T Nation

Strengthening VMO


I'd been to see a physio about my knee pain (Patello-femoral Pain Syndrome) months ago and he set me up with a load of rehab exercises to to strengthen the VMO of both legs as he said they were weak. After trying these the exercises for a few months there was no improvement.

I thought fuck it then, and started squating, using the empty bar and have now worked up to 110kg and the pain is gone for most of the time so happy days.

Now, as other people may know, the gym where I work is crap, and I can't squat there as there is the facility, so I've been doing RLESS/lunges/walking lunges and have worked up to 2x 25 kg dumbells (the max weight they have) - again with little or no pain.

SO today, to make things a little more difficult, I thought I'd try pre-exhaust my quads with leg press followed by leg extensions. Leg press went fine. Leg extensions. I set it to a light weight for the first warm up set - 10 reps - my VMO on both legs fired like crazy and I struggled to finish the set. I done 2 more sets at this "warm up" weight and had the same thing.

This has obvioulsy demonstrated how weak the VMO is compared to the rest of the leg. I have had no after effect on my knees (as of yet - time will tell).

The question is:

Is it wise to use this exercise to strengthen the VMO, as all other exercises given to me, I haven't felt it work at all and this I could feel firing like mad through the full ROM.

Is the leg extension a safe and/or knee friendly exercise, or will I do myself more damage in the long run if I stick with it.




I have read, and since im not a exercise physiologist i cant confirm this. But that it is impossible to isolate the VMO to be strengthened. You might need to look in other places of rehab, search in your area for an active release technique doctor and they may find whats really wrong. Could be tight or weak abductors or a myriad of things. Good luck


leg extensions are used extensively by bodybuilders and average gym goers. I do not believe a few sets of leg extensions will destroy your knees, provided you use smart form and don’t try to literally jerk and kick the weight up.


I have this same issue. My patella constantly glides and clicks when I bend my knee. It is a pain in the as$. As for the above comment, isolating the VMO is impossible so he is correct. It all works together, no isolation. Funny thing is, I can squat heavy and deadlift with no pain in them. Its just really ANNOYING!


CT has a thread on building the VMO through the use of 1 1/4 squats.
The idead is to go ass to grass then coming up to parallel, going down to grass and all the way back up.
This constitutes ONE rep.
This may also be done on the leg press (known as Froggies) where you elevate the heels with a wide stance.

The videos section would probably be the best place to ask CT about this !
good luck…killerDIRK


google peterson step ups.
Its more like a step down.

TKE terminal Knee extensions can help here too.

Personally I don’t think leg extensions are good for knees in general.
In that ( for me) It does not get the VMO to fire at all - its all rectus femoris
which has only promotes the imbalances that I have.


For the record, I have terrible tracking issues and Sissy Squats seem to be helping tremendously. They look super weird but man do they really burn. My patellas seem to track better almost instantly. Im sure it will take maybe months of doing these a few times a week to fix my issue, but if you have patellar pain, try them.