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"Pain in the Knee: Swimmers can get Breaststroker's Knee"

By Bruce McAllister, Marshall University Medical School Professor


There are three types of knee pain seen most often in swimmers:

  • Pain to the medial collateral ligament, which is the ligament on the inside area of the joint line (seen in breaststroker's knee).
  • Pain around the patella or kneecap itself; and pain around the entire knee joint, which in many cases may be referred from the medial side.
  • Pain on the inside of the knee at the joint line coming from the medial collateral ligament and is most common in the breaststroker.

By pressing on the inside of the knee, right along the ligament, you can elicit tenderness and pain. As with most of the conditions we have discussed, prevention is the best treatment.

Alter the swimmer's training program to omit the whip kick and substitute other strokes and kicks as much as possible. The constant stress of the whip kick can cause micro tears and an overuse syndrome to the medial side of the knee. Problems are often caused by the forces of the lower leg bone rotating out and the knee joint on the inside opening up. As a preventive measure, swimmers should do a 2,000-yard warm-up before swimming a hard breaststroke. If a knee injury does develop, however, have the swimmer refrain from doing the breaststroke for two months to totally rest the knee. Keep in mind that other strokes that are less stressful to the knee joint may be performed during this time.

Treatment

Treatment for breaststroker's knee consists of ice, compression, elevation, warming up with a hydrocollator pack before practice, and a deep friction massage program. All of these techniques will prove to be beneficial. It is important to obtain advice from a certified athletic trainer or physician if the athlete continues to have pain outside the pool or at rest.

Rehabilitation

Some rehabilitation techniques have already been mentioned. The use of surgical tubing, put on the foot and wrapped around a bedpost or doorknob, will allow an athlete to turn his or her foot inward, then outward, thereby strengthening the quadriceps, and especially the hamstring and the lower leg muscles, will help to assure a stable joint.

 

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