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The VMO (vastus medialis oblique) is a muscle in the front of the thigh that is part of the quadriceps muscle group. It is responsible for knee stabilisation and plays a role in controlling the movement of the kneecap. Weakness in the VMO can lead to abnormal tracking of the patella, resulting in knee pain and injuries. To target the VMO for strength training, specific exercises such as squats, step-ups, and quad sets are recommended. These exercises aim to activate and strengthen the VMO, improving its ability to stabilise the knee joint and reduce pain.
| Characteristics | Values |
|---|---|
| Location | VMO is a part of the vastus medialis muscle, located in the anterior (front) compartment of the thigh |
| Function | VMO is responsible for extending the knee and stabilising the patella (knee cap) within its groove |
| Structure | VMO is one of four muscles that make up the quadriceps |
| Weakness | Can lead to abnormal tracking of the patella, resulting in knee pain and injuries |
| Exercises | Squats, step-ups, lunges, straight leg raises, quad sets, and ball squeezes |
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What You'll Learn
VMO weakness and atrophy
The Vastus Medialis Oblique (VMO) is one of four quadriceps muscles. Located on the inside of the thigh, its primary function is to extend the knee. The VMO is important for knee-cap tracking, helping to control the movement of the kneecap and providing stability.
VMO weakness can be caused by a number of factors. One primary cause is disuse atrophy, which can occur following a period of inactivity due to injury or surgery. When the knee joint is not used, the muscle fibres begin to weaken and lose strength and mass. Poor biomechanics during physical activities such as squatting or lunging can also cause VMO weakness, as certain muscles are overpowered by others, inhibiting the optimal functioning of the VMO. Inadequate rehabilitation following knee injuries can also contribute to weakness, as can neuromuscular conditions or nerve damage affecting the femoral nerve. Age-related changes in muscle mass and strength (sarcopenia) can also affect the VMO.
VMO weakness can lead to reduced endurance during activities that require sustained knee muscle contraction, such as standing or walking. It can also cause difficulty with functional movements such as rising from a chair, or transitioning between sitting and standing. Athletes with VMO weakness may experience decreased performance in sports requiring rapid direction changes, jumping, or landing.
VMO atrophy is the wasting of the quadriceps muscles, leading to a visible loss of muscle mass and definition around the knee. This can occur as a result of VMO weakness.
To target the VMO, exercises such as squats, step-ups, and lunges can be performed. Wall squats involve placing a Swiss ball against a wall, then squatting slowly until your thighs are parallel with the ground. Step-ups involve stepping up onto a platform and driving from the gluteal muscle, ensuring the knee is stable and the VMO is contracted.
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VMO exercises
The VMO, or vastus medialis oblique, is a muscle in your quads that helps to stabilise the kneecap (patella) and control its 'tracking'. The VMO is the lower part of the vastus medialis muscle, which is one of the four muscles that make up the quadriceps. The VMO gets its name from the oblique orientation of its fibres.
The VMO is often targeted by bodybuilders, who refer to it as the "'teardrop' muscle of the leg", and those recovering from knee surgery or suffering from kneecap pain. Weakness in the VMO can lead to a condition called "patellar maltracking", where the patella does not track properly in the groove of the femur (thigh bone) or tibia (shin bone), causing the kneecap to glide over to the outer side of the knee. This can result in excessive friction and an increased risk of patella dislocation.
VMO strength exercises are used in most knee physical therapy programs and can help to reduce and prevent knee pain. However, isolating the VMO for strength training is difficult. Here are some exercises that can help activate and strengthen the VMO:
- Quad Sets: With the knee extended, contract the muscles in the front of the thigh as tightly as possible. Hold for 10 seconds, 10 reps x 2 sets.
- Straight Leg Raises: Lie on your back with one leg straight and the other bent. Tighten the thigh and lift the straight leg about 12 inches off the surface. Hold for 3 seconds, 10 reps x 2 sets.
- Squats: Stand near a support surface and slowly bend the hips and knees into a squat position, ensuring the knees stay behind the toes and are apart. Maintain VMO contraction throughout the exercise. Repeat 10 reps x 2 sets.
- Step-Ups: Stand in front of a bench or chair and step up onto it, driving from the gluteal muscle. Keep your knee in a stable, neutral position and your VMO contracted. Slowly step down, alternating legs. Repeat 3 sets of 10-15 reps.
- Wall Squat: Stand with your back against a wall, a squishy ball between your knees, and your heels about 6 inches away. Clench your glutes and gently squash the ball to activate the VMO, then slowly slide down the wall, bending your knees. Hold the squat for 3 seconds and slowly push yourself back up.
- Isometric Contraction: Sit on the floor with your legs out straight and a towel underneath your knee. Flex your quad muscle with your hip/leg slightly externally rotated. Hold the contraction for 5-10 seconds, placing your fingers on your VMO to ensure the muscle is activating.
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VMO and knee pain
The VMO, or vastus medialis oblique, is a part of the quadriceps muscle that sits on the inside of the thigh. Its primary function is to extend the knee and help with the locking mechanism of the knee joint. It also helps to control the alignment and movement of the kneecap, ensuring that it glides smoothly up and down the groove on the thigh bone.
When the VMO is not functioning optimally, the kneecap can shift out of place during movements such as squats and lunges, causing pain and inflammation behind the kneecap. This can lead to further issues such as biomechanical imbalances, with tight lateral structures pulling the kneecap laterally, and a weak VMO unable to pull it medially. This results in the kneecap tracking laterally in the groove, causing pain and dysfunction.
VMO dysfunction is common in runners, hikers, cyclists, and athletes involved in jumping sports, as well as after any knee injury. Anterior knee pain is a common issue for runners, and VMO strengthening exercises can help to improve knee strength, stability, and endurance, reducing knee pain.
To target the VMO, it is recommended to combine VMO exercises with strengthening and stretching exercises for the other knee muscles. Some specific VMO exercises include:
- Quad sets: With the knee extended, contract the muscles in the front of the thigh as tightly as possible. Hold for 10 seconds, 10 repetitions x 2 sets.
- Straight leg raises: Lie on your back with one leg straight and the other bent, tighten the thigh, and lift the straight leg about 12 inches off the surface. Hold for 3 seconds, repeat 10 repetitions x 2 sets.
- Squats: Stand near a support surface and slowly bend the hips and knees into a squat position, keeping the knees behind the toes and apart. Do not push through pain. Repeat 10 repetitions x 2 sets.
- Wall/ball squats: Place a Swiss ball against a wall and slowly squat down so that your thighs are parallel to the ground. Slowly come back up, avoiding locking your knees. Do 3 sets of 10 repetitions and increase as you become stronger.
- Step-ups: Stand in front of a bench or chair and step up onto it, driving from the gluteal muscle. Slowly step down, ensuring your knee is in a stable, neutral position and your VMO muscle is contracted. Alternating legs, repeat 3 sets of 10-15 repetitions.
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VMO and patella tracking
The Vastus Medialis Oblique (VMO) is a muscle located in the anterior (front) compartment of the thigh. It is part of the quadriceps muscle, which is made up of four muscles in the thigh that come together at the quadriceps tendon to pull on the kneecap and extend the knee. The VMO is particularly important in the final stages of knee extension, helping with the locking mechanism of the knee joint.
The VMO has an extra function of helping to control how the kneecap moves and provides stability. The shape of the knee means that the kneecap would naturally glide to the outer side of the knee when bending the leg. This would cause excessive friction on the cartilage lining the back of the kneecap and increase the risk of patella dislocation. The VMO counteracts this by drawing the kneecap inwards, ensuring that as the knee bends and straightens, the kneecap glides smoothly up and down the groove on the thigh bone.
Weakness in the VMO muscle can lead to biomechanical imbalances, which can cause the kneecap to track incorrectly. This can result in patellofemoral dysfunction, which is pain in the front of the knee between the kneecap and the underlying femur. This occurs when the patella is forced with excessive pressure against the underlying femur or when it tracks excessively on one side or the other of the groove.
To target the VMO muscle and improve patella tracking, various exercises can be performed. One such exercise is to sit with the knees bent and slowly straighten one knee, ensuring the VMO contracts. This exercise should be repeated several times daily until a strong, constant contraction can be maintained. Once this is achieved, the exercise can be integrated into functional movements such as squats, leg extensions, and lunges, ensuring that the VMO contraction is maintained throughout.
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VMO and squats
The Vastus Medialis Oblique (VMO) is one of the four muscles of the quadriceps, located on the inner thigh. It is responsible for knee stabilisation and patella (kneecap) tracking. When the VMO is weak, it can lead to a condition called "patellar maltracking", where the patella does not track properly in the groove of the femur (thigh bone) or tibia (shin bone), resulting in knee pain and injuries.
VMO squats, also known as Cyclist Squats, are an excellent way to target the VMO muscle and improve range of motion. By performing squats, you can build strength in the bottom part of the range, where the knees are flexed the deepest. This is because the knees flex more than the hips in a typical squat, allowing for greater involvement of the quadriceps.
To perform VMO squats effectively, start with your feet hip-width apart. Keep your arms out horizontally in front of you and control your hips back and down into a deep squat. Try to maintain a tall torso and keep everything stacked neatly above your feet, moving forward and backward in the same parallel lines. Avoid letting your knees widen at the bottom of the squat, as this can be a sign of tightness in the IT bands. Instead, focus on keeping your knees in a stable, neutral position throughout the movement.
Once you have mastered the basic VMO squat, you can increase the difficulty by adding weight. Start with a single dumbbell or a small kettlebell held in a front rack position. Gradually build up the weight, using a barbell in a front or back squat position. Remember to prioritise depth over weight and aim for 20 to 25 repetitions using only your body weight.
In addition to VMO squats, other exercises that can help target the VMO muscle include lunges, step-ups, and step-downs. These exercises can improve knee strength, stability, and endurance, reducing knee pain and helping with rehabilitation after knee surgery.
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Frequently asked questions
The VMO or Vastus Medialis Oblique is a part of the Vastus Medialis Muscle, which is one of the four muscles of the quadriceps. It is located in the anterior (front) compartment of the thigh and is often referred to as the "teardrop" muscle.
The VMO has an important function in controlling kneecap movement and providing stability. It helps to counteract the natural tendency of the kneecap to glide to the outer side of the knee when bending the leg, reducing friction and the risk of dislocation.
Some exercises that can help activate and strengthen the VMO include:
- Squats: Traditional bilateral squats or try VMO squats (cyclist squats) for deeper knee flexion.
- Step-ups: Step up onto a platform and drive from the gluteal muscle, ensuring the knee is stable and the VMO is contracted.
- Quad Sets: With the knee extended, contract the muscles in the front of the thigh and hold for 10 seconds, repeating 10 times.
- Straight Leg Raises: Lying on your back, lift the straight leg about 12 inches off the surface, hold for 3 seconds, and repeat for 2 sets of 10 reps.
A weak VMO muscle can lead to a condition called "patellar maltracking," where the kneecap does not track properly in the groove of the femur (thigh bone). This can cause knee pain and injuries. Most people with knee pain have some weakness in their VMO.
If you are performing appropriate VMO strengthening exercises, increased strength may be noticeable in a few weeks to a month.
