Stimulating the Vastus Medialis?

[Metal_Fingers]

Details:
-Both knee caps shift outwards due to muscle imbalance between vastus medialis and intermedius
-Other problems occur such as slight knock knee as well as knee cap/femur dont match up in terms of groove
-However, muscle imbalance is significantly causing pain, trying to correct the "suspension of the knee"
-Kind of hoping after I fix the imbalance to have them grind out and fit my knee cap with my femur, but the specialist wants so see about this first.

Question:
How can I adjust squats/leg press/leg extensions/deadlift so that I can stimulate the vastus medialis?
What exercises, outside of the therapy I do on my own, will stimulate the vastus medialis?

I am kind of hoping that once I fix this problem now, that perhaps I can adjust the exercises that I currently do so that the quad growth is more even.

Thanks.

[laughin_man]

hack squats, front squats (toes out)

[Hayeder]

this is in the May edition of FLEX magazine, in the gym bag section I think. GO GET IT!!

anyways it says that leg presses, with any stance, target the vastus medalis heavily. they suggested a vastus medialis focussed routine too:

Front squats
leg presses
hack squats
leg extensions (toes out)

I do suggest that you go into a magazine store (if this one is still in stock) and turn to page 186


P.S. I just found out that the new magazine came out a week ago, plus this is the UK edition

[Metal_Fingers]

So it seems toes out is the key to hitting the medialis? When I use to do back squat (haven't in two months) I had toes out? Why does toes out not hit it then?

[wolfbaden6]

If you do leg extensions, squeeze your quads for a second or two at the furthest point of the extension. That always works for me.

[steelmover]

hack squats with the barbell realy hit that leg muscle for me try them out plus they hit he traps good to due to it being a backasswards deadlift. It gives a realy good pump in that leg muscle.

[Metal_Fingers]

Well, right now I just started Westside Barbell For Skinny Bastards. I am on my second day. I am thinking for right now for leg day I will use front squats, light to start off with for sure. But for the "UNILATERAL MOVEMENT ? Perform 3-4 sets of 8-15 reps" would "single leg back squats with other leg elevated" hit the muscle I am trying to target. I have also taught about dumbbell lunges, which is also on the list of selected exercises for the Unilateral movement exercise scheme.

Thanks for the help thus far. reps.

[steelmover]

yeah lunges will work good. If you do one leg squats watch your knees due to know support i have tried it once didnt like it to well but it may be diffrent for you give it a shot. good luck

[-Lucifer]

If you do leg extensions, squeeze your quads for a second or two at the furthest point of the extension. That always works for me.

This.

Have your toes (pointing out) at an angle though.

[tonester]

Details:
-Both knee caps shift outwards due to muscle imbalance between vastus medialis and intermedius
-Other problems occur such as slight knock knee as well as knee cap/femur dont match up in terms of groove
-However, muscle imbalance is significantly causing pain, trying to correct the "suspension of the knee"
-Kind of hoping after I fix the imbalance to have them grind out and fit my knee cap with my femur, but the specialist wants so see about this first.

Question:
How can I adjust squats/leg press/leg extensions/deadlift so that I can stimulate the vastus medialis?
What exercises, outside of the therapy I do on my own, will stimulate the vastus medialis?

I am kind of hoping that once I fix this problem now, that perhaps I can adjust the exercises that I currently do so that the quad growth is more even.

Thanks.

Do you do anything other than gym work? Such as any sport where your body has to move in random (natural) ways to stimulate the stabilizers that you speak of? Have you ever noticed how well developed these stabilizers are on those who MOVE in multiple planes for their sport/passtime (field sports)? They are stabilizers therefore these movements develop them in a way that they are supposed to.

I would recommend adding some movement drills into your routine. This will mobilize (wake up) the muscles to do what they are supposed to do together. I believe you have an underlying issue that can be helped by adding some movement based work. ( This would be in conjunction with your weighted work).

Isolating stabilizers is not the answer. You'll end up chasing the imbalance.

[Metal_Fingers]

Do you do anything other than gym work? Such as any sport where your body has to move in random (natural) ways to stimulate the stabilizers that you speak of? Have you ever noticed how well developed these stabilizers are on those who MOVE in multiple planes for their sport/passtime (field sports)? They are stabilizers therefore these movements develop them in a way that they are supposed to.

I would recommend adding some movement drills into your routine. This will mobilize (wake up) the muscles to do what they are supposed to do together. I believe you have an underlying issue that can be helped by adding some movement based work. ( This would be in conjunction with your weighted work).

Isolating stabilizers is not the answer. You'll end up chasing the imbalance.

I played soccer up until I was 14. Then played half a season of basketball in 8th grade, had to quit due to busting up my knees and getting stitches. I play basketball on the weekends, but with my school/work schedule, getting time to work out is doing good. What type of movement drills would you recommend? Ill be honest, I am extremely unfamiliar with what you are talking about.

[ramrod63]

i dont mean to jack the thread but i have the opposite problem...my vastus medialis is over developed like a mofo, my knee caps point outwards when i bend my knees, im gonna see someone about this next week

any tips on how to correct this and things i should avoid

edit: OP if your knee caps are pointing outwards like me then its your medialis that over developed since that the muscle on the inside of the knee, you have flat feet too?

[Metal_Fingers]

i dont mean to jack the thread but i have the opposite problem...my vastus medialis is over developed like a mofo, my knee caps point outwards when i bend my knees, im gonna see someone about this next week

any tips on how to correct this and things i should avoid

edit: OP if your knee caps are pointing outwards like me then its your medialis that over developed since that the muscle on the inside of the knee, you have flat feet too?

I think you misunderstood me. My knee caps point outwards just like your. Think of it this way, nothing in the body pushes. So with that said, the knee cap is actually being pulled to the outside due to a muscle imbalance. This means the Vastus intermedius is disproprotionally bigger/tighter than the Medialis, thus causing the pulling of the knee cap. As for the foot question, I have an arch in my foot, but with size 16 shoe, I have really long feet, so honestly I might be wrong. But the arch isn't complete collapsed in, so probably not.

As for how you fix this, I am doing 6 weeks of self-physical therapy, meaning I have the ability to fix this on my own.

Here is some explainations of Patellofemoral Pain Syndrom:


It is important to note, that my case is abit more serious. The doctor noticed that I have a slight knocked knee as well as x rays showed that the grove in my femur is shallow, while the corrisponding bump in my patella is deep. Meaning, my patella/femur do not match up. But honestly, i am taking care of the pulling on the patellas first. (have it in both knees).

However, with that said here is what I do:

1. Hamstring stretch 3 sets of :30s stretching for each leg.
2. Quad stretch 3 sets of :30s stretching for each leg.
3. This is not on the diagram. Sit on the floor with your leg stretched out in front of you, flat. Take your fingers and pull the knee cap towards you and hold for :10s. Pull it left, hold for :10, down hold for :10, right hold for :10s. Repeat this clockwise cycle for 5mins. Do for both knees (or atleast injured knee)
4. Quad iscometric. "PUsh" the back of your knee into the ground and hold for 5s. Dont flex the quad, that will only work the VOI. Do 5 sets of 10.
5. Leg raises 6-8" off the ground. Hold for 5 secs, do 3 sets of 10 reps.

[too_small]

Wide stance for medialis. (teardrop)

Narrow stance for lateralis. (quad sweep)

[ramrod63]

I think you misunderstood me. My knee caps point outwards just like your. Think of it this way, nothing in the body pushes. So with that said, the knee cap is actually being pulled to the outside due to a muscle imbalance. This means the Vastus intermedius is disproprotionally bigger/tighter than the Medialis

ya i did, thanks for pointing all those things out
in my case i have flat feet so my knees cave in a little and my medialis is huge, really unproportonal
does your knee cap point outward just when youre bending your knee or always? (me its just when i bend)

[Metal_Fingers]

ya i did, thanks for pointing all those things out
in my case i have flat feet so my knees cave in a little and my medialis is huge, really unproportonal
does your knee cap point outward just when youre bending your knee or always? (me its just when i bend)

Ok, lets say the angle between my femur and tibula is 115 degrees. If I am looking at my knee, my knee cap is 30 degrees from normal to the femur. When the doctor got the x rays, he questioned whether I have had my knee caps dislocated.

Similar to this "merchant view x ray":


Mine are slightly further out than this, just by a hair i believe. Another problem that causes pain is the groove in the femur/knee cap that you see there dont match. The femur groove is shallow while the patella groove, er.. bump if you will is much larger.

[Blindead]

Why do you guys want to target them? Most bodybuilders I see have oversized ones, and they often make their legs look ugly. I see most people have noticable medialii without trying to get them.

[Metal_Fingers]

Why do you guys want to target them? Most bodybuilders I see have oversized ones, and they often make their legs look ugly. I see most people have noticable medialii without trying to get them.

Read much? My muscle inbalance medialius is causing my patella's to shift causing me much pain.

[Blindead]

Read much? My muscle inbalance medialius is causing my patella's to shift causing me much pain.

I skimmed it, but not really. Didn't expect a legitimate thread, every other thread involving this muscle has been about how to get it to pop to impress chicks or to look good on stage. Apologies broskie.

Leg extensions done using only the last 20-30 degrees with proper toe placement (I don't recall if it's in or out) can stimulate the VM well.

[Metal_Fingers]

I skimmed it, but not really. Didn't expect a legitimate thread, every other thread involving this muscle has been about how to get it to pop to impress chicks or to look good on stage. Apologies broskie.

Leg extensions done using only the last 20-30 degrees with proper toe placement (I don't recall if it's in or out) can stimulate the VM well.

Its cool. Now if I were to add leg extensions what type of set/rep scheme would I use? Obviously I would use light weight high reps for rehab purposes. 3x15? I would like to rehab the VM using other than contracting the quad and raising the leg 6 inches off the ground.

[low blow]

You've got patella femoral pain

Caues
Weak glute medius causing a tight illiotibial band
Weak vastus medialis oblqious (VMO)
Improper walking/running gait
Improper standing ability

-The exercises you listed above are what target the glute medius
-To target the VMO you need to do what is called end range knee extension, particularly eccentrically. This is basically doing leg extensions in the last 20 degrees of ROM (a very small ROM - you'll feel a tight tug in this medialis area from it).
-See a good podiatrist and get your gait and posture analysed just in case, though this probably isn't going to make a difference unless you just went through puberty or something.

hope that helps, ill keep an eye on this thread

btw i have this condition now lol, so im taking my own advice

[tinman15]

i dont mean to jack the thread but i have the opposite problem...my vastus medialis is over developed like a mofo, my knee caps point outwards when i bend my knees, im gonna see someone about this next week

any tips on how to correct this and things i should avoid

edit: OP if your knee caps are pointing outwards like me then its your medialis that over developed since that the muscle on the inside of the knee, you have flat feet too?

vmo doesn't cause knee caps to stick out... sounds like a hip/ham problem. VMO is knee stabalizer and a muscle that works primarily as an extensors not an adductor or abductor.

[tinman15]

You've got patella femoral pain

Caues
Weak glute medius causing a tight illiotibial band
Weak vastus medialis oblqious (VMO)
Improper walking/running gait
Improper standing ability

-The exercises you listed above are what target the glute medius
-To target the VMO you need to do what is called end range knee extension, particularly eccentrically. This is basically doing leg extensions in the last 20 degrees of ROM (a very small ROM - you'll feel a tight tug in this medialis area from it).
-See a good podiatrist and get your gait and posture analysed just in case, though this probably isn't going to make a difference unless you just went through puberty or something.

hope that helps, ill keep an eye on this thread

btw i have this condition now lol, so im taking my own advice

good advice for op.

I would like to add that while leg extensions are good for hypertrophy, it is a poor exercise for rehabbing. If you have an injury long term success should be the most important factor so nix the leg extensions.

As far as toes out, while this may help, the reason being is that doing so forces your knee to carry further past the toes which is what is stimulating the vmo. So there are other exercises you can do to stimulate the vmo instead of likely creating other muscle imbalances by doing exercises with the toes out. Ever date or met a dancer with knee problems? They almost all run and walk with the toes pointing away from the midline and that is no coincidence on why their knees hurt. 1 1/4 squats are amazing at building up the vmo, just make sure the knees don't cave in when you're deep and coming out the hole. Peterson step ups work well, so do heel elevated cable split squats. Hope this helps with your exercise selection.

[tonester]

To the OP. What he says ^^^

In my post above I made the assumption that you weren't into sport and was only interested in the body transformation thing. That is why I recommended agility drills to wake things up.

The stuff you are doing is great and the above advice is good.

I too have a similar problem but have never had pain or problems. I am convinced that it's because of a solid hip/gluteal structure as well as being very conservative about recovery. I feel my glutes firing with every step I take and coming out of the bottom of a bodyweight squat elicits a huge contraction that practically propels me up. Anyways, glutes rule.

[Metal_Fingers]

You've got patella femoral pain

Caues
Weak glute medius causing a tight illiotibial band
Weak vastus medialis oblqious (VMO)
Improper walking/running gait
Improper standing ability

-The exercises you listed above are what target the glute medius
-To target the VMO you need to do what is called end range knee extension, particularly eccentrically. This is basically doing leg extensions in the last 20 degrees of ROM (a very small ROM - you'll feel a tight tug in this medialis area from it).
-See a good podiatrist and get your gait and posture analysed just in case, though this probably isn't going to make a difference unless you just went through puberty or something.

hope that helps, ill keep an eye on this thread

btw i have this condition now lol, so im taking my own advice

I am not doing all the exercises listed in the diagram. The problem stated by the Orthopedic specialist is an over developed Vastus Lateralis along with an underdeveloped VMO. This tension imbalance causes the shift in the patella.

vmo doesn't cause knee caps to stick out... sounds like a hip/ham problem. VMO is knee stabalizer and a muscle that works primarily as an extensors not an adductor or abductor.

VMO imbalance can cause knee caps to stick out. I think I will stick with everything I have read thus far.

To the OP. What he says ^^^

In my post above I made the assumption that you weren't into sport and was only interested in the body transformation thing. That is why I recommended agility drills to wake things up.

The stuff you are doing is great and the above advice is good.

I too have a similar problem but have never had pain or problems. I am convinced that it's because of a solid hip/gluteal structure as well as being very conservative about recovery. I feel my glutes firing with every step I take and coming out of the bottom of a bodyweight squat elicits a huge contraction that practically propels me up. Anyways, glutes rule.

Same here. I dont think it is a glute problem. I have been squatting ATG for over a year and definately feel it firing as you said. I am just alittle thrown off because I worked myself up to 325x3 ATG and now I hear it I have underdeveloped quads.


But with all this said, right now I am strengthening my VMO. That is my main concern. I am still working on flexability, which I have been for year. Being this tall I felt stretching would make me more limber, but I will keep at it.

I was told my the rehap specialist to do my thing for 6 weeks and then I will go back for x rays to see if my patellas have readjusted. If not, he suggested in house therapy or surgery to releave the tension.



I am considering foam rolling for hams/calves/quads/IT Band relieve, if this problem is tension. What are you guy's thoughts on that?

[tinman15]

VMO imbalance can cause knee caps to stick out. I think I will stick with everything I have read thus far

Just trying to help, but the knees out was in reference to what the other guy said not you. He said his knee caps point outwards meaning away from the midline and toward his left and right. The vmo is not an adductor or abductor but instead part of the quad to help with knee extension. They have very little to no control over which direction the knee faces in relation to the mid line of the body. This is very basic body mechanics and so no, no imbalance between the vmo and other muscle will cause the knees to "stick out" in the way he described.

[Metal_Fingers]

Just trying to help, but the knees out was in reference to what the other guy said not you. He said his knee caps point outwards meaning away from the midline and toward his left and right. The vmo is not an adductor or abductor but instead part of the quad to help with knee extension. They have very little to no control over which direction the knee faces in relation to the mid line of the body. This is very basic body mechanics and so no, no imbalance between the vmo and other muscle will cause the knees to "stick out" in the way he described.

Are you talking "stick out" as in raise up off the knee? or stick out as in slide to the right?

Sorry about that. I misunderstood.

[Verdelet]

This was one of my knee complications i had with my knee injury. I just wondered, have you been to a physiotherapist. I was given exercises that took a hour a day and it took me a year until my knees got better. I did no real weighted exercises apart from extensions with ankle weights, so i just wondered whether or not you should get a physio to check it out.