Perhaps there is no other sport that causes unilateral, repetitive strain injuries more than curling. A 2004 study of competitive players competing in two USA National events found a high incidence of back, knee, hip, wrist, and shoulder injuries amongst competitors of both genders:
Sweeping the stone (55%) and delivering the stone (50%) were the skills most provocative of symptoms (fig 2A–C). Collectively, symptoms of knee (54%), back (33%), and shoulder pain (20%) were most prevalent (table 2). Knee pain was most often reported in the ‘‘tuck’’ knee, which is typically flexed well beyond 90˚ during stone delivery. Sixty-two per cent of those with knee pain were symptomatic in their tuck [slide foot] knee, while 31% complained of bilateral discomfort.
Our intent in writing this article was two-fold: one, to make other coaches aware of the prevalence of anterior knee pain in youth curling, particularly with young women, and two, to recommend that athletes who suffer from PFPS or other knee pathologies see a qualified physiotherapist for recommendations for exercise, stretching, taping, or other therapies. That therapy may include changes to an athlete’s curling delivery to mitigate their individual issues. Hopefully such adjustments are helpful and can assist an athlete to navigate the rigors of a competitive curling season with reduced pain and an improved prognosis.
In our own coaching we have encountered several athletes who present with chronic anterior knee pain. Some of these athletes have utilized a “tuck” or “toe” slide in their curling deliveries. A 2017 paper by researchers at the University of Dundee concluded that toe sliding in a curling delivery doubles the force applied to the knee in comparison to a flat-foot slide, and the greater the amount of knee flexion the greater the increase in load.
In this article, the 20th in our Technical Coach series, we present a brief overview of research and surveys related to anterior knee pain, and describe our experiences in helping young female athletes mitigate their knee issues by changing their delivery from “tuck”, or “toe”, to a flat-foot slide. Despite the amount of information available in the literature concerning anterior knee pain in various populations, we believe additional research is required to understand the scope of knee issues in youth curling, and more completely understand the biomechanics of a curling delivery that involves much greater knee flexion – much greater than 90 degrees – which makes a curling delivery difficult to compare to knee injuries in other sports.
Acknowledgements
We would like to gratefully thank Melissa Hay, who holds a Ph.D in Health and Rehabilitation Sciences: Physical Therapy from the University of Western Ontario and is currently a practicing clinical physiotherapist, located in Waterloo, Ontario, for her tremendous help in navigating the literature, explaining terms and knee biomechanics, and providing some very helpful references and useful feedback. We would also like to thank Estelle Haines, BMR PT, of Winnipeg, Manitoba for her analysis and helpful feedback during the development of this article.
Practicing a flat-foot slide on a slide board.