VMO Strengthening/Activation Exercises (Necessary/Possible to Isolate the Vastus Medialis Obliquus?)

[@E3Rehab]

Thank you so much for watching! Check out our newest video on what to do for patellofemoral pain! kzbin.info/www/bejne/gWSrqXVsp6aYetE

[@jimluvweng]

Do you have the link to this study?

[@pianofairy14]

Please, do a separate video on patellofemoral pain syndrome! My knee just doesn‘t get better... :(

[@AskBradFischer]

Well interesting topic and I’m trying to figure out a recent injury running to first base. I injured my lower quad area about 4 inches above the center of my kneecap. I’m not sure what muscle or tendon it is that made a light popping noise. Your thoughts would be appreciated? Thank you

[@vanillaglue]

valgus knee injuries, adductors, deep 6 muscles, rectus femoris please!

[@OscarDiaz-qg7jm]

I believe you addressed VMO strengthening very professionally. Most of exercises advised are difficult to perform initially. Is there a routine you can start with and gradually increase range or strength? Thank you in advance for your response Oscar Diaz from Chicago

[@mamawelder]

One problem with that advise is if you already have patella pain you physically cannot do any of those deep knee squats, weighted step ups or deep sissy squats. You have to start out at wherever your knees allow you to without pain. Which means less bend and shorter range.

[@TheCarpentersDaughterUK]

agree

[@jojomunz4790]

Try the Reverse Step ups with elevated heels.

[@jojomunz4790]

kzbin.infoBzvbBrS3zOQ?feature=share

[@mamawelder]

@@jojomunz4790 can you elaborate? I’m interested.

[@jojomunz4790]

@@mamawelder I do them myself, mind you Im not native speaker. Theres 3 versions of the reverse stepups. Basically its a unilateral stepping downward motion replicated specifically to target the VMO, meaning vastus medialis obliquus which is rarely well stimulated though crucial for healthy knees. The most applicable and pragmatic way is doing it on any stairways available. One leg rests on the stair, toes pointed straight forward (no tibial rotation meaning toes to left or right). The other leg is raised and flexed permanently, so that you train extention on the working leg as well as flexion on the passive leg. Contract your glutes and extend your working knee (the one that you unilaterally stand on) until the flexed passive leg‘s heel touches the next lower step of the stairway. Always keep your working knee over the 3th/4th toe meaning your toes/foot supinated. This is the first progression. 4 sets per 10-15 reps, rest 2 min in between. For the second progression you need some kind of wedge or shim which is shown in the linked video. ATG does sell very well factured ones. The oerformance is the same except that now your extending knee’s foot rests on the wedge/shim so that your dorsiflexion exhibits a different angle, so that your knee inevitably goes way over your toes in a very very comfortable manner. Youll notice an insane activation of the vastus medialis if 1. you keep your knee over your 3/4th toes 2. Keep your glutes engaged all the time and your upper body as upright as possible (if you hinge you lose the activation of VMO immediately and your rectus femoris and vastus lateralis get targeted) 3. do the extension at least 3 seconds, slowly and always with an engaged core and breathing (long exhale 4-6 seconds, short inhale 1-2 seconds) and flexion 1 second. A very useful location to orsctice this variation is a slope or hillslide so that you do not require this specific wedge or shim to apply under your foot. The 3rd version is the hardest one cuz it targets your profound muscles which stabilize you against rotation and other lateral forces. You combine both progressions so that you 1. stand unilaterally and raise other leg 2. raise the calf muscles of your standing leg whilst extending the knee with an upright torso and flexed glutes so that your heel is off the stair and your whole body weight rests on your forefoot 3. keep extending and balancing until your other flexed leg‘s heel touches the lower stair in front of you and immediately return to the basic stance. This is the Poliquin (?) reverse stepup. Terms might be messed up.

[@hamzavanderross1235]

You guys provide some of the most insightful and professionally produced content on the Web! Thank you so much

[@E3Rehab]

Thank you!

[@Bernardus_McJamesicus]

You just stopped me right in my tracks of researching how to preferentially isolate and activate my VMO to combat tendonitis on the medial, posterior side of my knee. Thank you for the good work and you just earned a sub

[@Stereotypee]

what exercises are you doing in your rehab for knee pain?

[@Syed-wj4pj]

nice. How are you doing now? Did you have knee cap popping??

[@frankfromupstateny3796]

Now....get some specific exercises by watching the "knee over Toe guy", on UTube. You're welcome!

[@RealPerson6969]

Did you end up figuring out what was wrong with you knee? I stopped running 2 months ago because of some pain in my medial, posterior section of knee. Well I believe I have figured it out. Pes Anserine Tendinopathy. It is where three hamstring muscles connect over the pes Anserine Bursa in the knee. I have just started Romanian DL, laying down hamstring curls (light) and Bulgarian split squat and so far I think it is helping. Still a dull pain after going for a walk but I’m hoping to get back running soon. I’d research Pes Anserine Tendons and see what comes up

[@waterprosurge]

​@@RealPerson6969are you back to running?

[@tudoramr8432]

Man, you saved my life. I love your channel. God bless you! For real.

[@lifelovesme]

Absolutely love when you bust long-standing myths and gives us more-correct information (until that’s busted as newer-still research emerges). Thank you !

[@calisthenicsindia8498]

The knees over toes guy does huge rage of motion in his exercises

[@slee2695]

As a long leg/short torso guy, i solved my knee pain by focusing more on quads like lunges, front squats, leg extensions, etc

[@Twistedbullsh1t]

What was your pain from?

[@slee2695]

@@Twistedbullsh1t basketball

[@Twistedbullsh1t]

@@slee2695 i should of been more specific. What was your injury?***

[@joshdennison5777]

@@Twistedbullsh1t i dont think he had an injury. It was just wear and tear on the knees from having long levers and not properly compensating for it.

[@airheather]

Progressive knee pain / limited ROM that seemed to be untreatable is now more functional (it’s better at 50 yrs than it was when I was 45!) with big muscle-group lifting. I appreciate your video confirming this!

[@sampejke]

Great. I got injured because of lifting. Feels like I could have been very healthy if I had never lifted

[@TroyBrownTV]

I have no injuries. I just like these physical science breakdowns

[@C0C023a]

You are simply amazing and so underrated! Love you videos and thank you so much for your research and and efforts! This is what I am looking for! Keep up the great work and stay AWESOME!

[@andreyzubkov8435]

Was looking to strengthen VMO to prevent cramps after very active snowboard sessions. Thanks for all the advice.

[@jackiealv6547]

Excellent information but I’ve been diagnosed with condromalacia patella and my knees hurt with squatting and lunging not to mention adding weight , all the things I did up until the pain was unbearable and the MRI confirmed the damage of the cartilage behind the patella. The VMO strengthening exercises that my PT has recommended are working and I’m in less pain and better mobility

[@RahulYadav-dd7qe]

Yupp, I also don't understand how can one do squats, lunges etc, when the doctor mentions to do otherwise. These PTs should be careful recommending exercises as in your case, it can lead to more degradation.

[@geekvargen9824]

What a great video. You are conveying the message in a very efficient way. With the references you are using and displaying it's obvious that you have done your research, super solid content mate. Thank you for taking the time to do this. It feels like you got my back. I have subscribed and will look through your other videos and look for tips on how to fix my lateral meniscus tear + anterolateral extra-articular ganglion cyst pain.

[@smirnovTri]

Great video. Ive been dealing with VMO problems for several years, and get the same opinion. Thank you

[@rehabilitace_bez_hranic]

Damn, such solid video! Lot of effort behind it. I'm glad I found your channel. Definetly gonna follow it for more EBM knowledge :) Thank You

[@Procrast-f9n]

Thank you for that concise and informative presentation! The best video on the subject I have seen backed by science.

[@davidschulman4598]

I do find when I do super deep squats, heel elevated etc. I get an amazing pump right in my VMO teardrop area, so from experience I'd personally say its probably doing a better job of targeting my VMO.

[@HPKazan]

Platz Squats are devastating for that purpose! Need to do more of those.

[@tkats9673]

Me as well, for me it does target my VMO alot more with my heel elevated as I feel it burning.

[@319jmp]

Your studies may show one thing but I can confirm that wide stance leg press and pushing the knees outward during the contraction does preferentially target mine and others vastus medialis. Likewise, a narrow stance, with foot and knee turned slightly inward, preferentially targets my vastus lateralis.

[@kaitango]

I work as an orthopedic PA. I noticed in most of the exercises your knees riding are over the toes, which is contrary to the form I've been taught. Now you have WAY more knowledge in rehab than I do for sure, so I'd just love your thoughts on that :) Thanks for your informative, evidence-based video!

[@Mikebenson141]

That myth was based on 1 study in the 70’s and was debunked about 20 years ago. Scary you don’t know that as a PA

[@E3Rehab]

Hi, Kai. Thank you so much for approaching the topic in such a professional and respectful manner. It is okay for the knees to the pass the toes while squatting. If I'm really trying to emphasize loading the quads and/or patellofemoral joint complex, I'll actually encourage someone to drive their knees forward more. If someone has a symptomatic knee, temporarily reducing the amount of knee flexion is one strategy that may be helpful. Summary - yes, it's fine/normal. Depending on your goals, you may want more or less.

[@averyladwig6257]

@@Mikebenson141 what myth?

[@iwantlee9510]

That's a dumb myth.

[@johnwig285]

@@Mikebenson141 what's even scarier that ure tryna sound smart without even linking ur source. Dude's a PA, not a Doctor or Physical Therapist ffs

[@briandebaets3041]

EXCELLENT video! Thank you for putting work in and making this thorough.

[@sammelina12]

But my fear is that when I do squats/lunges/steps, my knee makes a grinding/clicking noise. There’s no pain most of the time (sometimes on the inner knee), but I don’t want to make it worse. 😢

[@tsepomarobani9085]

yh bro I can relate, its like you seem to know its getting better so you ignore the fact of doing squats etc... really bc of the fear it might start playing up again in the long run. I had a MRI scan they said there nothing wrong with my knee

[@user-fu5ib8no3b]

@@tsepomarobani9085 my MRI was fine too but my knee still buckles and I feel my VMO is weak. How is your knee now?

[@laurarhodes7193]

@@user-fu5ib8no3b My doctor said my MRI results looked fine but I insisted on taking the images to a surgeon and found out there was an injury. If you haven't done so yet, I suggest taking it to a good orthopaedic surgeon. All the best.

[@user-fu5ib8no3b]

@@laurarhodes7193 aw okay. My physio just said I can either see how time heals it or be referred for surgery because apparently the positioning of my knees is slightly out but I’m not really fussed on having surgery. I get a sharp pain in my medial/inner knee that comes after walking for a while but I kind of have given up now and I’m going to continue doing some strengthening exercises and hope for the best and that this pain will go away with time although it has been a year

[@darkxkai5754]

@@user-fu5ib8no3b knees over toes guy on youtube might be able to help, he has a pretty good program too

[@toniportenier4374]

OMG!Thank you so much I have been waiting for a video on this. Could send me the video on reverse NordicTrack, and quad strength building. Happy new years to you .

[@tomkramer6587]

Fantastic video. I really appreciate your evidence-based approach!

[@HJOTech]

Interesting that you cannot isolate the VMO, yet I noticed that I can flex my right quad and can feel my VMO defined yet on my left quad I don't seem to get the same "activation" or definition. And of course my left knee is where I have the most pain due to patella not tracking properly. I wonder how that's possible.

[@datastories143]

I have to say that this video is irrelevant for Patello Femoral Syndrome as those exercise are just not possible with the pain caused by PFS. I have a stage 4 PFS and the only thing that helped me have a normal life again was to work on the atrophy of the VMO by isolating it and using electro stimulation with Compex, also work on the glutes, metatarsal muscles and the roller as shown in this video. This video should not mention the FPS or pain as it's definitely won't help you fix it.

[@pedromiranda2356]

Thank you so much for the scientific research evidence on this topic. I had an ACL surgery one year ago (pattelar tendon graft) and i am being unable to build my VMO - Phisioteraphy and gym are not showing expressive results on it. As a skateboarder since a child i always had my left leg weaker than the right leg, even before ACL accident, so i think this might be even another reason for struggling to build VMO again, but i won't give up - thank you again for hte motivation !!

[@user-fu5ib8no3b]

How is your knee? Have you strengthened your VMO ?

[@christofferbrandel6491]

I really like how this channel present information. I'm going to start doing reverse nordic after seeing your other video!👍

[@Bakamiloto]

very informative. thank you! keep uploading you deserve a subscriber

[@jawzzy3]

Great video... Got a wicked case of PFPS from cycling and was given a release VL/strengthen VMO protocol from my physio to no avail. One day I said screw it and went back to the gym and did full barbell squats, deadlifts, and the like legs day. Knee mechanics felt immediately better afterwards! Releasing and stretching the rectus femoris (couch stretch) and knee swings to circulate the fluid were a huge help also.

[@joshhazel742]

This is happening to me.. I have lateral patella tracking and my pt wants me to strengthen vmo and release tension from lateral muscles.. should I just start doing normal compound movements with good form?

[@jawzzy3]

@@joshhazel742I didn’t have any success with the “strengthen vmo, release VL” protocol. What helped me overcome this is 1. Avoiding triggers (mostly sitting for too long) 2. Knee swings sitting on edge of kitchen counter multiple times per day (100s per day) 3. Releasing the rectus femoris via barbell quad smash (roll it up and down) (foam rolling was too intense for me) and regular couch stretches for 2+ minutes 4. Looking for strength and flexibility imbalances up and down the chain (found I had a really tight outer hip on the problem knee side) Good luck 👍

[@jawzzy3]

@@joshhazel742 also, walking more (10k+ steps per day), consistent hydration, good nutrition, etc seemed to help

[@anaszamel7912]

thanks a lot, your info is really great and your timestamp videos and overall comprehensive

[@HolidayFortnight]

TKE squats are also often prescribed to “bulletproof” the knees. I was curious if you had any opinions on that and whether training terminal knee extension in general is really as important as current theory suggests.

[@E3Rehab]

I'd be wary of anyone who claims that an exercise can "bulletproof" a joint (whatever that means). If you're recovering from an injury, training terminal knee extension might be helpful. Training terminal knee extension in isolation (like with a banded TKE) probably isn't all that important for most people.

[@slowlydrifting2091]

How in the heck I’m I going to focus on dynamic lifts if I can’t do step ups or Patrick steps pain free. I have been doing VMO training from light rotation leg Lifts and the aforementioned Pilates ball exercises.

[@frankfromupstateny3796]

Men/women and kids....start "walking backwards to strengthen the front or anterior chamber of the leg....the "shin" area....as related to walking and running over time.

[@jsweetness5]

So when you are below 90 degrees at the knee what muscle of the quad activates first! Say a catcher in baseball

[@pranavgautam96]

Then, how do I fix my Chondromalacia? It's been going on for 2 years now! Those exercises shown at the end are too heavy for me at the start.

[@johnd.obrien6838]

Same here, would like to know what exercises we're supposed to do when we have damage to the cartilage under the patella.

[@dayday1016]

Bro try walking backwards up a hill #kneeovertoesguy

[@amritpalsidhu6454]

@@johnd.obrien6838 i had a surgery for chondromalacia . And after 5 month i still can not walk fast . But know i cannot even raise leg while sitting on chair . Knee hurt . Started doing cycling 2 days ago hope i get better and taking collagen medicine or supplement and vitamin c

[@joshhazel742]

Well.. what did y’all ever figure out?

[@RyanC232]

I just didn't "feel" like what my PT was saying was true. Trying to do air squats with a ball between my legs or foot rotated out straight leg lifts. It didn't seem right for sports conditioning. Glad I could get educated today.

[@mutlaqalsubaie7409]

I hope you do a video about " patella alta rehab"

[@islandisland9306]

Here's a smoother version of your sentence: "I'm not a native speaker, so please feel free to correct me if I'm wrong. Did I understand the message of this video correctly? It seems to suggest that the theory of focusing on strengthening the VMO and relaxing the IT band for relieving PFPS is scientifically unsupported, and instead, we should be strengthening all the quadriceps muscles evenly?"

[@Akashap22]

Please make a video of recovering thigh atrophy after acl reconstruction

[@tuffhellfire]

Have you found any good ones?

[@dollySouthEastHuman]

SUPER THANKS FROM PHILIPPINES 💕✌️🥰🇵🇭 for this video is this applicable for a stroke patient?

[@BlackSIH22]

Trying to recover from a quad tendon re- rupture in my left leg. I did both at the same time 20 years ago, but had a small mountain bike accident a year ago ( tried to do. Wheelie ) and ended up rupturing the left one again. This time in having some patellar tracking issues. When doing lockouts with a band behind my knee, my patella " clunks " back over into its groove. It only happens if I lockout my knee and then start to bend. I do have alot of atrophy and I need to get this under control. Im about 10-15 degrees off from being able to fully extend my leg to 180 degrees. I could use all the help I can get, thanks.

[@cortezsb7727]

Have you ever heard of the Knees over toes guy? He claims his programs can bulletproof your knees and has a lot of great testimonies (including his own). One exercise in his program is body weight VMO squats. If you've heard of this program *(called ATG) I'd like to hear your thoughts

[@vortexsophia]

this was great, thank you

[@NEXTLEVELHEALTHwithTim]

So what should we do if we have quad shutdown after injury/surgery? Quad exercises that don’t re-injure the knee?

[@filukkasunivers2389]

ok sir, but when you have a bad knee you can NOT do the exercises you suggest

[@witch_hour7042]

Baby steps man

[@Tahiha]

Ironically leg extensions -- which they tell you not to do if you have bad knees-- have literally cured my bad knees. I couldn't climb stairs or bend without sharp pain. Much less squat. After 4 years of weight training I am now lifting 100lb on leg extensions, running stairs with weights, doing bulgarian split squats, and squatting parallel and below. With zero pain.

[@mannysingh768]

@@Tahiha ma'am can you please tell me the exercises you did for knee

[@pokemonbacon1237]

@@mannysingh768 nah I won’t

[@lati_da]

If you have knee issues you can watch the knees over toes guy for all of his exercises

[@dstod4481]

Can you do a video about knee and elbow Hyperextension and how to fix it/if it’s even a bad thing when lifting?

[@code5829]

never lockout your joints. keep constant tension on the muscle

[@looktotheworldwithhope5464]

I use NMES on VMO with ankle weight and last 15 degrees of leg extension to train VMO and keep it firing and strong. Works very well.

[@hcp0scratch]

How do you know?

[@looktotheworldwithhope5464]

@@hcp0scratch Personal experience

[@hcp0scratch]

That's what I thought. No value to a one person, non-scientific study.

[@looktotheworldwithhope5464]

@@hcp0scratch You're welcome!

[@rhiannonmorgan-williams8575]

I’ve had right knee pain for over five years and finally had scans. Sports doctor says I have minor quad enthesopathy. I have pain everytime I squat to parallel, do lunges, knee tracks over the toes and step up. He says I have patella femoral problems. Issue is all the exercises that build vmo give me pain. Doing the passive exercises in this video doesn’t make the pain better or worse! I hate this just want to be pain free and be able to squat again! Any recommendations for exercises for patella knee pain?

[@tsepomarobani9085]

Pray for healing

[@roy6419]

Check kneesovertoes guy, find where you are comfortable in training. For me I get least pain in deep squats which is odd but works for me and I build my muscles that way

[@jonatanvenema6884]

Always good to see someone actually substantiate with research! Great advice

[@KunjanChauhan]

I have been to two docs. One advise isolating the vmo and recommended exactly the same exercises you debunk. The other recommended stretching the outer thigh muscles as he felt they were too tight in relation to the vmo hence the propensity for the patella to mistrack. I have noticed that whenever the patella mistracks often a minute or so of stretching the thigh muscles restores normal functioning until the next time. I wonder now if there are three avenues to be explored for rehab...muscle strengthening, muscle stretching and proper neural firing. Wld love to hear your thoughts. Ty.

[@mc_416]

You should have received the same info from each doc. The outer muscles being tight, those bands, does contribute to the tracking issues & interestingly, to much of the "knee" pain from runners knee. I find when my physio works on the bands, my knees loosen greatly. the foam roller is a good way to achieve that, shown in the video. However, as someone with a significant imbalance in those vmo muscles being so weak, plus knee pain, I can't even approach most of the exercises above. I think that the exercises he suggests as not useful, are very useful, if you have low to no conditioning or a big imbalance or bad pain. Then I would graduate to the others, cautiously and move up very slowly. I have almost no cartilege left under my knee and so it's a whole different ballgame. I think that advice should be qualified a bit, because we are not all starting with the same intact body parts, lol! Per the comment above, about biking, it's funny. I can bike with the seat up very high. But absolutely cannot if the seat is low. You need to get as much leg extension as possible. That takes a lot of pressure off the knee and works other important muscles. I will never run again, for sure. I hadn't in decades and soon as i tried, very cautiously, knee blew up like a balloon and the next 6 weeks were spent recovering and trying to get down stairs normally again.

[@PPGC1998]

They both are right, since most leg problems come from unproper alignment and/or muscle balance issues. First, if u feel u have to be stretching frequently, get ur daily posture in check, as well as ur lifting/exercising technique: thats not supposed to happen - stretching/massaging may help temporally until u solve the underlying causes (most commonly limb dinamic misalignment, mobility issues, muscle imbalance or a combination of them 3). One problem can reinforce the others, so you may have several aspects to check, but trust me its worth. I elaborate on next comment ⬇️

[@PPGC1998]

That might just be ur patella tracking through places it shouldnt be, placing excesive stress to femoral cartilage. No damage or signicant damage are usually show after sessions (just that popping and slight swell), but the cushioning may slowly wear out - and when thay process is advanced enough there comes pain. Ive also suffered myself from patellar maltracking (turned into severe chondromalacia patella overtime) and its hard usually hard to solve because of the many reasons that could be causing it. First, technique wise: make sure you are tracking ur knees properly over toes. Sounds obvious, but even the slightest deviation (to either varus or valgus) can become a problem when under repeated loading. No matter how wide ur stance is, aim to get knee over between 2nd to 3rd toe, pushing through lateral sole while keeping 1st toe on the floor. Film urself from the front of the foot to better see, since the upper perspective usually makes us think the path isnt where it really is (ur head is lateral to ur knees). If thats hard at ur usual depth, it may be because of some mobility decifiency: check ankle dorsiflexion, tibial rotations and hip rotations (total amount and simetrically-wise). If it didnt solve through limb alignment correction and find some weakness/ assumetry, work on what is deficient. If nothing works and specially if the click/pain is lateral, it may just be VMO weakness (tho ive found its not as common as the aforementioned reasons - yet most times mentioned as such cause its the "easy solution"). Best exercises to try to isolate it are terminal knee extensions, letting ur tibia to externally rotate in last 10° (open chain) or ur femur to internally rotate in last 30° (closed chain). Remember knee isnt a pure hinge joint and needs rotation to happen in order for the proper mechanics to take place on last extension degrees. If it keeps clicking on VMO exercises considering ur tracking upper and lower leg properly, its rather too weak or u cant activate it properly. Try regressing to an easier exercise (you can do that as pre-activation before harder ones or as main exercise). If that doesnt work neither, then electrical stimulation can be ur way until you can make the VMO strong/controllable enough to pull that patella medially. Care with overdoing the "weak side" correction, since pain and clicking can come if u go too far to the other side. Hope it helps to keep those knees healthy and let me know if ud like further explanation. Take care!

[@triwrightfitness6894]

This is all great except all of the strength building exercises you suggested hurt my knee ….. so where do I start? I’ve tried working through the pain and that only made things worse

[@thedevil1667]

Knee dislocation... Hurts like hell and after that you can't move for 2 months and then you lose muscle mass which makes it more likely to happen again... That was my life this past year...

[@vivianeraw8448]

How r u now? Did u heal?

[@KatsKettlebellDojo]

Thank you, this was a very helpful video!

[@charuduttsapra]

Thanks for this video. I have constant pain and stiffness in my vmo . I do streching every time when I do the vmo strengthening exercises (intermediate) . Should I do icing for hot water bottle massage for the pain ?

[@simonsilva250]

great video as always

[@edwardomeza4022]

I tore my patella tendon over 2 years ago and the VMO’s atrophy has been a constant battle. Thanks for this video to stop me from just trying to isolate the VMO. Question I have no is, post surgery my patella is now higher. What can I do to get it to its original position. The pain from the pinch where the repair is tells my brain to deactivate my quad.

[@DebasisPoddar-qu9kp]

I have mild Osteoarthritis on my right knee . I was advised all those exercises what u call low level . Can I do running again if I perform the exercises recommend by u in this video ? Thanks in advance.

[@francesstager997]

I was very optimistic about your approach when I first discovered your channel! Citing papers and data is really helpful. However, I am NOT able to perform any of the exercises that you have demonstrated because of my knee issue! Where does that leave me??

[@blackjackool]

My ortho diagnosed me with patellar tracking disorder and recommended physio therapy. I have a crunching sound when bending my knee completely but no pain. I had an ACL surgery last year and found this crunching sound when I returned to the gym after 8 months. What should I do? I want to be able to lift weights in the gym again.

[@brunogamboa6591]

Love this video, huge help!

[@Bumblebee5229-s1s]

Hello thankyou for this video, please how do i fix my muscle's when im bone on bone

[@DavidJones-qx5yf]

My patella femoral syndrome won't heal with vmo exercises. I know the problem lies in my hips because sometimes when I'm in bed lying on my side with my legs bent at about 90 degrees then I turn to lie on my opposite side, moving my top leg first, I feel my femur turn, at the same time my patella clicks over my femur head with a loud crack, also feeling at least one of my quads shift in a major way and instantly I have complete relief of my pfs . The problem is I can't keep it like this for more than a few days and I don't know what it is exactly that causes it to correct itself.

[@dollySouthEastHuman]

super thanks from Philippines 🥰✌️💕🇵🇭 is this applicable for a stroke patient? i can put a strength in my knee but when im trying to make a normal straight leg its popping/buckling

[@wakeupandroar3488]

I was diagnosed with patella alta and also had a meniscus surgery . In a few months my vmo atrophied completely. Everytime i try to do the usuallly recommended exercices for vmo, the nerves and tendons in my hip area often get damaged. Not to mention the knee itself in the case of squats.. so i guess i am a bit in a vicious cycle...

[@spirosnikolouzos6722]

i have also the same problem is 1,5 yaers(osgood surgery) and my leg and vmo hasn't muscle tone.i am better if i had good warm up to doing squat lounges some therapists say is inner with pelvic muscles,

[@wakeupandroar3488]

@@spirosnikolouzos6722 I started following the advice of the knee over toes guy on KZbin and also walk a lot and do cycling. I decided to approach the leg strength as a whole.. and I feel it's working.

[@strikerz2668]

Does imbalance or weakness in any one of those 3 quad muscles cause pain while extendening kne

[@krisfairhurst7585]

I have had micro fracture surgery in 3 parts of my right knee. Since having it I lost nearly all muscle in my quad as I couldn’t weight bear for 8 weeks. I still have a lot of knee pain but can manage to squat but leg extensions are a no go. even years later I cannot get the tear drop to grow at all, do you have any suggestions Thanks

[@vivianeraw8448]

Hey i dislocated my pattela I know how hard leg extension is I started by stretching and leg extension without weight just for improving circulation and range of motion overtime i felt it beccomes painless and easy i added ankle weight When i went back to thé gym i have to warm up really well do leg extension on a chair before jumping on the leg extension machine do few reps and rest i started with lowest weight now put it on the second disc its an acheivement for me😁 On the other hand the leg curl machine was easy no stress on the knee or knee cap

[@vivianeraw8448]

You Can work your quads without bending your knees Leg raises u put the disc of weight on you thigh on front Other variation thé VMO leg raises with hip externel rotation, and for the side of thé quads you lay on your side do put the weight on your side outer quads and lift your legs

[@scottmrodriguez]

Great info! I’m a runner and have developed knee cap issues. Would you recommend the same approach? (Bigger range of motion movements)

[@babyriri01]

Will these exercises help get rid of the clicking with patellofemoral pain syndrome?

[@punji1977]

Any thoughts on how to accelerate building VMO mass after a TPF injury and VMO atrophy ?

[@mobilidade4269]

excellent teachings. could have better lighting in the video.

[@135Jaeger531]

Any studies found on contractive NMS to assist in re-educating/strengthening a VMO?

[@Nixs778]

Thank you for your video! Really helpful

[@DavidDeeble]

Great content as always, guys.

[@E3Rehab]

Thanks, David!

[@DavidDeeble]

@@E3Rehab KZbin says you need comments I'll give you comments!

[@lymedog3176]

Knee over toe exercises will affect the VMO to a greater extent..ie people who regularly and are strong in the hack squat ,sissy squat, knee forward lunge and people who ass to grass squat… the norm is a well developed VMO on each leg.

[@jamesclark6722]

Hi, I do somewhat disagree... from my experience the VMO definitely does counteract the pull of the larger VasLat Also, like other areas of the body, the VMOs job is the same as the MFPL (anti lateral dislocation) VMO works best when the knee is bent most (obviously alot of people can fully bend knee for many reason) Any bike with a low seat and high resistance is a good starting place for VMO strength and progression 👍

[@fabriziopiva6]

How can we then train the quads in a single leg way without eliciting pain? Because those exercises that you propose at the end of your video are amazing, but if you have an imbalance in one leg, then the good leg is going to take over most of the load, making the exercise useless. Can you then mention some exercises that are single leg to strengthen the quads?

[@-edvins.388]

Hi mate, I absolutely love doing single-legged wall sits! It requires minimal equipment, hits the quads really well and is kind on the tendons in the knee! You can also easily load by adding a weight plate to your chest or increasing the time you sit depending on your goals.

[@fabriziopiva6]

@@-edvins.388 Thanks for the comment! Yes indeed that is a good exercise, I am planning to start doing it in partial ranges because until 90 degrees it seems to be a bit aggressive for my knee

[@-edvins.388]

@@fabriziopiva6 Ok. Sounds great. Please get back to me after a while and tell me how it is going!

[@SecretAgentLamarScrotus]

When he said ball squeeze between the knees at 3:15 I felt that 😔

[@nikitaw1982]

Great presentation thank you.

[@DRKIMJIHOON]

AWESOME CHANNEL!

[@andrew.schaeffer4032]

Wow you researched the crap out of that. well done. Quick question - knees over toes program - what are your thoughts?

[@maksenDK]

I have had pain in my VMO for a year now. I don't know how the pain started, it was gradual. I went to a physiotherapist and he told me some exercises, but none of them have worked. I think I will look into these exercises. So tired of having pain.

[@surgegv6033]

Has it worked?

[@timocuyvers1501]

Hi, we have 4 muscles but do we also have 4 different quad tendons attached to the knee ? If so, what is known about them ?

[@bradleyv2823]

I broke my femur and during the rehab process i felt a pop on my innner thigh right above the knee, i could still walk but for a few months it was just hard to squat all the way down... Now, when i extend my leg, the muscles pops or snaps into position. Why is this happening?

[@ceironedwards7646]

Can a weak VMO/ quads in general put more pressure onto the patellar? I’ve got one leg significantly weaker than the other and a tight feeling in the patellar on the weaker 🤞🏻

[@erngetsgood]

How do you do these exercises if you have knee pain?

[@quetzgo]

The doctor who was doing a surgery on my right leg., dislocated my other patella and now I have a lot of pain and can’t rotate mri doesn’t show much can you tell me what this can be? Thanks so much

[@johnnichols2710]

Change up foot placement even on leg extensions

[@JuanFlores-zv9nw]

Nice video doctor thanks🎇🗽

[@takeshii]

But what about pain directly on the vmo during squat eccentric after acl surgery?

[@fred1234fred]

Do you have any advice for my problem: The activation of the VMO on my right leg is significantly and very noticeably much stronger than that on my left. The VMO activation on my left knee is incredibly weak, and the muscle seems smaller. Whenever I try and do exercises which are highly dependent on the VMO I get clicking/crunching on the knee joint. It’s like a couple of little crunchy-like clicks. My guess is there is some sort of misalignment going on which is preventing the neurons from delivering the signals to fire the muscle correctly, but I’m not expert. Any advice would be gratefully received. Thank you. p.s Also my ankle dorsiflexion is less on my left side which seems like this could be the issue, BUT the clicking/crunching and limited activation happens for any range of motion, way before I get to the extremes which are close to maximum ankle dorseflexion, so in my mind that doesn’t explain it. I think that’s a separate issue. Also, I think I made another discovery just now, so I was doing an exercise that is supposed to strengthen the VMO which is a leg extension with a foam roller under your knee. And I was comparing both legs and I’m pretty sure I noticed that it was all the muscles in my left quads which were weak and were harder to squeeze/activate than the quads in my right leg. Any ideas how to fix this and what this could be?

[@davidbarnhard1614]

I'm basically having the same problem. It sounds like you have lateral compression syndrome where your vmo isn't firing correctly so it cause your vl to over power the vmo and then your patella tracks laterally and grinds on that femoral head. I've only found papers from before 1999 that advocate vmo reeducation and taping. The papers seemed to have good results and were able to show that their exercises decreased the lateral tilt of the patella. But it seems after the year 2000 or so the vmo heavy retraining and specific protocol was abandoned in favor of a lateral release and I'm not sure why.

[@michaelrch]

I have had patellofemoral syndrome for over a year after a slight tear of the quadriceps tendon. I was doing PT for ages but it wouldn't go away. I recently noticed that my VMO is very reluctant to fire on the affected leg vs the good one. I have been consciously concentrating on making it fire, when resting as well as when; active, and that is slowly working. It seems to be waking up. Is it plausible that a very inactive VMO (rather than a weak one) could cause the problem. Or do you think it's irrelevant?

[@kiwicoproductions2828]

Hi E3. A few weeks ago I ran down a hill and immediately noticed some VMO pain in my right leg. Later that week I also noticed some knee pain when bending at the knee. I also have Ischial “sit bone” pain, so, unfortunately, I tend to avoid squats and movements that compress the ischial tuberosity at the moment until my rehab with that progresses. Anyway, until I get to the point where I can squat low without pain again, can my VMO rehab suffice with exercises like Sissy Squats and the Reverse Nordics?! Thanks for the great information.

[@malakadam4540]

Thanks Dr 😊. Actually I need it for kneecap problem . and my muscles are weak. So how many times should i repeat each exercise ? Thanks.

[@zutejudd7603]

so for someone with a pelvic imbalance and miserable malalignment, should i just focus on large motor function exercises?

[@angelapolly1]

Does taping really not work? My patella has slipped over to the outside of my leg 3 times in my life - (once turning a weird way, second when a little dog ran into it and third when a lower cabinet handle caught it when I was turning). My knee started clicking/popping with every single squat and going downstairs - clicks on flexion and extension. I want to stop it before there’s real damage. Doesn’t taping help stop the clicking for many?

[@khairukiakram5865]

My patela keeps getting dislocated outwards due to week vmo i got therapy but when i missed at most a week , it happened again , i recovered quick but functionality reduced , i just want to know how to get better to a point of sports participation because currently sprinting is enough to cause a dislocation

[@jean_pascalgrenier3125]

Great content! Thank you!

[@bbnp1978]

I like your videos shall I both legs? In 2018 Due to my acl ligament injury my right leg vmo is weak please advice me

[@Ali-7676]

What if you got Patellofemoral pain due to doing deep squats and leg presses?