Logan Steele
The vastus medialis (vastus internus or teardrop muscle) is an extensor muscle located in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group and is one of four muscles that make up the group. The muscle is involved in knee extension and contributes to the correct tracking of the patella. The VMO (vastus medialis oblique), a distal segment of the vastus medialis, is the primary medial stabilizer of the patella. The VMO is evaluated and recorded using electromyography to analyze the biomechanics and detect abnormalities, weakness, or fatigue.
| Characteristics | Values |
|---|---|
| Muscle name | Vastus Medialis |
| Other names | Vastus internus, teardrop muscle, VMO, Vastus Medialis Oblique |
| Muscle group | Quadriceps |
| Muscle type | Extensor |
| Muscle location | Medial aspect of the thigh, anterior compartment of the thigh |
| Muscle function | Extends the knee joint, contributes to correct tracking of the patella |
| Muscle innervation | Femoral nerve |
| Muscle blood supply | Femoral artery |
| Muscle evaluation | Electromyography, surface electromyography (EMG) |
| Muscle weakness | Associated with patellar maltracking, patellofemoral pain, and anterior knee pain |
| Muscle treatment | Quadriceps strengthening, patella tracking exercises, rehabilitation exercises |
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What You'll Learn
Vastus medialis (vastus internus or teardrop muscle)
The vastus medialis (vastus internus or teardrop muscle) is an extensor muscle located medially in the thigh that extends the knee. It is part of the quadriceps muscle group, which also includes the vastus lateralis, vastus intermedius, and rectus femoris. The vastus medialis is the most medial of the "vastus" group of muscles and arises along the entire length of the femur, attaching to the other muscles of the quadriceps in the quadriceps tendon.
The vastus medialis muscle originates from a continuous line of attachment on the femur, which begins on the front and middle side (anteromedially) on the intertrochanteric line of the femur. It continues down and back (posteroinferiorly) along the pectineal line and then descends along the inner (medial) lip of the linea aspera and onto the medial supracondylar line. The obliquus genus muscle is the most distal segment of the vastus medialis muscle and plays an important role in maintaining patella position and limiting knee injuries.
The vastus medialis is involved in knee extension, along with the other muscles of the quadriceps group. It also contributes to the correct tracking of the patella. A division of the vastus medialis muscle into two groups of fibres has been hypothesized: the vastus medialis longus, which runs inline with the quadriceps ligament; and the vastus medialis obliquus, which is shorter and more obliquely oriented. However, there is insufficient evidence to confirm or deny this hypothesis.
The vastus medialis muscle is important in maintaining knee health and stability. Its weakness has been associated with patellar maltracking and patellofemoral pain. Proper rehabilitative plans and training techniques are crucial to preventing injuries and maintaining proper knee function. Specific exercises, such as step-ups, lunges, and squats, can help strengthen the vastus medialis and improve knee stability.
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Vastus medialis obliquus (VMO)
The Vastus Medialis Oblique (VMO) is one of the four muscles that make up the quadriceps group of muscles. It is located in the anterior compartment of the thigh and is an extensor muscle that extends the knee joint. The VMO is the most medial of the "vastus" group of muscles, arising medially along the entire length of the femur and attaching with the other muscles of the quadriceps in the quadriceps tendon.
The VMO is functionally different from the Vastus Medialis (VM) due to the different orientations of their muscle fibres. The VMO runs obliquely and helps with medial translation of the patella, while the VM runs more longitudinally and contributes more to knee extension. The VMO is the most distal segment of the VM muscle and plays an important role in maintaining patella position and limiting injuries to the knee.
The primary function of the VMO is to pull the patella medially, making it the primary medial stabilizer of the patella. The VMO helps align the patella within the trochlear groove during knee flexion and extension, and it is most active in the last 20 degrees of knee extension. When the VMO does not function properly, the patella can track laterally and cause pain and instability.
VMO strengthening exercises have been recommended for treating anterior knee pain and preventing injuries. However, some researchers doubt the existence of the VMO and question the effectiveness of isolated VMO exercises. It is argued that any quadricep exercise will similarly activate the vastus muscles, and that strengthening further up the kinetic chain may be a more effective approach.
To evaluate and record the electrical activity produced by the VMO, electromyography can be used. This analysis can help establish proper rehabilitative plans and prevent injuries by detecting abnormalities, weakness, or fatigue in the muscle.
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Vastus medialis longus (VML)
The vastus medialis (vastus internus or teardrop muscle) is an extensor muscle located medially in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group and is one of four muscles that make up the quadriceps, the others being the vastus lateralis, vastus intermedius, and rectus femoris. The vastus medialis arises medially along the entire length of the femur and attaches with the other muscles of the quadriceps in the quadriceps tendon. The vastus medialis muscle originates from a continuous line of attachment on the femur, which begins on the front and middle side (anteromedially) on the intertrochanteric line of the femur.
The vastus medialis is divided into two groups of fibres: the proximal vastus medialis longus (VML) and the distal vastus medialis obliquus (VMO). The VML is a long and relatively inline group of fibres with the quadriceps ligament. The VMO, on the other hand, is a shorter and more obliquely oriented group of fibres. The VMO is the most distal segment of the vastus medialis muscle and plays an important role in maintaining patella position and limiting injuries to the knee.
The VMO muscle is the muscle that resembles a "tear drop" above the knee and on the medial side of the quadriceps muscle group. The VMO is the primary medial stabilizer of the patella and helps with medial translation of the patella. It is most active in the last 20 degrees of knee extension and receives its nerve supply from the branches of the femoral nerve. The VMO can often be evaluated using surface electromyography (EMG) to detect abnormalities, weakness, or fatigue.
The VMO strengthening exercises have been a topic of debate among healthcare professionals. While some believe that isolated exercises for the VMO are necessary, others argue that it is not possible to isolate the VMO from the other quadriceps muscles due to their shared nerve innervation. Recent studies indicate that the VMO and vasti muscles work together to control the patella and the way it moves within the groove. Overall, the vastus medialis muscle plays an important role in knee extension and patella tracking, and its weakness can lead to biomechanical imbalances and patellofemoral pain.
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Vastus lateralis
The vastus lateralis (VL), also called the vastus externus, is the largest and most powerful of the four muscles that make up the quadriceps femoris. The other three muscles are the vastus medialis (VM), vastus intermedius (VI), and rectus femoris (RF). The VL is a unipennate muscle and is located in the thigh.
The VL serves to extend the knee joint, moving the lower leg forward. It arises from a series of flat, broad tendons attached to the femur, and attaches to the outer border of the patella. It ultimately joins with the other muscles that make up the quadriceps in the quadriceps tendon, which travels over the knee to connect to the tibia. The VL is the recommended site for intramuscular injection in infants less than 7 months old and those unable to walk, with loss of muscular tone.
The VL is bordered laterally by subcutaneous tissue, and medially, it is bordered by the femur and the VI at the level of the greater trochanter. The RF forms the anteromedial border while the posteromedial aspect of the VL is bordered by the intermuscular septum, sciatic nerve, and biceps femoris muscle at the level of the greater trochanter. The VL has a broad, continuous origination about the proximal femur. Origin points include the intertrochanteric line, greater trochanter, lateral aspect of the linea aspera, gluteal tuberosity, and the lateral intermuscular septum.
The muscle fibres of the VL converge and contribute to the quadriceps tendon, inserting on the lateral aspect of the patella, and terminally inserting on the tibial tuberosity via the patellar tendon. The VL is innervated by the muscular branches of the femoral nerve (L2, L3, and L4). The blood supply for the VL is primarily the lateral circumflex femoral artery, which has three main branches: ascending, transverse, and descending. The muscle also receives some blood supply from perforating arteries of the profunda femoris, also known as the deep artery of the thigh.
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Vastus intermedius
The vastus intermedius is a muscle that is part of the quadriceps group of muscles. It is one of the four muscles that make up the quadriceps, the others being the vastus lateralis, vastus medialis, and rectus femoris. The vastus intermedius originates from the upper two-thirds of the anterior and lateral surfaces of the femur and the intermuscular septum. It inserts via the quadriceps femoris tendon, forming the deep part of the tendon, and then inserts into the lateral margin of the patella.
The vastus intermedius muscle facilitates knee extension, along with the other muscles that are part of the quadriceps femoris. The descending branch of the lateral circumference femoral artery supplies this muscle. The vastus intermedius is innervated by a branch of the femoral nerve, originating from lumbar nerve roots 2, 3, and 4.
The vastus intermedius is difficult to palpate and cannot be stretched by hip extension like the rectus femoris. It is also not accessible for massage therapy to stretch the fibres sideways, unlike the vastus lateralis and vastus medialis. Due to its position as the deeper middle-most muscle of the quadriceps group, the vastus intermedius is the most difficult to stretch once maximum knee flexion is attained.
The vastus intermedius and vastus medialis appear to be inseparably united, but when the rectus femoris is reflected during dissection, a narrow interval can be observed between the two muscles. This separation can be continued as far as the lower part of the intertrochanteric line, where the two muscles are frequently continuous.
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Frequently asked questions
VMO stands for Vastus Medialis Oblique, a muscle that is part of the quadriceps group of muscles. It is located in the thigh and is involved in knee extension.
The VMO muscle helps to pull the patella medially, keeping it centred in the groove of the thigh bone during knee motions. This reduces compressive and sheer forces on the patella and groove.
Weakness of the VMO muscle can lead to patellar maltracking, causing the patella to "rub" against the lateral side of the trochlear groove. This can result in pain and instability, as well as secondary issues such as biomechanical imbalances.
