“I kept getting injured, so I started swimming.”
Dr. Kelly Henry here!
My physical therapy patient was frustrated when she saw me for her first physical therapy appointment. She ran recreationally and loved her group exercise classes consisting of various strength exercises.
But she had been struggling through several different injuries for months and was looking for a safer exercise alternative.
She started swimming, thinking that she found her solution. Unfortunately, her optimism was short lived.
Although it is less impactful on our joints, swimming isn’t without its fair share of injuries and I see many in McLean as physical therapy clients.
In fact, the repetitive nature of swimming strokes can lead to a variety of overuse injuries, particularly among competitive athletes. Recognizing the unique demands of each stroke and tailoring rehabilitation and strength training exercises accordingly is crucial for optimizing performance and preventing injury recurrence.
Competitive swimming comprises four primary strokes: freestyle, backstroke, breaststroke, and butterfly. Each stroke involves different biomechanics and engages specific muscle groups. Just as different positions on a football team require specialized training, swimmers specializing in different strokes benefit from individualized approaches to injury management and prevention.
Today, let’s start with breaststroke.
Part 1: Breaststroke
Among the four competitive strokes, breaststroke stands out for its complexity and technical demands, making it challenging to master (but my favorite stroke!). Central to the breaststroke technique is a bilateral coordination of arm and leg movements, executed in a rhythmic, cyclical pattern. However, it is the intricacies of the kick that often pose the greatest hurdle for novice swimmers. To achieve a legal breaststroke kick, swimmers must be able to access positions of simultaneous hip external rotation, knee flexion, and ankle flexion. This culminates in a rapid hip internal rotation moment “whip kick”, and a powerful propulsion forward.
Muscles Engaged in Breaststroke:
Upper Body:
- Pectoralis Major and Deltoids: Initiate the arm pull, driving the circular motion that propels the body forward.
Lower Body:
- Quadriceps and Adductors: Power the kick, providing significant forward propulsion.
- Hip Flexors: Facilitate the kicking motion, aiding in lifting and extending the legs.
- Core and Lower Back: Essential for maintaining stability and body position throughout the stroke cycle.
Despite its elegance, breaststroke is not without its risks. Medial knee pain and patellofemoral pain are common complaints among breaststrokers, stemming from the substantial demands placed on the knee, adductors, and quadriceps during the kick phase. Strengthening the hip rotators and hamstrings is crucial for mitigating these forces and promoting a strong internal rotation moment at the hips. Additionally, compensatory movements, such as excessive lumbar extension, can contribute to low back pain if left unaddressed.
To address and prevent knee pain, incorporating targeted exercises to strengthen the glutes, hamstrings, and adductors is essential. Consider integrating the following exercises into your training regimen:
- Side plank variations: Targets core/abductors
Easier:
Harder:
- RDL variations: Targets hip extension/hamstring strength
Easier:
Harder:
- Bridging progressions: Helps address low back and hip positioning with the knees bent
Easier:
Harder:
By addressing muscular imbalances and improving functional strength, swimmers can enhance performance, reduce the risk of injury, and optimize their experience in the water. Stay tuned for the next installment of our series, where we will explore the biomechanics and injury considerations of another iconic swimming stroke.
