How to Fix and Prevent Breaststroker’s Knee

Michael Butler
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The Research on Breaststroker’s Knee

There has been a lot of research done on breaststroker’s knee.

We only need to look to recent breaststroker Adrian Nicol for an example of an athlete intolerant of pain. Nicol dropped out of the 100-meter breaststroke at the 2016 Rio Olympics due to breaststroker’s knee. And other swimmers in the Olympic pool were suffering from the condition as well.

It’s not just elite swimmers that are at risk for breaststroker’s knee (also called swimmer’s knee).

Many recreational and competitive swimmers have suffered from it as well. In fact, a study of 133 swimmers found that breaststroker’s knee affected 18% of them. It’s not uncommon.

Breaststroke means different things to different swimmers, and how aggressively you start your catch phase of the stroke does have some correlation to how likely you are to develop this condition. But in some cases, excessive stretching can also be an aggravating factor. And in many situations, specific swim strokes can make it worse.


Breaststroker’s Knee

In breaststroke swimming, the weak link of the freestyle stroke is not the catch or the pull but the underwater portion of the stroke. Breaststroke transfers a lot of energy through the legs on the way out of the water. At the finish, those who run into the brackets often involuntarily kick the back of the knee of the trailing leg.

The cause is a fatigue issue, meaning the muscles just plain get weaker and weaker. Malleoli tend to roll inwards, which creates a strain. The same neuromuscular issues seem to also apply in the opposite direction; you get the same fatigue, strain, kicking, and possible tears from kicking too hard at the wall.

In this athlete’s case, the knee pain started at a national meet. He improved with rest, ice, and massage, but the pain came back after four days of increased training. After three weeks of reduced training with steroid injections, he still had pain. It got better when he stopped all kicking at the wall.

The lesson here is that knee pain can be caused by bad technique or can be a symptom of some underlying problem. This athlete needed to rehabilitate the knee in terms of strengthening and flexibility. But a bigger emphasis needed to be placed on the catch, pull, and extension phases.


Phases of the Breaststroke Cycle

The breaststroke is a popular style of swimming that requires a rotation of the arms and legs to move both hands and feet forward at the same time. After extending both arms and legs, they take the breaststroke position. The swimmer returns to the water surface and repeats the cycle.

The breaststroke cycle can be divided into five phases:

The preparatory phase: In this stage, the swimmer bends her legs and arms. The breaststroke positions are achieved and the body moves to the surface of the water. The upper body moves out of the water, while the lower body remains submerged. The propulsive phase: The arms and the body move in the underwater direction. The propulsive phase ends with a movement forward and to the side. The recovery phase: The arms move to return to the breaststroke position. This phase ends when the swimmer’s body moves to the upper area of the water. The pull phase: This is the first phase of the cycle during which both hands are under water. The pull phase ends when the arm is above water in the recovery position. The recovery phase ends with the arm curled behind the head. The push phase: As the hips move downward, the legs push the body out of water into the preparatory position.


The “kinetic chain” and breaststroke mechanics in relation to injury

The “kinetic chain” describes the series of muscle and joint actions initiated by the hip rotating and extending (swinging open) during the kick portion of a breaststroke. The height of the kick is dependent on the degree of hip extension and hip flexion, and on the position of the knees and ankles. This chain of kinetic components forms a functional relationship that allows the swimmer to most efficiently use their body weight, or load, to propel them forward. This relationship is complex and not fully understood.

How to Prevent Breaststroker’s Knee

Breaststroke in swimming is considered to be the most difficult of all four strokes. Among the many things that you need to get right in breaststroke is the kicking.

The breaststroke kick is a little confusing for beginners and can lead to knee injuries. So, here’s a look at how to fix breaststroker’s knee in freestyle.

Ask a Trainer:

Are Hand Weights The Best Way To Workout?


The world of fitness is constantly evolving. New techniques, equipment, and vocabulary crop up all the time. While just a few years ago the word “functional training” was barely recognizable, today it’s used by pretty much every trainer, personal trainer, and even crazy person who’s seen one too many infomercials.

Recently, another term has entered into the fitness lexicon. “Hand held weights,” or “hand weights,” are becoming as ubiquitous as the shiny plates that adorn the walls of your local gym.

Warm-Up Properly .

Strength Training & Dryland.

If you’re experiencing breaststroke knee, you may also be experiencing other swimming pains. If you swim regularly, swimming-related shoulder, arm, or back pain is common. Swimming is a great cross-training sport that builds strength and endurance for other sports, especially running. But when done incorrectly, the muscles surrounding the shoulders, arms, and back can become discouraged. Seek the advice of a swim coach or physical therapist to create a conditioning plan that addresses your specific pain points.

Stretching and mobility.

Breaststroker’s knee, also known as patellar tracking disorder, is the most common knee injury among competitive and recreational swimmers of all ages. It’s caused by the quadriceps muscle getting overused, its tendon becoming stretched, and the patellar tendon moving out of its normal groove in the patella.

Like any injury, the best way to prevent breaststroker’s knee is to avoid overusing the affected muscle. Because breaststroke is a rhythmic stroke with breath included, it’s one of the most repetitive strokes in the sport. It’s important for breaststrokers to focus on staying within their range of motion before, during, and after training.

A few basic prevention tips include:

  • Refrain from repetitively bouncing up and down
  • Move the knees to the outside of the shoulder during the catch phase to reduce the tension on the patellar tendon
  • Keep the knees fully bent and pointed towards the bottom of the pool for the duration of each stroke
  • Refrain from boot camp dives for breaststroke training

How to Fix Breaststroker’s Knee

If you’re a breaststroke swimmer, you may have experienced knee pain. This kind of pain is most commonly associated with a torn meniscus or knee cartilage, but this is often misdiagnosed as a general knee injury when it’s actually something specific to breaststrokers.

Pain in the knee of a breaststroker is caused by the tightness of the pectoralis major and latissimus dorsi muscle during the pull and kick movements. This tightness squeezes the forearm muscles on the inner side of the joint to cause the pain during the catch position.

If you are a breaststroker who has experienced this knee pain, try loosening up during your warm up. This is particularly important if you’re unable to stretch your chest and shoulders properly.

If you are having a hard time protecting yourself from this injury, you should consider using a flutter kick technique. With a flutter kick, every other kick consists of moving both legs at the same time. However, you don’t actually kick hard, just gently move your legs.

This technique will reduce the stress on one of your knees to help you swim through the strokes more quickly.

Communicate early.

Breaststrokers need to glide on their knees. This movement is a very quick one, and a good glide can bring you about 16 inches forward.

To glide, you need to keep your head, shoulders, and torso low while bending your knees and keeping your feet on the wall.

If you can’t execute these steps, you are very likely to develop breaststroker’s knee because you’ll be pivoting on the kneeling knee.

To reduce any potential strain on your knees, you need to communicate early with your coach about your knee pain.

Then, work with your coach to change the propulsions mechanics so you are using your legs for power and kneeling on the side of your knee.

You can still use your hands for assistance, but without putting as much pressure on your knees as you would if you were just using your hand.

Recognize good pain vs. bad pain.

Breaststroker’s knee is a common injury among breaststroke swimmers. It’s caused by the repetitive movement of the legs while pushing off the wall.

It is often characterized by a feeling of burning or pressure in the front of the knee (patella femoral pain syndrome) and is often accompanied by inflammation (swimmer’s knee), which can be identified by redness or warmth around the joint area. S/he may also experience a popping sound, a feeling of weakness when climbing stairs, and a feeling of creaking during the bend and straightening motion of the knee joint.

The good news is that there are several therapeutic and prevention measures that a breaststroker can take to reduce the frequency of breaststroker’s knee.

Since breaststroker’s knee is often caused by overuse, it is important for the breaststroker to allow the body to rest and heal itself. This can be done by taking short breaks to allow the body to cool down before facing the next set. Even better, taking a break longer than a few minutes would be better. It is recommended to take at least a 30-minute rest after a set.

Have a plan moving forward.

The best coaches create a plan for their athletes to implement when they get to the wall. Think about the advice you give your swimmers when they come to the wall. You tell them to relax, roll to their backs, and have a plan for how to get back to the start position, how long they will rest, and how they will set up to their next pull.

It is very common for someone who is tired to have no plan and to do a poor job of catching this stroke.

This results in the arms not being fully extended or possibly even hitting the back.

Create a plan for the wall and make sure the athlete executes it each time.

The Takeaway

If your only goal in the sport of swimming is gaining fitness, chances are you’re not experiencing any pain from breaststroker’s knee. It’s a popular injury among competitive breaststrokers. It happens when the kneecap (patella) flexes the wrong way while the leg is extended.

Recognizing the symptoms of breaststroker’s knee is the key to avoiding the injury. At first, pain will be located in the lower part of the knee. Stretching the patellar tendon or just resting and taking pain relievers will usually do the trick. If the injury goes untreated and continues to worsen, it can also cause a bump to form on the back of the knee or cause the knee to begin to bow outwards. In both of these cases, you’ll need to get it checked out by a doctor.

By taking simple precautions like knowing how to prevent this injury and taking it easy on your knees if you already have breaststroker’s knee, you can stave off long-term damage to your knee and keep your regular workouts moving along.

See Also:

Breaststroker’s knee is an overuse injury common to those who breaststroke. The pain is usually felt just behind the kneecap or medially on the inner part of the knee. It’s specifically the iliotibial band at the knee that’s affected, though the iliopsoas tendon and anterior part of the patellar tendon can also become inflamed.

The injury is usually caused by incorrect kick technique, overuse, and tight leg muscles.

Other factors that can lead to breaststroker’s knee include poor posture or knee alignment and issues with the lower back, hips, and ankle joints.

Treatment for breaststroker’s knee includes rest, ice, and anti-inflammatory medication, as well as physical therapy and strengthening exercises. Incorrect kicking may require you to relearn how to kick correctly. Other reasons for this injury can be addressed through physical therapy to loosen tight muscles, improve posture, and improve alignment.

Some swimmers also wear a knee brace or a sleeve to help with the pain and swelling, or swim slightly shallower to shift the weight off of the knees.