CARING FOR ATHLETES
Breast Stroker’s Knee
It is not uncommon for many interscholastic and intercollegiate swimming seasons to occur during winter months. As the season progresses, repetitive use causes muscles and tendons to weaken and may result in an overuse injury. Probably the most interesting, as well as misdiagnosed injury that swimmers sustain is called “breast stroker’s knee.” Given that a top-level swimmer may perform between 3,000 and 4,000 whip-kicks per day, swimmers’ knee tissue fatigues and becomes inflamed.
When performing a breast stroke whip-kick, the swimmer creates tremendous stress on the knee. While pulling the legs inwardly together water resistance is applied to the ankles and lower leg, whereby creating a torquing stress to the inside portion of the knee. The anatomical structures that are strained usually involve the medial collateral ligament, but may also involve a variety of tendons and joint linings.
Over years of breast stroke kicking, the swimmer may become “knock-kneed.” Subsequently, the newly acquired “knock-kneed” posture causes additional stress to the swimmer’s back, hips, lower legs, and even feet. For athletes who congenitally already have even minimally knock-knees before becoming a breast stroker, the onset of knee pain is initiated quicker.
Initially the injured swimmer will experience pain only when performing the whip-kick. However, with continued participation the symptoms may evolve into being persistent and present during out-of-water activities. Usually the swimmer experiences tenderness. It is uncommon for swelling to be present. Even on land, the swimmer may experience sharp pain when positioning the knee in a position of strain or stress.
Once the swimmer’s symptoms have occurred sports medicine treatment should be initiated. Conservative physical therapy is usually the treatment of choice to alleviate painful symptoms. Carefully prescribed biomechanical stretching and strengthening exercises of certain leg muscles are effective in both treatment and preventing the stress that causes breast stroker’s knee.