T Nation

Anyone got a good exercise to hit the VMO really good?


But yeah im having a bout with platefemoral(sp?) syndrome so im gonna start hitting my hams hard tommrow (thank you christian for that great article "The Painful Seven") but i need a good exercise that really concentrates on the VMO, can anyone tell me of any and explain their execution?


When I subluxed my knee playing baseball ... Allow me to share. I went for a big home run swing which caused me to fall, however, my back foot stayed planted -- result? I reached down and couldn't find my knee. It was on the side of my leg. I actually put it back myself. Ugh, the memory makes me shudder.

Anyway, the orthopedic surgeon told me to do the last 5 degrees of a leg extension as it hits the VMO hard. Well, not being keen on that advice, and having a bit of a background in rehab myself, I talked to my chiropractor (Kinakin), who told me to start squatting, with as much ROM as I could and to work myself back to full squatting. It was also suggested I front squat and do 1 1/4 squats as well. The latter proved to be extremely beneficial strengthening the VMO and counteracting all the lateral pull.


Try doing leg press while squeezing a ball between your lower quads.

Also, just simply tightening the quadriceps unilaterally and raising the leg 4-6 inches off the table for sets of 20 can be excellent for the VMO, especially after knee surgery or in Patello-Femoral Pain Syndrome. You can even use ankle weights if your up to it.

If you don't have access to equipment you can use a chair: Place both of your legs inside the legs of the chair and push them outward against the chair legs. Hold for 30-60 seconds, and do like 3-4 sets of 10-20 reps. Then place both of your legs on the outside of the chair legs and squeeze inward and slightly upward against the chair. Same sets and reps. It hits the VMO more if you externally rotate the hips before squeezing.


Thunder's right on the money, although it's more like the last 15-degrees of knee extension. In addition to deep squats, you can do leg extensions with the toes pointed outward.


agree with the above but thought i would throw in the idea of barbell hacksquats. They tend to hit VM a bit, maybe, kinda, a little... dont they..?


The reason I am not too keen on the leg extension when someone has a knee injury is that while the last 15 degrees may recruit the VMO, the movement itself reinforces any faulty tracking problems that you might have and chances are if you've been told to strengthen your VMO, you have faulty tracking patterns and too much lateral pull.


Petersen Step-Ups


Just a side note: Make sure you focus on stretching. Stretch your entire lower body, concentrating on the illotibial band running from the side of your butt down the side of your leg to your calf. Hold each stretch about thirty seconds (do both sides) for about 5 reps each. I stretched for about an hour a day for about 3 months for the pain to go away (vmo was never a problem).


thanks for all the advice guys, im gonna give squats another go tommorow :slight_smile:


Try pulling a sled backwards. Grap the rope in your hands, and backpeddle like a cornerback does. That should do the trick. :slight_smile:


Herbie Hancock,

Are you talking about Patello-Femoral Syndrome, also known as Chondromalacia Patella? If so, then performing squats and excess activity where the knee is bent and under pressure will only aggravate the injury.

All injuries are the consequence of some pathology. The underlying pathology must be discovered and attacked in order to fully evaporate the ill condition. Something like cryotherapy might be a very good solution.

Now, in the event that I'm reading into this improperly, then I apologize. If instead, you're experiencing pain/weakness in your vastus medialis or medial ligament/knee, then I don't suggest that you attack the problem in this manner. If this is the case, it's not because of a weakness in your vastus medialis or the like. Instead, the injury is due to an imbalance somewhere else such that your VM must take on twice as much stress (or more) as it should!

Let me explain. If I tore my hamstring medially, it's not because my medial hammie is weak and cannot handle its load. On the contrary, it's because the lateral hamstring is weaker or not firing and the medial side must compensate. In the event that the stress is just too great, it tears.

Even if I'm totally off base in the context of this particular thread, I think this information is paramount in injury pre-habilitation.



You make a great point; closed chain exercises are preferred in the initial stages of rehab because of the decreases in patellofemoral compression forces and tracking issues. The leg extensions will come in handy further down the road.


You also make a great point, as tightness in the lateral retinaculum (which holds the patella to the femoral condyle) can also predispose an individual to this condition (even if the VMO is strong). Strech everything, especially the lateral rotators.


Tim, While you make some good points i need to disagree that all injuries are the consequence of some pathology... people fall out of trees and get hit by cars all the time and there is not necasserily any pathology. But i do get your point, the hamstring example was excellent and perhaps i am being pedantic.

I have a feeling however that perhaps moreso with the VMO then most other muscles that there does not necasserily need to be underlieing pathology to cause injury. In my case there was pathology ... torn cartilage in my knee... but my VMO was strong despite that untill i had my knee scoped. It was only after the surgery when my knee had been 'cleaned up' and i was not on my feet my that my VMO atrophied and I developed PFPS. The pathology if there was any was not somethign that i could do anything about.

Perhaps the pathology timbo is talking about in this case though is tight lateral musculature...

you should definetly look to adress it if it is a problem

what tim said beside the fact that i am sometimes a pedantic mother fucker was good advice.


here are some exerts from a similar topic that i participated in here in
january this year.

Could you please outline the VMO exercises and stretches that you have been doing? Did he recomend taping your nee?

As far as other things you can do... Just stick to what he said AND KEEP UP THE STRETCHING. Also Poliquin I think actually recomended getting back to full squats, he mentioned using 1 and 1/4 squats as a method of ehabilitating some injured athletes VMO with great success. This would be something that you would definetly work up to and not rush into. I have had a similar injury for a while now and while I can deadlift 450+ can not full squat the bar without pain......

Ohh yeah on the supertraining list it was mentioned that leg adduction exercises have been shown to increase activation of the VMO relative to the
lateral musculature of the thigh.

Something was also mentioned about squats with the thighs slightly rotated inwards also preferentially recruiting the VMO.

This got me thinking...What if you combined these two exercises with the end range leg extensions that most physios will prescribe.

Now this is just a hypothesis of mine and I am not a physio or a doctor or a
internationally renowned strength coach but...what if you did the leg presses
etc while squeezing a small ball (small soccer ball perhaps) between your knees. You would be getting the benefits of the adduction, the internally rotated squat and the leg extension...possibly .... on the other hand you may injure yourself more...

Also backwards running I have heard is good but this hurt me. I guess that
means I over did it a little. I have tried walking backwards against resistance (uphill or dragging a tire with a rope) also and found that I could definetly feel it in my VMO. Not very scientific I know but the best I coud come up with.


The best thing for this is,.......drum roll please................ART.


Patella-femoral is not necessarily the same as chondro. While they may be related, it is possible to have patella-femoral with associated chondro, all patella-femoral does not include crepitus under the kneecap.

Patella-femoral is a garbage basket term for knee pain associated with the patella. When you don't know exactly what it is, diagnose it as patella-femoral. Typically the patella tracks improperly along the condyles of the femur. Sometimes it is a strength issue, sometimes flexibility, sometimes firing patterns.

Chondro is the softening of the articular cartilage behind the knee cap.

Turning your feet on a leg extension is worthless. The muscles still fire in the same pattern and the all or non principle comes into play. With leg extensions you are actually putting more stress on the knee than it needs, plus increasing the amount of shearing force.

You would be better off working on Split squats and single leg squats off a box.


peterson step ups- start off low and go one leg at a time for 1 min. slowly increase the height of box.
Also some other of my favorites:
one legged ski squats, one legged squats, front squats, 1 and 1/4 back squats, back squats with isometric pauses, sissy squats