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Kick Away Knee Pain

It’s time to highlight the Breaststrokers!

Did you know that ~85% of breaststrokers will experience at least 1 episode of knee pain in their career? Moreover, breaststrokers also show a ~70% higher incidence of MRI abnormalities compared to same age controls.

This is because the forces that the knee endures during a breaststroke kick are torsional and/or valgus (medial knee gapping) forces by nature. While the knee is physiologically capable of torsional and valgus movements, they should only occur in small ranges and not repetitively. Being a hinge joint, the knee primarily moves forward and backward, such as in a flutter or dolphin kick. Such is the case, it makes sense that the knee would be more susceptible to injury in breaststrokers as it is generally always moving outside of its standard physiological planes of motion.

Moreover, having sufficient hip rotation is vital to creating power during the breaststroke kick. In fact Dr. Gary Hall points out that “for every additional degree of internal rotation in the hip, [he] estimates that propulsion from the kick increases by 5-10%.” This is because internal rotation enables a swimmer to create more “surface area of the instep during the propulsion of the kicking motion, while keeping the knees relatively close together.” This means less stress on the knees AND more force generation. A win-win situation.

Therefore, more often than not, to actually fix the knee issues we must also address any underlying rotational hip issues. Which is to say, the knee is often the victim of the hip! Gaining range of motion and strength at the hip combined with relearning proper kicking patterns are a great place to start to kick knee pain away!

Seeing a physical therapist is a great place to start when it comes to addressing the actual issues that plague your performance.

Thanks for reading!

Dr. Jacob Reynolds PT, DPT – Physical Therapist

Board Certified Specialist in Orthopedic Physical Therapy


Instagram: @theswimmingphysio


Wanivenhaus F, Fox AJ, Chaudhury S, Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012;4(3):246-51.

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