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Patello-femoral syndrome

Hey guys, my girlfriend has patello femoral syndrome in her right knee. I took her to the orthapedist and he x-rayed her knee, and her kneecap was tracking too far to the outside of the knee, indicating that her vastus medialis is weak in relation to vastus lateralis.
I put her on a good lower body stretching program, hitting quads/hams and illotibial band.
What execises would you guys recommend to specifically target the vastus medialis ?

When I was running a lot (and very skinny), I had some knee problems. Two things I did which helped A LOT:

  1. Leg extensions utilizing only the last 30 degrees of motion.
  2. Straight leg raises (sitting on the floor) with the foot tilted away from the body (laterally) and pulled up as far as possible (vertically). This can also be done seated in a chair during the day.
    Hope that helps.

I would try 1 and 1/3 squats. I recall poliquin saying that the vastus medialis is used most in the bottom portion of the squat.

I recall and have tried with some success doing step ups, using a standard step, focusing on keeping the torso perfectly erect and holding the dumbell in the oposite hand, maintain perfect tracking of the knee directly over the knee without letting it stray. I am about to start doing these with a wobble board, (a circlular board, diameter appr = to foot length, with a half of a ball on the bottom in the middle.) They cost about $50 but I found a guy who make real good ones and he only charges $17. No its not a commercial, I am not the guy, but he is a student and could use a few bucks.) these with the 1 1/3 are brutal, but seem to really recruit the vastus medialas. ART would also be a good start, prior to any training. Tell me, can she touch her heel to her but when lying on her stomach? If she can’t, you can help her. without her hitching her hips, provide resstance to her while she tries to straighten her knee, stetep 2, hike up her knee while lying on her belly with her heel on her butt. use your shoulder to provide resistance to her foot, your hands to lift her knee. Now have her try to push her knee into the bench or floor while simultaneously trying to push her foot away from her butt cheek. This is F’n brutal. you could have her do 5 secs contraction, take a breath, you lift her knee further, 5 seconds again. 3-5 sets of these. Have her focus on not hitching her hip to the side. If you help her with these, then insist on reciprocal sex. Its only fair. In all seriousnes, ART, flexibility and exercise can help a lot.

i would try split squats, going down as far as she can without pain, right knee in front.

If she does leg extensions with her feet turned out it will target the vastus medialis.

Your stetching routine seems to be on. Remember to also stretch the rectus femoris (acts as hip flexor).
This syndrome is a bitch and I’m just recovering from it. I’ll tell you what has worked for me. Focus on closed chain exercises. The muscles need to be re-educated as a whole and you’ll need co-contraction for that. Mini squats worked best for me. Try using a smith machine. Stack on a bit of weight and only go through pain free range of motion. The pain should not be worse after exercising. Focus on the eccentric portion and repeat using the affected leg only. One legged squats are tricky so remember to keep neutral spine throughout. Straight leg raises in all 4 directions should also be done.
Another effective exercise is walking on the treadmill backwards at maximum grade (targets the quads). You’ll get some strange looks from other gym members, but that’s a small price to pay for the effectiveness of this exercise.
After she can do a full squat pain-free, move on to proprioceptive exercises and lastly plyometrics. Good luck.

PMac, thanks for the advice. A few questions. Why leg raises in all 4 directions? Squatting hurts her at the bottom range of motion so i definatly could have her to partial squats, perhaps one legged, will have to assess how strong she is at the moment.