Does Strengthening the VMO Help With Patella Femoral
Ask just about anyone who has had
for patella femoral syndrome about what types of exercises they did and
you will probably hear all about strengthening the VMO. Ask them if
they got better and some will say yes, but the vast majority will tell
you not really.
is the VMO, and does
strengthening it really help to decrease pain associated with patella
What is The
The VMO is a very small portion of one of the
muscles of the thigh. VMO stands for vastus medialis oblique - It is
the muscle on the inside of your thigh just above the patella.
idea is that because this part of the muscle runs diagonally across the
leg and inserts on the patella, if it is strong it will pull the
patella medially and help prevent some of the problems associated with
patella femoral syndrome.
It sounds like a good
theory, but let me explain why I believe that way too much emphasis is
placed on the VMO.
It Is Only One Muscle
VMO is only one of the four quadriceps muscles - in fact, it is really
only a small part of one of the quadriceps muscles. So, for arguments
sake, lets say that it provides 25% of the pull on the patella.
other three quadriceps muscles make up the other 75% of pull on the
patella. The VMO attaches medially, the others attach at various points
on the patella, each pulling in a slightly different direction.
all though, the quadriceps muscles will contract together and always
pull the patella towards your hips - in a direct line to the ASIS.
idea that one small part of one muscle can make enough difference to
overcome the other three muscles and their pull on the patella, when
all four muscles are strengthened together, just doesn't seem possible.
The other thing to remember is that the patella
is not the only problem with patella femoral syndrome. The femur is the
The femoral groove is where the patella
must sit and move during knee motion. Remember those quad muscles can
really only pull the patella towards the hips, with maybe a little bit
of side to side motion.
What happens when the
femur is rotated, or is too far medial or lateral? When the track is
crooked, the train gets derailed. The same thing happens to the
When the femur moves in
different directions, it directly
affects where the patella goes. When the femur rotates medially, the
patella becomes tilted in the groove.
the femur adducts or moves towards the middle of the body (when your
knees come together when you land) the patella is pulled laterally.
position of the femur determines where your patella goes, not the
strength of the VMO or quadriceps muscles.
vs. Twenty Two
Now, think about this - there are four muscles
that attach to the patella. These four muscles do not really have much
choice as to where the patella goes when they contract. It goes up.
are 22 different muscles that attach to the femur and cross the hip
joint. That means that you have 22 different muscles that can help to
control where the femur goes.
Now, what do you
think is a more efficient way to spend your time strengthening - on the
four muscles of the patella, which only really have one way to pull, or
on the 22 muscles of the hip which can pull the femur in many different
I know where I will be spending my time.
of the VMO may help to improve quadriceps function, but it won't cure
patella femoral syndrome. It just doesn't have enough "pull" on the
patella to be effective. Spend your time working on improving your hip
strength and controlling your femur. That is the key to beating patella
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