Breaststroker’s Knee - Cause, Clinical Manifestations, Diagnosis, Treatment, and Prevention

Introduction

Swimmers, especially those who specialize in the breaststroke swimming technique, frequently have breaststrokers' knees. The knee joint and surrounding structures are the main targets of this type of overuse injury.

What Is Breaststrokers Knee?

Breaststroker's knee is a knee injury that swimmers encounter during swimming. Knee discomfort and pain are mainly seen in swimmers who perform breaststroke swimming and hence the name breaststroker’s knee. Tenderness on the inside of the knee (medial side) is the defining feature of a breaststroker’s knee.

What Is the Cause of Breaststrokers Knee?

• The swimmer kicks forcefully backward and downward with a "whipping" motion during the propelling (pushing) phase of the breaststroke leg kick.

• The medial collateral ligament (MCL) that begins on the inside of the upper shin bone and ends on the inside of the lower thigh bone) may be injured as a result of the abnormal rotation of the knees that might occur during this activity.

• Breaststroker’s knee is more likely to happen if the leg kick is executed incorrectly.

• Long and rigorous kick training sessions might potentially result in breaststroker's knee.

What Are the Clinical Manifestations of Breaststrokers Knee?

• A common sign of a breaststroker's knee is discomfort in and around the knee, which can get worse with any kind of physical activity.

• Swelling at the joint.

• Decreased movement at the knee joint.

• Due to decreased mobility and swelling at the joint, it becomes difficult to bend or straighten the knee.

How Is Diagnosis of Breaststrokers Knee Made?

A swimmer should seek medical attention if they have frequent or severe knee discomfort when swimming. It is not usual for a swimmer to experience these symptoms. A delay in identification and treatment and holding out through discomfort might make the situation worse and hamper the career of the swimmer. A physiotherapist or sports physician with experience in treating knee and swimming injuries is ideally qualified to diagnose a swimmer's knee or breaststroker’s knee.

• Clinical symptoms, physical examination, clinical evaluation, and radiological imaging are all used to make the diagnosis of a breaststroker’s knee. Radiographic imaging is used to support or supplement the clinical diagnosis.

• Palpation of the knee is part of the physical examination. The inner or the medial side of the knee joint will have pain and discomfort upon palpation.

• Ligament stress tests are also conducted. The medial collateral ligament stress tests are positive for discomfort, pain, and instability.

• Additionally, the knee joint's strength and flexibility will be evaluated by the sports physician. Limitations in the knee's range of motion and the strength of the quadriceps, hamstrings, and adductor muscles, in particular, are also noted and assessed.

How Is Breaststrokers Knee Treated?

• Rest - It is essential to take a break from swimming when diagnosed with breaststroker’s knee. A swimmer should also reduce volume, frequency, or intensity to address this condition. Rest and a decrease in the frequency and intensity of swimming will give the medial collateral ligament more time to heal, and the swelling will subside. Active healing and rehabilitation techniques can be used additionally after a proper rest period. The rehabilitation process can be overseen by a physical therapist, and in the beginning, or if the knee is in excruciating pain, most of the rehabilitation process should be conducted only on land. Later stages of rehabilitation could still involve land-based workouts, but they might also include breaststroke-specific activities in the water.

• Strengthening the Muscles - The knee may be supported against the lateral stresses produced during the breaststroke kick by strengthening the quadriceps, hamstrings, and adductor muscles in particular. Strengthening the gluteal, calf, and core muscles will also help to ensure the effectiveness of the stroke. For the treatment of breaststroker’s knee, the following exercises are effective:

  • Squat - For quadriceps muscles.

  • Bridge - For gluteal (a set of muscles that form the buttock region) and hamstring muscles (a set of three muscles that go from the hip to just below the knee along the back of the thigh).

  • Scissors - Abductor muscle (any muscle that moves a limb away from the body's center).

What Is the Prognosis of Breaststrokers Knee?

If diagnosed soon after the beginning of symptoms and the recommended rest or reduction in activity is followed, along with the proper physical therapy and rehabilitation exercises, Breaststroker’s knee will last four to six weeks. If symptoms are disregarded, allowed to intensify, or endure for an extensive amount of time, this time frame will be greatly extended. It can take many months to recover in the worst-case scenarios. When necessary, early intervention can nearly always prevent the need for invasive therapy like injections and surgery.

How Is Breaststrokers Knee Prevented?

Breaststroker’s knee can be prevented by doing a proper warm-up and cooling down before and after the training session. This can greatly lower the chance of getting hurt, including getting a breaststroker's knee.

1. Each training and competition session should begin with an appropriate poolside warm-up. Ankle rotations, leg swings, and lunges are a few examples of particular lower limb warm-up exercises that the swimmer should make sure they do before performing.

2. An essential component of a swimmer's recovery and injury prevention program is a thorough cooldown after the training session. The swimmer has to make sure they do specialized activities for their lower limbs, like calf, quad, and hamstring stretches.

3. The coach should be able to reevaluate the swimmer's technique and offer advice on any necessary technical modifications.

4. The frequency and intensity of training sessions should be reduced.

5. The swimmer may be recommended to rest until the symptoms go away.

6. However, if the swimmer's problems continue, they could be encouraged to consult a doctor, who will likely prescribe some anti-inflammatory medicine as a standard course of treatment.

7. Some swimmers receive therapy from a sports physiotherapist, which can help to lessen the pain, build up the supporting muscles, and hasten recovery.

Conclusion

In conclusion, swimmers who often employ the breaststroke method are at risk for developing breaststroker's knee, a common overuse condition. Since breaststroke kicking requires strong pressures and repeated action, it causes discomfort and inflammation around the knee joint. A multimodal strategy is advised to treat the breaststroker's knee. For a precise diagnosis and a tailored treatment plan, it is crucial to speak with a healthcare practitioner. They can assist a swimmer successfully by offering tailored advice based on their particular set of conditions. Breaststroker's knee can be managed, and the sport of swimming can still be enjoyed by those who have it by taking the right steps and getting the right medical advice.