Changes

The VMO is a subdivision of one of the four quadriceps muscles that is believed to impact the tracking of the kneecap and therefore a factor in knee pain[[Knee Pain]].

Part of the Vastus medialis that has the greatest angle to the kneecap is often considered as a separate [[Muscle|muscle]], the Vastus Medialis Obliquus or VMO. In reality the VMO is not a separate muscle, but a subdivision of the VM. There is some evidence that the VMO is activated by a separate nerve from the rest of the VM<ref name="KneeVMONerves"/>. A relative weakness in the VMO has been linked to kneecap alignment<ref name="KneeLinTomo"/> and therefore [[Knee Pain]]. It has also been observed that people with knee pain [[Knee Pain]] have a weaker VMO<ref name="KneeVMOAtrophy"/>.

There have been many approaches in trying to find the best resistance exercise to strengthen the VMO relative to the other quad muscles. These approaches include using knee only or multiple joints (angle/knee/hip), eccentric, concentric or isometric exercise, and position of the limbs<ref name="KneeVMORelative"/>. A review of the studies that looked at exercising the VMO was inconclusive<ref name="KneeVMOEx"/>. Therefore it is hard to recommend any exercise that will strengthen the VMO relative to the other quad muscles. Of course, exercises that strengthen the quad muscles will tend to strengthen the VMO as well, but may not restore any imbalance. More importantly, the main reason for strengthening the VMO is knee pain[[Knee Pain]], and most exercises to strengthen the quad put extra stress on the kneecap, aggravating the problem. Therefore, resistance training the quads is not recommended for those with knee pain[[Knee Pain]]<ref name="PPConcepts"/>.

[[Massage|Massaging]] the VMO and its [[Trigger Points]] may help to restore muscle function and strength<ref name="TPMassHou"/><ref name="TPMassHanten"/><ref name="TPMassCesar"/>. The VMO can easily be overlooked during routine massage[[Massage]], especially if a [[Foam Roller]] is used. The [[Foam Roller]] is a good way of massaging the other muscles in the quads, but it's hard to get to the VMO. [[The Stick]] is generally more effective for massaging the VMO, and the [[Thumper]] is great if you are having problems with specific [[Trigger Points]] in the VMO.