I have a client whose doctor most recently and her physical therapist years ago gave her the task of strengthening her quads, particularly the VMO. I looked at her old PT program and the exercises were pretty common activation exercises for the VMO, i.e. slight external rotation at hip, tighten VMO, lift leg. After assessing her, the way her knee and ankle are diving in, I agree with the current doctor and I think her old PT exercises are still relevant.
Here’s the issue.
She also tends to lock out her knees in standing, coming up from squats, etc. She is having trouble tightening the VMO without hyper-extending the knee. If she weren’t already a “knee locker,” I might not be so concerned, but I’m trying to teach her how to stabilize around the knee without also locking it. I can fire my VMO without locking my knee joint, and I’m trying to teach her how to do the same. Her body awareness is a little less than mine, so it’s a challenge for her to know what she is feeling and tell me back.
What are some of the tricks or cues, please, that you’ve used to help someone be more aware of whether the VMO is tensing, and then how to do it without locking and hyper-extending the knee?
First of all, can she selectively contract the vastus medialis? You can do all the exercises possible to activiate the muscle, but if it is not in the motor unit loop,so to speak, it won’t do much good. I suggest you look up VMO activation.
And there is some argument that the VMO is a psuedo myth. That the vastus medialis is not functioning well as a whole in some individuals. There are multidirectional fibers in the v.m., but as to selectively activating or if just the VMO is the issue is not clear as far as I know.
Either way, look into get the vastus medialis to contract overall.