Does Strengthening The VMO Really Help Knee Pain

VMO muscle strengthening is often recommended by healthcare providers when it comes to knee pain. But there’s really just one time when VMO strengthening is actually beneficial. Otherwise, it’s going to make your knee problem worse. I’ll be talking all about this in today’s video.

My name is Dr. David min off and I’m a specialist physical therapist here at El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile. while avoiding an unnecessary surgery, injections and pain medications. Please subscribe to our channel so that you don’t miss out on any of the helpful videos that we post every single week. So let’s get into it just so that we’re all on the same page.

Let me tell you where the VMO muscle is. I’ll show you the skeleton and then on myself. Here’s the right knee. There’s a kneecap, the VMO stands for vastus medialis oblique, and it’s just part of the inner quad muscle right above the inside of the kneecap. So it’s on this side. And then of course on the other leg, it’ll be on the other knee. Just inside the kneecap.

This muscle is famous for being teardrop shaped. And on your leg, you’ll be there’s my kneecap right there. And it’s this muscle that’s right here. So oftentimes when people have knee pain problems, they think that they need to be strengthening this knee, this inner quad muscle called the vastus. medialis oblique is the whole inner quad muscle is called the vastus medialis.

The VMO vastus medialis oblique muscle is just the distal or the this section of the muscle right above the kneecap right here. isolating strengthening in this one section of the muscle is believed to help with kneecap tracking. But we have scientific medical research evidence that shows that that’s not the main reason why kneecaps are not aligned and tracking well.

It’s very rare that it’s related to a vastus medialis weakness. So the only time that you need to be strengthening this portion of your quad muscle is this. If you’ve had trauma to your knee, a trauma could be an accident, like somebody fell into your leg and you sprained it pretty bad. Y

ou were in an accident or some sort of like a car accident bike motorcycle accident, you fell you were knocked down you something abruptly injured your knee and traumatized it a surgery is another great thing a surgery is a controlled injury done by a healthcare professional with the hopes that things are going to heal nicely and leave you better afterwards. But all of this is trauma.

If there’s a trauma to the knee, it is common for quad muscles. Sometimes the vastus medialis oblique is to get weak to even shut down where it doesn’t activate very much. If you’ve had some knee surgery in the past, you probably realize this that your quads just shut down, they don’t work for a while. And in the first month or so after a knee surgery, you’re working on just getting your quads to activate consistently so that you can use them when you walk.

Another situation that’s kind of related is if you have a loss of full knee extension, if you cannot straighten out your knee all the way like this, if it only goes to just a little bit compared to the other side of it’s slightly bent, then you might actually have a vastus medialis weakness, if you don’t have massive arthritis, but even then strengthening the vastus medialis oblique is the VMO may not be necessary if there’s no chance of your knee fully extending because of your knee arthritis.

So only in this situation where there’s been trauma, whether it’s surgical or from an accident, would I be looking to strengthen the vastus medialis oblique the vo VMO muscle in any patient. And of course before we even go into strengthening, we’d look to see if it’s shut down or if it’s active. And the way that you can do this on yourself to see if your VMO is firing. And if you’re the type of if you have the type of knee problem that does need the most strengthening, it’s really simple.

Just look at your leg. Just sit down and look at your leg, you might try to straighten it out a bit. Move up a bit more. And think about tightening up your quad muscles and think about dividing your quote quad muscles into three sections is called the quads because there’s four muscles, but two of them are right on top of each other and it’s hard to figure out what’s going on in the deeper one.

But you got a muscle on the outside of your thigh you’ve got one that runs right along the middle kind of thinner and ropey and then you’ve got one on the inside of the front of the thigh. So outer, middle and inner. If you try to tighten up your quads, make them real tight as possible.

You should feel like the muscles are popping up on the outer right In the middle on the front, and then on the inner, if you look to tighten up your quads, and one of those sections is not firing very good, especially this teardrop shaped muscle just above the kneecap on the inside part of the front of the knee, then you probably have a vastus medialis oblique is a VMO weakness. And you might actually need to strengthen that muscle and specifically exercise it. And the way that you would do it, it’s pretty straightforward.

There’s tons of videos on the internet and how to do this, any physical therapist will know how to do this, you simply are looking at extending your knee with your toes out a bit, and you might lift your leg from right there at work on extending your knee with your foot out. And you should feel that that muscle starts to burn right away.

If you have good activation of this muscle, then chances are you don’t need to strengthen it much it probably as firing every time you need it whenever you get up to to stand up or to walk or do your daily things, it’s probably working just fine. If you’ve got knee pain, and you have a functional VMO it turns on whenever you go to straighten out your knee, then you’re probably going to hurt yourself.

If you strengthen that VMO you need to look at the muscle imbalance differently here. You need to look for a muscle imbalance, it’s usually not weak quad muscles, it’s not a weak VMO it’s almost always a glute weakness on the back of the hip. I’ve got a great video that goes into the top five glute exercises for knee pain. It’s linked in the description below here, go check out that video and start working in your glutes.

There’s tons of other videos on our channel here that discuss why the glutes are so important in fixing knee problems. And if you’re out there right now, and you’ve been working on your VMO even if your healthcare professional told you to you saw your doctor, a physical therapist, some health care professional or fitness professional as well.

And they’re working on getting you stronger quads, specifically a VMO and you haven’t had any recent trauma or you don’t have a shutdown VMO muscle, then I would think twice about strengthening that VMO muscle. And even for healthcare professionals out there, if you’re watching this.

Think long and hard if you’re going to make somebody get stronger quad muscles, it increases the pressure at the knee and greatly compresses the cartilage of the kneecap right behind the kneecap onto the thigh bone under the femur. And it can grind down the joint over time and create arthritis and cartilage problems.

So it’s really important to look at the glute and talking about patellar knee tracking. The thought with that is that if this muscle here, the VMO gets weak that the kneecap begins to drift outwards and does not track properly on the femur. But in reality, what is affecting patellar tracking is not the muscles because the kneecap can float and shift and it’ll tend to follow the the groove of the bone of the thigh bone.

It’s actually the position of the thigh bone which is influenced by the glute muscle. If your leg tends to roll inwards tends to be more straighter inwards, because we should be walking and moving with the foot slightly out. But if your leg is more straight or rolls inwards, and you train like that, and typically you’ve got stronger quads when you do so then the thigh bone is relatively if this is the kneecap right here and this is the thigh bone the thigh bone rolls inwards. So it’s a relative outward shift of the of the kneecap.

But it’s not the kneecaps fault, it’s the thigh bones fault the thigh bone rolls in, which makes the kneecap be relatively out. So when they take x rays of somebody’s knee and they say oh your patella, your kneecap is shifted outwards. It’s really not the kneecaps fault, it’s the thigh bones fall it’s shifted and the kneecaps in position because your muscles are working.

They’re your quad muscles are the dominant muscle group. And they’re pulling your kneecap into that position. But you’ve got to get stronger glutes to get that thigh bone in position. And the way this works if you just stand up and think about it, look at your legs and think about tightening up your butt muscles. I

t makes your hips want to turn out just a bit, which turns the thigh bone out. And this sets you up to have better alignment of your thigh bone under your kneecap. And just so that you can visualize this a bit better. Check out the skeleton here. Right in there, there’s a groove. And there’s a kneecap and the kneecap even has a bump in it where it sits in the groove.

So what I’m explaining here is if your knee rolls in like that, because of glute weakness, then your kneecap will tend to stay in the same position. And it’s not a matter of strengthening the VMO which is thought to pull it this way. It really does Important overall a whole lot.

What is more beneficial for this situation is strengthening the glutes so that you get the thigh bone in position under the kneecap that is setting you up for less pressure of the cartilage in this area. I hope this video helps you out. Please give us a thumbs up if you thought this video was helpful.

And don’t forget to subscribe so that you don’t miss out on any of the great videos we put out every single week. Have fun guys and best of luck to you and your knee problem.