Patello-Femoral Pain Syndrome:
There are many sources of knee pain, but a very common one that occurs in both athletes and the general (non-athletic) population is called Patello-Femoral Pain Syndrome (PFPS). It is usually felt as pain at the front of the knee, and is worse with descending stairs, squats, kneeling, and sitting for extended periods of time. Occasionally, artistic swimming swimmers can get this type of knee pain, aggravated by long periods of “egg-beatering” in the pool. It is often characterized by abnormal tracking of the kneecap or “patella” over the knee as the knee bends and straightens during activity. This can cause irritation and inflammation of the cartilage on the back of the knee cap, which is felt as pain at the front of the knee.
Abnormal tracking of the patella can be caused by a combination of several factors. Some of which include a sudden growth spurt of height in an adolescent, an overly tight iliotibial band (ITB) (a a fibrous “band” on the outer part of the thigh), weak quadraceps muscles – especially the quad muscle (the “VMO”) near the inner thigh which controls the side to side motion of the patella, and overly tight hamstrings and calf muscles. Also important is the foot and knee position while walking and standing, as it affects the angle of the pull of the quadraceps muscle on the kneecap. Persons who have flexible arches in the foot that fall too flat in standing (called “over-pronation” or “flat feet”) can be more susceptible to PFPS, especially if they tend to be “knock-kneed” or have very flexible joints (which some folks refer to as “double jointed”).
In artistic swimming swimmers, PFPS may be aggravated by the prolonged eggbeater that they use to stay upright in the water. They may develop tightness of the ITB and hip muscles, that can cause an imbalance of muscle forces on the patella that lead to abnormal tracking. This is one of the reasons why the regular stretching and strengthening portions of the “dry-land” part of artistic swimming practice are so important – to prevent injury.
Fortunately for many people, rehabilitation that focuses on the restoration of normal patellar- tracking can solve most cases of PFPS. Therapy usually involve lots of different types of strengthening exercises for the quads muscle (especially the VMO), stretching and massage/or “active release” of the ITB, and possibly foot orthotics to improve the foot and knee position if needed. Taping of the knee is also a very common treatment – which helps to align the patella in a better position while exercising. Maintaining a healthy weight and keeping strong will also go a long way towards preventing this type of knee pain.
Thank you to Olympium Synchro for above article