Understanding Knee Health
The key to maintaining knee health lies in the proper functioning of the muscles surrounding the knee. This includes the Vastus Medialis Oblique (VMO), a crucial muscle in knee stability and function.
Importance of Knee Muscles
The Vastus Medialis Oblique (VMO) is one of the four quadriceps muscles located in the anterior compartment of the thigh. Its primary function is to extend the knee, with the role of the VMO being especially important in knee health and stability. The VMO muscle primarily functions to pull the patella (kneecap) medially and its unique horizontal alignment of muscle fibers make it the primary medial stabilizer of the patella. Additionally, the VMO, along with the Vastus Lateralis (VL), helps align the patella within the trochlear groove during knee flexion and extension, and it participates in the last phase of knee extension [1].
Common Knee Issues
Weakness of the VMO is associated with common knee issues such as patellar maltracking and patellofemoral pain. Effective treatment options often involve restoring balance between the VMO and Vastus Lateralis, strengthening the oblique fibers of the VMO, and assessing the degree of dynamic supination and pronation of the foot [2].
Anterior knee pain, a common issue especially among runners, can be influenced by factors such as muscle fatigue, running surface, and patellofemoral joint issues. A comprehensive assessment is often required to determine the root cause, and to develop an effective treatment plan.
Understanding these knee health fundamentals is crucial for individuals looking to enhance their VMO strength. By understanding how to grow the Vastus Medialis, individuals can better manage common knee issues and improve overall knee health and function.
Vastus Medialis Overview
The vastus medialis, part of the quadriceps group of muscles, plays a central role in knee stability and function. This muscle extends along the inner part of the thigh, attaching to the kneecap, and plays a pivotal role in knee extension and stabilization.
Role of Vastus Medialis
The vastus medialis, often known for its teardrop shape, contributes to the overall functionality of the knee joint. Its primary role is to aid in knee extension, particularly in the final degrees of straightening the leg. This action is crucial for everyday activities such as walking, running, and climbing stairs.
In the context of knee health and rehabilitation, the vastus medialis is often a focus of strengthening exercises. However, a systematic review of 20 papers concluded that clinicians should not focus on vastus medialis oblique (VMO) strengthening over general quadriceps training when rehabilitating patients with patellofemoral disorders, as isolating the VMO may not be possible.
VMO vs. VM Muscle
The vastus medialis oblique (VMO) is often referred to as a separate muscle from the vastus medialis (VM). However, an anatomical study suggested that the VMO may not even exist as an independent muscle. It was not found to be truly separate from the vastus medialis longus (VML), and the nerves activating these parts are not independent, making independent activation of the VMO unlikely.
Moreover, research has shown that patellofemoral pain may not be solely due to patella maltracking and that the VMO is not more important than other parts of the quadriceps in addressing this pain. Generalized quadriceps strengthening is recommended over trying to isolate the VMO with exercises, as it can address patellofemoral pain effectively. The Academy of Orthopaedic Physical Therapy lists quadriceps strengthening as an A-level recommendation for treating patellofemoral pain.
Understanding the role and the limitations of the vastus medialis in knee health is paramount for those seeking to improve their knee strength and stability. It is critical to consider that strengthening further up the kinetic chain, such as hip strengthening, has been suggested as a more effective approach for improving patellofemoral pain compared to knee strengthening alone.
Rehabilitation Strategies
To address knee health effectively, particularly when seeking to grow the vastus medialis, a few key strategies can be implemented. These include quadriceps strengthening, dynamic versus static stretching, and the benefits of hip strengthening.
Quadriceps Strengthening
Generalized quadriceps strengthening is recommended over trying to isolate the VMO with specific exercises. This comprehensive approach addresses patellofemoral pain effectively, with the Academy of Orthopaedic Physical Therapy listing quadriceps strengthening as an A-level recommendation for its treatment [4].
Improving quadriceps strength and size through a robust strengthening program is one of the best ways to improve patellofemoral pain syndrome. Isolated quadriceps strength can enhance VMO strength and size as well, supporting the overall health of the knee joint.
Exercise Type |
Recommendation Level |
Source |
Quadriceps Strengthening |
A-Level |
The Prehab Guys |
Dynamic vs. Static Stretching
In terms of stretching, research indicates that dynamic stretching is more effective in increasing quadriceps muscle activity and knee extension angular velocity during the final swing phase of a maximal soccer instep kick, compared to static stretching.
Stretching Type |
Effectiveness |
Source |
Dynamic Stretching |
Increases quadriceps muscle activity |
PubMed Central |
Static Stretching |
Less effective in increasing quadriceps muscle activity |
PubMed Central |
Hip Strengthening Benefits
Strengthening further up the kinetic chain, such as hip strengthening, has been suggested as a more effective approach for improving patellofemoral pain compared to knee strengthening alone. Research by Khayambashi et al. supported this notion, highlighting the multi-faceted approach required for effective knee rehabilitation.
Strengthening Type |
Effectiveness |
Source |
Hip Strengthening |
More effective in improving patellofemoral pain |
Physio-Pedia |
Knee Strengthening |
Less effective in improving patellofemoral pain alone |
Physio-Pedia |
These rehabilitation strategies are geared towards improving knee health and specifically growing the vastus medialis. They offer a comprehensive approach that addresses different aspects of the knee joint and the surrounding musculature.
Effective Exercises
Strengthening the vastus medialis is essential for maintaining knee health and stability. Here are three effective exercises that target the vastus medialis and promote knee strength and resilience.
Floor Extension Exercise
The Floor Extension Exercise is a highly targeted movement aimed at isolating and strengthening the vastus medialis muscle. To perform this exercise, one should sit tall with an upright posture, ensuring that they feel a contraction above the knee. This is a clear indication that the vastus medialis muscle is effectively engaged during the exercise.
Steps |
Description |
1 |
Sit on a firm and flat surface, extending the legs out in front. |
2 |
Bend one knee to a comfortable degree while keeping the other leg straight. |
3 |
While maintaining a straight back, slowly raise the straight leg about six inches off the floor. |
4 |
Hold the position for about two seconds, then slowly lower the leg back to the floor. |
5 |
Repeat this for 10-15 repetitions, then switch legs. |
This step-by-step guide is beneficial for performing the exercise accurately and efficiently for maximum results [6].
Lateral Heel Drop Exercise
The Lateral Heel Drop Exercise is another effective movement that not only strengthens the vastus medialis but also exercises the muscles in the front and back of the legs and the lower back. This exercise is particularly helpful for individuals who want to improve their lunging and squatting capabilities without experiencing knee pain.
Steps |
Description |
1 |
Stand straight and tall, holding onto a wall or chair for balance if needed. |
2 |
Slowly lift one foot off the ground and balance on the other foot. |
3 |
With control, slowly lower the lifted foot to the side, creating a lateral movement. |
4 |
Lift the foot back to the center and repeat the exercise for 10-15 repetitions. |
5 |
Switch to the other foot and repeat. |
The exercise should be performed with both legs for maximum benefits [6].
Single Leg Raises
Single Leg Raises are a versatile exercise that can be performed anywhere and at any time. They work on strengthening the quadriceps, hamstrings, calves, and glutes. It's important to note that when performing this exercise, the leg should be raised only as high as the opposite thigh. This ensures the focus remains on strengthening the knee rather than challenging hip flexibility.
Steps |
Description |
1 |
Lie on your back on a flat surface, with one leg bent at the knee and the foot flat on the ground. |
2 |
Keep the other leg straight and slowly lift it to the height of the opposite knee. |
3 |
Hold the position for a few seconds, then slowly lower the leg back to the ground. |
4 |
Repeat this for 10-15 repetitions, then switch legs. |
Remember to perform the exercise with both legs for balanced strengthening [6].
Factors Affecting VMO Strength
When it comes to the knee's health and specifically understanding how to grow vastus medialis, various factors come into play. These include muscle activation patterns and age-related muscle loss.
Muscle Activation Patterns
It's worth noting that an anatomical study suggested that the VMO may not even exist as an independent muscle. It was found not to be truly separate from the vastus medialis longus (VML), and the nerves activating these parts are not independent, making independent activation of the VMO unlikely. This information suggests that muscle activation patterns play a significant role in VMO strength.
Furthermore, research has shown that patellofemoral pain may not be solely due to patella maltracking and that the VMO is not more important than other parts of the quadriceps in addressing this pain. This finding further emphasizes the role of muscle activation patterns in VMO strength and knee health.
Age-Related Muscle Loss
Age is another significant factor that can affect VMO strength. With age, the body naturally loses muscle mass, a condition known as sarcopenia. This loss can affect all muscles in the body, including the VMO. Therefore, maintaining muscle health with age is paramount to ensuring the strength of the VMO and overall knee health.
One approach to counteract age-related muscle loss and maintain VMO strength is through generalized quadriceps strengthening. The Academy of Orthopaedic Physical Therapy lists quadriceps strengthening as an A-level recommendation for treating patellofemoral pain, emphasizing its importance in maintaining VMO strength [4].
Moreover, strengthening further up the kinetic chain, such as hip strengthening, has been suggested as a more effective approach for improving patellofemoral pain compared to knee strengthening alone. Research by Khayambashi et al. supported this notion.
In conclusion, both muscle activation patterns and age-related muscle loss significantly affect VMO strength. Understanding these factors can help individuals develop effective strategies for growing vastus medialis and maintaining knee health.
Rehabilitation Techniques
To improve knee health and specifically grow the vastus medialis, it is crucial to follow appropriate rehabilitation techniques. These techniques should focus on building strength and flexibility in the knee joint and surrounding muscles.
Resistance Exercise Programming
Resistance exercise programming, particularly with a hypertrophic focus, is recommended to increase muscle mass and strength, including the vastus medialis. This type of programming generally involves performing 8-12 repetitions of an exercise at 75-85% of the individual's one-repetition maximum (1RM) [3].
Exercise Type |
Repetitions |
Percentage of 1RM |
Hypertrophic Resistance Exercise |
8-12 |
75-85% |
This approach can help restore the vastus medialis muscle function, leading to improved knee stability and a reduced risk of knee pain and injury.
Progressive Resistance Training
Progressive resistance training is another effective rehabilitation technique for knee health. This form of training involves gradually increasing the resistance or weight used in exercises over time. This method is particularly effective in slowing down the process of muscle mass loss, especially after the age of 30 due to sarcopenia [3].
Age |
Technique Recommended |
Reason |
Above 30 |
Progressive Resistance Training |
Slows down muscle mass loss (sarcopenia) |
By consistently challenging the muscles, progressive resistance training can help maintain and even increase muscle strength and size, including the vastus medialis.
Addressing Anterior Knee Pain
Anterior knee pain is a common complaint among runners and those with knee osteoarthritis. It can be influenced by various factors, including muscle fatigue, surface terrain, and patellofemoral joint issues. A comprehensive assessment is necessary to determine the root cause of the pain.
According to research by Khayambashi et al., strengthening further up the kinetic chain, such as hip strengthening, has been suggested as a more effective approach for improving patellofemoral pain compared to knee strengthening alone [2].
Pain Location |
Recommended Approach |
Anterior Knee |
Hip Strengthening |
By focusing on these rehabilitation techniques, individuals can effectively work on growing their vastus medialis and improving overall knee health.
References
[1]: https://www.physio-pedia.com/VastusMedialisOblique
[2]: https://www.physio-pedia.com/Vastus_Medialis
[3]: https://bendandmend.com.au/news/physiotherapy/the-seven-best-exercises-for-vmo-activation-early-knee-rehab/
[4]: https://theprehabguys.com/vmo-exercises/
[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916919/
[6]: https://www.healthline.com/health/fitness-exercise/vastus-medialis-exercises