.
Seven a side, six field players and a goalkeeper, in water at least 2 m deep. Touching the floor of the pool during play is a foul, except for goalkeepers in their own 6-metre area, so players stay up with the eggbeater kick. Women's balls are 0.65 to 0.67 m round and men's 0.68 to 0.71 m.
Source 5
Intense bursts of under 15 seconds are separated by easier spells averaging under 20 seconds. Elite women made 330 separate movements a match, a change every 6.2 seconds, with 54 high-intensity efforts and about 700 m of swimming, and intensity fell as matches went on. Overall intensity sits around the lactate threshold. Goalkeepers spent 85.6% of a match below their anaerobic threshold, with sudden spikes above it, most of all when their team was a player down.
Centres wrestle at the 2-metre area and take the most head impacts; perimeter players sprint more; goalkeepers block shots, often with the head in the line of the ball.
The Compendium lists water polo at 10.0 METs, an estimated value, so our calories calculator doesn't include it. Vigorous treading water (9.8 METs) is a measured value, but it isn't water polo.
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The sites the studies point to:
Rotator cuff and shoulder-blade strength for throwing, heavy pulling and pressing, leg power, hip and groin strength for the eggbeater, trunk rotation for the shot, and repeated swimming sprints.
Tournament studies count injuries per player or per match hour, college studies give shares of injuries, and surveys ask players what happened. Figures in different lines aren't directly comparable.
The numbers, by group:
Head cuts (12.7%) and bruises (10.9%) were the commonest tournament diagnoses. In US college water polo, 81.9% of concussions happened outside matches, and 26.2% of goalkeepers had a concussion against 16.0% of field players, goalkeepers mostly from the ball. Canada's senior women's teams had 14.3 concussions per 100 player-years, and 36% of players answering a USA Water Polo survey said they'd had one. Offensive centres took the most head impacts. Our concussion guide covers the graduated return.
Studies put shoulder injury in water polo at 24 to 51% of players. In sub-elite players, the shoulder was the commonest injury and 67% were overuse injuries. Of 153 adult players, 38.1% had shoulder pain at the time of a survey and 81.2% had had it. Low rotation strength and a side-to-side difference in rotation range went with later injury, a previous injury raised the odds of a new one 6.5 times in international players, and previously injured players had weaker outward rotation, relative to inward rotation, when lowering. Our shoulder pain and shoulder impingement guides cover these.
33.1% of adult players had hip or groin pain, more in elite players, and players with shoulder pain were more likely to have hip pain too. Hip labral tears went with more hip bend in the eggbeater, and half the operations in US college water polo were on the hip, groin or pelvis, mostly for hip impingement. All 10 college players who had hip arthroscopy for impingement returned to the same level, at about 6 months. As players tire, eggbeater force falls and the hips turn inwards, which the authors linked, speculatively, with knee pain. Our hip impingement, hip labral tear and knee pain guides cover these.
Sprains and dislocations of the hand and fingers were 9.5% of tournament injuries. Our broken or jammed finger guide covers what to do.
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21% of 415 Swiss players had injured a tooth, and 57.9% of 347 Spanish players had a mouth or face injury in one season, but only 7.7% and 1.2% wore mouthguards. These are surveys.
Perforated eardrums and eye injuries are recognised water polo injuries, but we found no rates. Water polo players' risk of outer-ear infection was similar to swimmers'. Strain on the inner elbow, including the ulnar collateral ligament, is described in water polo throwers, young players included. Our elbow pain guide covers elbow pain; we don't have a guide to ear or eye injuries yet.
Matches; men, for injuries that cost time in matches; goalkeepers for concussion; offensive centres for head impacts; a previous shoulder injury; low shoulder rotation strength; elite level for hip and groin pain; and fatigue in the eggbeater. These are associations.
No injury prevention programme has been tested in water polo. The rules, in their own section below, are the main protection, and the shoulder, groin and mouthguard evidence is borrowed from other sports; each note says so.
Most acute injuries come from contact with other players, and the tournament authors call for a critical review of in-competition rules, a fair play programme and concussion education. Under World Aquatics' rules, holding, sinking or pulling back an opponent and violent action are exclusion fouls.
A 6-week shoulder programme improved rotation range but not strength, and the Thrower's Ten exercises improved shoulder stability and flexibility; neither measured injuries. In one trial, a strength block raised shoulder pain without improving performance. The nearest tested programmes are handball's: Shoulder Control and the Oslo programme cut shoulder injuries in handball players, but they're borrowed here and untested in water polo, as our swimming page says for swimmers.
The Copenhagen adductor exercise cut groin problems by 41% in semi-professional footballers; it hasn't been tested in water polo. The authors of the hip survey suggest watching how much eggbeater work players do.
No rule requires them, though World Aquatics asks organisers to consider dental services at events. Across sports, people without mouthguards had over twice the risk of mouth and face injuries, and elite water polo players were most satisfied with thinner, conventional custom-made guards.
The cap with ear protectors is the rule everywhere we looked. The National Health Service (NHS) advises using earplugs or a swimming hat over your ears when you swim to help prevent ear infections. No study has measured how many eardrum injuries ear protectors prevent (our search).
In Canada's senior women's teams, the time players lost after a concussion fell after better guidelines came in in 2017. The US college authors suggest looking at goalkeepers' practice set-ups and protective headgear.
No study has tested padded concussion caps, ear guards' effect on eardrum injuries, or shoulder taping or braces in water polo (our search), and evidence-based guidance on water polo injuries is generally thin.
27 elite men were randomised for 18 weeks: one group added two strength sessions a week (bench press, full squat, military press, pull-ups, loaded jumps and abdominal work) to 5 days of water training. Jump height rose 6.9%, bench press 10.5%, squat 14.2%, throwing speed 2.8% and 20 m sprint swimming 2.3%; players who only trained in the water didn't improve.
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In 30 professional players, 6 weeks of 3 weekly sessions of combined dryland and in-water strength, in-water strength alone, or jump training raised throwing speed by 11.4 to 17.5%, bench press by 7.6 to 12.6% and squat by 11.5 to 14.6% in all three groups. There was no group that didn't train.
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In 56 young men over 18 weeks in season, five strength methods all raised throwing speed, and training with heavy lowering phases (eccentric overload) gave the biggest gains in throwing speed and in bench and squat strength. Across 26 studies in water sports, jump training improved land jumps and squat strength and, a little, time-trial speed, but not in-water jumps or agility.
In 43 players randomised to maximum-strength or power training, neither improved water polo performance, and shoulder pain rose over the block in all of them. Build loads gradually and keep shoulder care in every session (our suggestion).
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In two elite clubs over 8 weeks, strength training twice a week (4 sets of 5 at 85 to 90% of the most a player could lift once) alongside interval swimming raised bench press strength by 14 to 19%; 4 × 4-minute hard swims improved aerobic swimming speeds by 7 to 9%, while 16 × 100 m efforts did more for the faster end. In national-level players, intensified in-season sprint training lowered aerobic fitness again while keeping repeated sprints in matches. Counter-attack drills with the ball gave the same heart-rate load as interval swimming.
An eggbeater test wearing a weighted jacket (5 to 17.5 kg) separated elite from amateur players and was proposed for training and recovery from injury, and eggbeater force falls with fatigue. No study has tested eggbeater training on performance (our search).
In 8 high-level players, two hard weeks followed by two weeks with training load cut by 19% and then 36% improved 20 m and 400 m swim times and how well players felt before play-offs; the bigger the cut, the bigger the 20 m gain. Over a 4-day international tournament, heart rate variability recovered and rose, but players felt less recovered.
Pre-season: about 6 weeks of 3 dryland and in-water strength sessions a week, with interval swimming twice a week. In season: 2 strength sessions a week with shoulder care in each, and game drills for much of the conditioning. Keep the 48 hours before a match free of heavy legs and maximal jumps (our suggestion).
Before a major tournament: 2 weeks of lighter training after a hard block. Swimming technique and swim sets are on our swimming page.
From World Aquatics' Competition Regulations (in force from February 2026, updated 18 February 2026). No study has measured these rules' effect on injuries or drownings (our search).
"Players must wear caps at all times while on the Field of Play", and caps "must be fitted with malleable ear protectors of the same colour as the rest of the cap", "will be fastened under the chin" and may be thicker than 2 mm. Goalkeepers wear red caps.
Source 5
Players must remove "any articles that could cause injury", have "their fingernails properly cut in a manner that will mitigate the risk of injury", and have no grease, oil or similar substance on the body or hands.
Source 5
"The bleeding Player must leave the pool immediately", and "must not re-enter the Field of Play while bleeding".
Source 5
"Water Polo is a contact sport and there is therefore an inherent risk of traumatic injuries in Water Polo. The incidence of such injuries in Water Polo is the highest of any Aquatic sport." So every competition must have a medical team trained in trauma recognition and water extraction, and lifeguards "who must practice water retrieval on a daily basis". At World Aquatics events, lifeguards experienced in deep water rescue are on the poolside at all training and competition sessions.
Source 5
"The depth of the water inside the Field of Play will at no point be less than 2.00 metres." Holding, sinking or pulling back an opponent, a defender swimming under the water to gain position, intentionally splashing an opponent's face and violent action are exclusion fouls; touching the floor of the pool and holding the whole ball under the water when tackled are ordinary fouls.
Source 5
Swim England applies World Aquatics' water polo rules; the latest changes took effect for English clubs from 1 July 2025. In US high schools, "Each player (in the water or on the bench) shall wear a cap with protective ear guards at all times".
For a concussion or suspected concussion, healthcare staff "must use the Sports Concussion Assessment Tool (SCAT ...) to evaluate the Athlete", which "cannot be performed correctly in less than 10 minutes" and is used from age 13. World Aquatics can remove an athlete whose taking part poses a risk.
Source 5
Swim England's concussion guidance (March 2023) "leads with the message 'if in doubt, sit them out'", includes an example return-to-training plan for water polo, and says "any return to sport should be guided by an appropriately qualified medical practitioner"; we couldn't open the guidance document itself. The UK guidelines for grassroots sport apply too: off at once, NHS 111 or a healthcare professional within 24 hours, a graduated return and no competition before day 21.
Goalkeepers had the highest concussion rates in US college and Canadian senior women's water polo, mostly from the ball, and offensive centres took 37% of head impacts in one men's college team. The authors suggest looking at protective headgear and practice set-ups for goalkeepers; no study has tested a padded cap (our search).
World Aquatics requires lifeguards and a medical team trained in water extraction at its events. We found no Swim England safety rule for club water polo sessions (our search). Our suggestion: never train in deep water without a lifeguard or trained coach on the poolside, and be a confident deep-water swimmer before you join contact drills.
Source 5
Match intensity and eggbeater force both fall as players tire. A player who can't keep their head up, or keeps grabbing the lane rope or the side, should come out and rest (our suggestion).
St John Ambulance: if they're unresponsive and not breathing, ask a helper to call 999 or 112 while you start CPR (cardiopulmonary resuscitation), beginning with five initial rescue breaths, then 30 chest compressions to 2 breaths. After a near-drowning, "Medical advice should be sought, even if they appear well".
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Holding, sinking or pulling back an opponent is an exclusion foul, and violent action is punished more heavily.
Source 5
Built on our warm-up guide and our swimming warm-up, with two Shoulder Control exercises borrowed from handball (editorial): no water polo warm-up has been tested on injuries. Do the first five steps on the poolside.
Loading the 3D figure…
The movement on the figure: Standing band external rotation
Shoulder care, the dryland workout's lifts and jumps, and hip work for the eggbeater. Each has a 3D demo.
3D demoStanding band external rotationBeginner · A band + An anchor point
3D demoBand internal rotationBeginner · A band + An anchor point
3D demoBand pull-apartIntermediate · A band
3D demoScapular push-up (push-up plus)Beginner · No equipment
3D demoScaption raiseBeginner · A dumbbell
3D demoCable press and rotationIntermediate · A cable machine
3D demoBarbell bench pressIntermediate · A barbell + A bench or box
3D demoBarbell back squatAdvanced · A barbell
3D demoPull-upAdvanced · Pull-up bar
3D demoWeighted jump squatAdvanced · A barbell
3D demoTwo-hand overhead throwIntermediate · Medicine ball
3D demoCopenhagen plankAdvanced · A bench or box
3D demoStanding hip CARsBeginner · A wall
3D demoLateral band walkBeginner · A bandThe first two are new: a dryland workout and a poolside warm-up. The swimming workouts cover swim strength and swimmers' shoulders; the others add throwing-arm care, hips, the groin, pulling strength, the trunk, a warm-up for asthma, and light exercise after a concussion.
A 55-minute water polo gym session: loaded jumps, medicine-ball throws, heavy bench press and squats, pull-ups, rotator cuff work, Copenhagens and trunk work.
55 minIntermediate16 movesA band, An anchor pointA 12-minute poolside warm-up for water polo: arm circles, rotations, band work, scapular push-ups, hip circles, leg swings, band walks and trunk rotation.
12 minBeginner11 movesA band, An anchor pointA 45-minute dryland session for swimmers: jumps for starts and turns, heavy pulls, leg strength and trunk work, twice a week alongside the pool.
45 minIntermediate14 movesA band, A bench or boxA 20-minute rotator cuff and shoulder-blade routine for swimmers, from a 12-week trial in competitive swimmers, plus a daily cross-body stretch.
20 minBeginner9 movesA wall, A dumbbellA 35-minute session for baseball and softball players: the five Shoulder Control exercises, rotator cuff and forearm work, medicine-ball throws and legs.
35 minIntermediate17 movesA dumbbell, A cable machineA 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.
25 minBeginner12 movesA wall, A bandA 15-minute hip opener: 90/90 switches, windshield wipers, CARs, Cossack squats, frog and pigeon.
15 minIntermediate8 movesA wallThe Nordic hamstring and Copenhagen adduction programmes from the football trials: a 10-week build, three adductor levels, then once a week in season.
15 minIntermediate6 movesA wall, An anchor pointWork up to your first pull-up: dead hangs, scapular pulls, rows, negatives and assisted pull-ups.
25 minBeginner7 movesPull-up bar, A stepA 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.
15 minBeginner6 movesNo equipmentA 15-minute warm-up for exercise-induced asthma: easy movement, then short hard bursts that can reduce symptoms in the session that follows, then moving stretches.
15 minBeginner5 movesCardio machine, A wallA 20-minute light session after a concussion: a symptom check, 10 to 15 minutes of easy cycling or walking, gentle bodyweight moves and a cool-down.
20 minBeginner8 movesCardio machine, A bench or boxA 10-minute cool-down for after a run, a class or a gym session: a few minutes of easy movement, stretches for the muscles you used, then slow breathing.
10 minBeginner9 movesCardio machine, A wallTwo strength sessions a week fit the season, three in pre-season.
Two full-body strength sessions a week: the minimum that meets health guidelines, with every set, rep and rest, and an 8-week progression.
2 training days45 minBeginner3 days a weekA beginner gym plan: three full-body sessions a week, alternating workouts A and B, with sets, reps, rest and an 8-week progression.
3 training days45 minBeginner3 days a weekA 12-week calisthenics plan for beginners: three bodyweight sessions a week with push-up, pull-up, squat and dip ladders, and a bar if you have one.
3 training days40 minBeginner3 days a weekA 12-week beginner barbell program: squat every session, alternate bench and row with press and deadlift, and add weight each time until it stalls.
3 training days50 minBeginnerThe PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or losing consciousness, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your doctor or a qualified exercise professional first. If you're over 45 and not used to hard exercise, ask a qualified exercise professional before the hardest sessions, and delay if you're ill.
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Matches are played in water at least 2 m deep, and eggbeater force falls as you tire. Be a confident deep-water swimmer before contact play, and train only with a lifeguard or trained coach on the poolside (our suggestion).
Our epilepsy guide explains that swimming is in the International League Against Epilepsy's moderate-risk group, and that people with epilepsy are 15 to 19 times more likely to drown. Agree water polo with your neurologist first, never swim alone, have someone in the water who knows what to do, and tell the lifeguard.
Follow Swim England's guidance and the UK guidelines: off at once, a graduated return guided by a medical practitioner, and no competition before day 21. Our concussion guide has the stages.
The NHS says "do not go swimming or get your ear wet until your eardrum heals", and "do not go swimming while you have an ear infection". Wait until it has healed.
A previous shoulder injury raised the odds of a new one 6.5 times. See our shoulder pain guide, keep the shoulder care from our workouts going, and throw less while it settles (our suggestion).
A third of adult players had it, more at elite level. See our hip impingement and groin strain guides, and cut back on eggbeater work while it settles.
Our asthma guide explains that chlorine can be a trigger: if you only get symptoms when you swim, it could be the chlorine in the pool.
The NHS advises seeing a GP if you've fainted, and calling 999 if someone faints while exercising; losing consciousness in deep water is a drowning risk (our reading). Check with your doctor before you play.
The NHS says swimming can be good exercise in pregnancy, but advises against sports with a risk of bumping your tummy. Swim rather than play contact water polo (our suggestion), and talk to your midwife or GP.
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Shout for the lifeguard. Once they're out, if they're unresponsive and not breathing, ask a helper to call 999 or 112 while you start CPR with five rescue breaths, then 30 compressions to 2 breaths. After a near-drowning, get medical advice even if they seem well.
Source 55
The NHS says to call 999 if someone has hit their head and:
Source 61
If in doubt, sit them out: out of the pool at once and no return that day. Get help from NHS 111 (the National Health Service's urgent advice line) if they're being sick, feel dizzy or take medicine that thins the blood.
Hearing loss, ringing, ear pain, fluid or blood from the ear, or dizziness after a blow can mean a perforated eardrum. Ask for an urgent GP appointment or get help from NHS 111 if you have sudden hearing loss, and don't swim until it heals.
Source 57
Go to A&E (accident and emergency) or call 999 if the eye was hit at high speed, your sight has changed, it's very painful, you have a headache or are sensitive to light, you feel or are being sick, you can't move the eye or keep it open, or blood or pus is coming from it.
Source 62
A chipped or broken tooth needs a dentist: keep any piece in milk or saliva. Call 999 or go to A&E for a nosebleed that won't stop, clear, watery fluid from the nose, a cut that won't stop bleeding, or a bad cut on the face. Under the rules, a bleeding player leaves the pool at once.
Go to A&E if a finger points at an odd angle, looks blue or feels numb, or bone can be seen, or if you can't move your arm or the shoulder looks out of place. Don't try to put a shoulder back in yourself.
If someone is unresponsive and not breathing normally, call 999 or 112, start CPR straight away, and ask a helper to find and bring a defibrillator.
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Water polo had the highest injury rate of the aquatic sports at the 2013 world championships and was among the three highest across three championships, and World Aquatics' own rules call its injury rate the highest of any aquatic sport.
They're a rule, in World Aquatics' regulations and in US high schools, because a blow to the ear can perforate the eardrum. No study has measured how many injuries they prevent.
A higher share of goalkeepers than field players had a concussion in US college water polo (26.2% against 16.0%), mostly from the ball, and goalkeepers had the highest rate in Canada's senior women's teams.
No study has tested one (our search); the US college authors call for research on protective headgear for goalkeepers.
Source 9
Two strength sessions a week for 18 weeks made elite players' 20 m sprint swim faster, as well as raising throwing speed.
Source 10
Throwing and swimming both load the shoulder; low rotation strength and a previous injury went with new injuries, and in one trial a strength block raised shoulder pain. Shoulder care and gradual loading both matter (our reading).
21% of Swiss players had injured a tooth, and 57.9% of Spanish players had a mouth or face injury in one season, but few wore mouthguards.
Holding, sinking or pulling back an opponent is an exclusion foul, and violent action is punished more heavily.
Source 5
Strength training twice a week, with bench presses, full squats, pull-ups, loaded jumps and trunk work, raised throwing speed, jump height, strength and sprint swimming over 18 weeks in elite players. Add shoulder care and hip work, and build loads gradually, because shoulder pain rose over a strength block in one trial. Our dryland workout puts it together.
Because the rules require them: World Aquatics' caps must have malleable ear protectors and be fastened under the chin, and US high-school players must wear a cap with protective ear guards at all times. A blow to the ear can perforate the eardrum, though no study has measured how many injuries ear guards prevent.
In World Aquatics competitions, at least 2 m everywhere in the field of play. Players aren't allowed to touch the floor of the pool during play, apart from goalkeepers in their own 6-metre area, so field players keep themselves up with the eggbeater kick for the whole match.
You can't hold the whole ball under the water when tackled, and holding, sinking or pulling back an opponent is an exclusion foul, as is a defender swimming under the water to gain position. Players still go under in the contact, which is why World Aquatics requires lifeguards and trained medical teams at its events.
At major championships, cuts and bruises to the head and face, and sprained or dislocated fingers and hands, mostly from contact. In US college water polo, the shoulder was the most injured part and concussion the single commonest diagnosis. Shoulder and hip or groin pain are the common overuse problems.
No shoulder programme has been tested on injuries in water polo. Low rotation strength and a previous injury go with new injuries, and the nearest tested programmes are handball's, which our workouts borrow. Build throwing and gym loads gradually and keep shoulder care in every session.
It has the highest injury rate of the aquatic sports, mostly cuts, bruises and sprains, and concussion is common. The rules protect players with caps and ear protectors, short nails, bleeding players out of the pool, and lifeguards and medical teams at World Aquatics events.
No study has tested eggbeater training on performance. A weighted-jacket eggbeater test separated elite from amateur players and was proposed for training, and eggbeater force falls as you tire, so build endurance in the water and strengthen your hips and groin on land.
Interval swimming: in elite players, 4 × 4-minute hard swims twice a week improved aerobic swimming speeds by 7 to 9%, and sprint sets did more for the faster end. Counter-attack drills with the ball gave the same heart-rate load as interval swimming. Before a big tournament, two weeks of lighter training improved sprint and 400 m swims.
World Aquatics doesn't require one, but surveys found 21% of Swiss players had injured a tooth and over half of Spanish players had a mouth or face injury in a season. Across sports, players without mouthguards had over twice the risk of mouth and face injuries, and water polo players found thinner custom-made guards most comfortable.
Exercise education for people who play sport, not a personal prescription or a diagnosis, and clinical review of these pages is pending. Check with a GP or physiotherapist before hard training if you have a heart condition, chest pain, dizziness or an injury that isn't settling, and stop for sharp or increasing pain. Health disclaimer.
