I've been having knee problems for a while now, and finally saw a physical therapist the other day. He told me that I've got an overdeveloped vastus medialis, and that it's pulling my knee cap inward, causing a "tracking issue." He also mentioned that this was strange, as it's far more common for the opposite to be the case, with the vastus lateralis being overdeveloped and pulling the knee cap the other way. As such, he says he's going to have to research this one, because he's never come across it before. Anyone know how to help with this?
EDIT: On a side note, I've found some info that says the knee should rotate inward from 45 degrees to full extension, implying that my physical therapist has no idea what he's talking about. Any thoughts on this?
11-21-2011, 11:16 PM #1
How to target the vastus lateralis?
Last edited by CMSI; 11-21-2011 at 11:22 PM.
11-22-2011, 12:47 AM #2
11-22-2011, 08:05 AM #3
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11-22-2011, 10:13 AM #4
If your PT seemed unsure of what was being said I would seek a second opinion.
As far as rectifying that if it is actually the case, I've heard some bodybuilders attest to doing hack squats as a great outer sweep builder. So you may want to try doing hack squats? It may be the way you squat now or the type of accessory leg movements you're doing that's causing the problem though. What do you do when you hit legs? It's possible if you gave your usual workouts a rest for a while and focused on simpler movements where you can make sure you're extending at the knee without any type of rotation then it may fix the problem.
Again, I'd probably just see a different therapist though. 1) so you know for sure you have an imbalance there and 2) so that you speak with some one who can actually give you a legit answer as to what caused it and what you can do. If some one in healthcare told me "Oh I've never seen this before. I'm going to have to look it up and get back to you," I would never go back.
11-22-2011, 10:35 AM #5
11-22-2011, 11:08 AM #6
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The answer is machine work, which will take balance issues out of the equation. Try Machine Hacks, V-Squats, and/or Smith Machine Squats with your feet out in front of your body enough that your knees don't travel too far past your toes, and your feet 6" or so apart from each other. Start relatively light, and work your way up in weight as you get accustomed to the new positioning. VL is a large, strong muscle, and you'll probably find that you have to use heavy weight to get it to respond.
EDIT: On a side note, I've found some info that says the knee should rotate inward from 45 degrees to full extension, implying that my physical therapist has no idea what he's talking about. Any thoughts on this?No brain, no gain.
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11-22-2011, 01:22 PM #7
11-22-2011, 07:41 PM #8
I've never done narrow stance leg press or squats before, so maybe only doing wide stance leg work for the past year and a half really has created a muscle imbalance afterall - perhaps my therapist was right (though I'm still a little put-off by the fact that he didn't really know how to address the issue). Hopefully by correcting this, my knees will start to track properly and I can get back to squatting, cause I really miss it. Thanks for the help man, I really appreciate it.
04-05-2017, 09:55 AM #9
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04-05-2017, 10:14 AM #10
Nice bump from 2011
Quote from Mark Rippetoe
And how about the classic "VMO that's not firing"? First, there is no such thing as the VMO as a separate muscle.
Dissection studies on hundreds of cadavers have proven this conclusively. There are oblique fibers on both the vastus medialis and the vastus lateralis, but neither of these have their own fascial sheath or epimysium, their own innervation, action, or antagonist. All of the quad bellies are innervated by the femoral nerve, which arises from L2-4.
In the words of a better-than-average DPT: "If they all have the same segmental innervation, and they all extend the knee, then how the **** is it possible to isolate out the function of the VMO?"
And if this is the case, how's it possible that a weak VMO is responsible for "Patellar De-tracking Syndrome"? And how would it then be possible to fix this non-existent problem by teaching a muscle that doesn't exist how to fire with "corrective exercises"?
Might weakness be confused with "not firing" – either purposely or through ignorance? Why wouldn't squats done with correct symmetrical technique solve this problem?─█─────█─ Ivanko Barbell Crew #19 ─█─────█─
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04-05-2017, 10:40 AM #11