Breaststroker’s Knee

Breaststroker's Knee

Article by John Miller

Breaststroker’s Knee

Although less common than swimmer’s shoulder, injury to the knee is prevalent in the swimming population and is almost exclusively reserved for the breaststroke population due to the nature of the kick [1]. Overuse is once more the primary culprit here, with repetitive stress placed on the medial knee and producing pain during the whip-like motion.

The breaststroke kick is a high valgus load produced during sudden flexion-extension, adduction and external rotation of the knee against the hydrodynamic environment, resulting in stress to the medial compartment. The result, therefore, is a strain to the medial collateral ligament and compression on the lateral knee. Consequently, it is not uncommon for swimmers to present with ligament sprains on the MCL, irritation of the medial plica and bursal irritation at the muscular insertions of the adductor and hamstring muscles. Furthermore, strain injuries can be present in the adductor muscles (adductor magnus and brevis, especially) [2].

Please consult with your PhysioWorks swimming physiotherapist for an individualised assessment of your swimmer’s knee pain.

Other Causes of Knee Pain in Swimmers

Abnormalities in turning ability (quick knee flexion-extension during the somersault) can result in anterior knee pain such as patellofemoral pain syndrome. This condition arises as a result of patella mal-tracking or quadriceps strength and is consistently amenable to physiotherapy input and intervention.

More info: Patellofemoral Pain Syndrome

Common Swimming Injuries

Shoulder Pain

Knee Pain


Foot and Ankle:


Wrist and Hand:

Common Causes - Knee Pain

Knee pain can have many origins from local injury, referred pain, biomechanical issues and systemic issues. While knee pain can appear simple to the untrained eye, a thorough assessment is often required to ascertain the origin of your symptoms. The good news is that once a definitive diagnosis is determined, most knee pain quickly resolves with the correct treatment and rehabilitation.

Knee Ligament Injuries

Knee Meniscus Injuries

Kneecap Pain

Knee Arthritis

Knee Tendon Injuries

Muscle Injuries

Knee Bursitis

Children’s Knee Conditions

Other Knee-Related Conditions

Knee Surgery

Knee FAQs

For specific information regarding your knee pain, please seek the assistance of a healthcare professional with a particular interest in knee condition, such as your knee physiotherapist.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.


If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  


Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.


Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.