Hi all,
Could anyone offer any advice or tips for VMO activation techniques please?
I've been told I have weak VMO and glutes and am working with some gluteal exercises but the VMO ones seem to aggrivate my patellar tendonosis.
Does anyone have any tips for VMO strengthening that dont aggrevate the patellar tendon too much?
Will Meredith - Pennine
Hi,
I had some trouble with this a while ago. If I remember rightly, from a seated turn your foot outwards and lift up, pressing your foot against something (eg, underside of another chair) if you put your fingers on your vmo you should feel it working.
Hope this helps.
Yes thanks - how did it work out for you? I was thinking of doing something similar perhaps using some kind of weight.Originally Posted by Mj83
Will Meredith - Pennine
You don't really need to use weights or any resistance techniques. Try just dangling your leg off the edge of the couch with it totally straight, fully relaxed, and your heel on the floor so the weight of the leg is taking your knee joint to its limit of travel. Then just tense and untense your quads with a focus on getting 100% tension in the muscles instantaneously and feel the VMO to make sure it's firing up. I do this 200 times a day and i can do all 200 in around 2mins now i've got the recruitment nailed as good as i have. When you say Patella Tendonitis is it the Patella Tendon and not the Quadriceps Tendon? If it's the top quads tendon be careful as you might have a maltracking related problem such as Patellofemoral Syndrome- it can feel like Tendonitis.
Luke Appleyard (Wharfedale)- quick on the dissent
Thanks for the tip. I'll give it a go. Did it help your knee pain?
Yes does seem to be the patellar tendon as is below kneecap. Rehab was going OK till I overdid it recently and now seems sore again. Have been doing squats on a slant board which seems to help the tendonosis. Then overdid it and think I need to strengthen the vmos on each side along with glute strengthening.
I dont think mine was a VMO strength issue. I overdid it in a race which pulled it. For the next few months the kneecap didnt seem to track right, felt like I had a bit of grit under the knee on the inside of the leg, pretty much as soon as I started running. This would then swell up for a few days after.
Those exercises and getting the knuckles in there to knead out the kinks seemed to do the trick. Like Mr B said, its more about getting it to fire on time than strengthening it.
I should add, this was over a year ago. I havent bothered doing the exercises since I've been back running and I've had no further problems - so fortunately for me it was just repairing damage done.
It helped my knee pain by about 50%, but the maltracking and general knee physiology is so awful that i considered it to be a massive leap forward. I now have something called Chondromalacia Patella which is damage to the cartilage on the back of the kneecap and the gritty sensation that Mj83 is referring to. This is what you could end up with if you carry on trying to push your recovery. Mine was eventually triggered by Tendonitis of the quads tendon, due to the tendon actually sheathing the Patella and not stopping and starting either side of it. Most people get over it in a few months, but because i have the legacy of years of maltracking i've now had it for 2yrs and i'm still only about 60% of the way to getting rid of it. I'm nearly 36 and i don't expect to be running at full fitness again until i'm in my 40s...if at all. This is only anecdotal, but take it as a reminder of just how bad things can hit you if you try and 'run through' a knee injury that had a pathological cause. Think very carefully about just how much your running life means to you, and then decide if you really want to push it or be sensible.
As for your glutes; glute exercises are a standard exercise for anyone with knee problems because getting your glutes to do more work relieves load on the quads. Once again i'd focus on recruitment, and let the muscles build up naturally once the recruitment is better. Most people will respond to basic recruitment exercises, for example- lie on the floor tummy down and clench each arse cheek one at a time, focus on isolating the glutes completely keeping your legs relaxed. Once you have achieved a good degree of control over each cheek individually (takes weeks, not days) you can start to lift a leg flexing at the hip, make sure the glute is doing the lifting not the hamstring. You'll know if the glute is doing the lifting or not because your weeks of recruitment tensing will have given you such precise control it will be as easy to detect as a calf raise is in the calf muscle, and you should get DOMS from a good few sets the next day. I can actually now bias between individual glute sides when i'm getting back up after dropping a bolt on the floor; building rehab into your everyday life in this way is one way of keeping it going.
Luke Appleyard (Wharfedale)- quick on the dissent
I've been battling this one for a little while. Had ACL surgery last September following a year of running without one. It's meant my VMO is taking a long time to come back along with hamstring strength and checking in with the physic yesterday, it seems I default to using my calf as a temporary fix to do the job when my hamstring/vmo combo switch off.
In terms of getting it activated I've found the best for me is to sit with both feet out in front and lift my heels off the floor straight legged from the knee by firing the VMO. I'm hyper mobile so this is a good test. Strength wise I have what the physic described as an incredible capacity for cheating on form and using the wrong muscles to get the job done so we're just doing strict isolations at the moment.
Think very carefully about just how much your running life means to you, and then decide if you really want to push it or be sensible.
As for your glutes; glute exercises are a standard exercise for anyone with knee problems because getting your glutes to do more work relieves load on the quads.
Yes that's good advice thanks. Sorry to hear about the ongoing problems - I've found the old article that Denise Park did for the Fellrunner on 'Fellrunners Knees' (2006?) was very helpful.
I'll give the glute activation a go. Is tricky not to tense hamstrings at first.
Definitely have to try to be sensible with the tendonosis I think. It was going well till I did 4 shortish races in 10 days (stupidly) and all flared up again. Weight gain has become a problem for me since I've past 40. Used to do a few long days out and the weight would drop off - now it has to be down to will power - more difficult to do when the running isn't going well as I overcompensate with eating/drinking.
For my rehab I've found that a few 'golden rules' have really helped, such as;
*Dont run on consecutive days (cycle if you have to do something)
*No fishwicking (no more than 1 race in a week)
*Religiously stick to the exercises
*Daily stretching (I have been doing 'static' stretching although should warm up really)
*Avoid roads at all costs
*Stupidly I did the old mistake of trying to increase speed and distance at the same time - used to be fine to overwork things but I'll be adding this one to my list of rules for the future...
Patellar Tendonosis rehab seems to be a bit like Plantar Fascitis rehab - cannot be rushed. Needs to calm down and slowly be reworked.
Last edited by Sasquatch; 09-07-2015 at 09:29 AM.
Will Meredith - Pennine
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