The following are
the most effective exercises, and their progressions, used to strengthen a
relatively weak vastus medialis oblique (VMO), which can be revealed with
diagnostic tests like the overhead squat, and the Klatt test. A weak VMO,
relative to other muscles located around the knee joint can be problematic, as
it is the primary muscle responsible for tracking the knee. The list is not
exhaustive by any means, and corrective measures are not limited to the
exercises, and their variations listed.
- Step-ups
- Split squats
- Lunges
- Squats
Step-ups:
There are 4 basic
ways to perform step-ups to help strengthen the VMO:
1. Heel elevated
step-up
2. Peterson step-up
(This is said to be the most effective exercise to strengthen the VMO)
3. Standard step-up
4. Side step-up
NOTE: For the heel
elevated step-up, and Peterson step-up, the height of the step can be as low as
one inch, but no higher than mid calf.
The progressions,
from easiest to hardest, of the step-up variations are:
1. Hold dumbells in
hands
2. Place barbell on
back
3. Place barbell on
front
4. Raise the height
of the step (this will increase the difficulty of the movement more than simply
adding or increasing the weight)
To clarify, the first
variation, to which others should build upon, of a step up would be a low step,
heel elevated step-up with dumbells. The most difficult variation would be a
high step, side step-up with a barbell on front.
Key points in
regards to step-ups are:
- The leg on
the step should do all the work
- The bottom
leg should remain straight to prevent you from relying on it to help perform
the step up
- The foot of
the bottom leg should be dorsi flexed (toe pointing up towards the knee)
throughout the set
- The foot of
the leg on the step should be turned slightly outwards (about 5 degrees)
Split Squats:
There are 4 basic
ways to perform split squats to help strengthen the VMO:
1. Low pulley
2. Dumbells
3. Barbell on back
4. Barbell on front
The progressions,
from easiest to hardest, of the split squat variations are:
1. Front foot
elevated
2. Both feet at same
level
3. Rear foot
elevated (also known as the “Bulgarian” split squat)
To clarify, the first
variation, to which others should build upon, of a split squat would be a front
foot elevated, low pulley split squat. The most difficult variation of the
split squats would be a Bulgarian, barbell on front split squat.
Some key point in
regards to split squats are:
- The front leg
should do most of the work, the back foot is only there for stability
- The front
foot should be turned slightly outwards (about 5 degrees)
- The back foot
should be facing forward
- Stance should
be hip width (feet should be on “tracks”, not a “tight rope”)
- The body
should resemble an “escalator” during the movement, not an “elevator. That
means the body should travel both horizontally and vertically, not just “up and
down”
- The hamstring
should touch the calf at the bottom position
- The body
should remain upright throughout the entire movement
- The back knee
should be behind the hip at the bottom of the movement. If it is aligned or in
front of the hip then your stance is to close and your back foot should be
further back.
Lunges:
There are 3 basic
ways to perform lunges to help strengthen the VMO:
1. Lunge
2. Walking lunge
3. Drop lunge
(standing on a step and lunging forward off the step)
The progressions,
from easiest to hardest, of the lunge variations are:
1. Hold dumbells in
hands
2. Place barbell on
back
3. Place barbell on
front
To clarify, the first
variation, to which others should build upon, of a lunge would be a standard
lunge done with dumbells. The most difficult variation of a lunge to strengthen
the VMO would be a drop lunge with a barbell on front.
Here are some key
points you should know about in regards to lunges:
- The front leg
should do most of the work, the back foot is only there for stability
- The front
foot should be turned slightly outwards (about 5 degrees)
- The back foot
should be facing forward
- Stance should
be hip width (feet should be on “tracks”, not a “tight rope”)
- The hamstring
should touch the calf at the bottom position
- The body
should remain upright throughout the entire movement
- The lunge is
basically an explosive and dynamic variation of a split squat
Squats:
There are 4 basic
ways to perform squats to help strengthen the VMO:
1. Back squat
2. Front squat
3. Myotatic squat (1
¼ reps – full squat with additional quarter rep done at the bottom of the
squat)
4. Double barrel
squat (full squat with quarter rep done at the bottom AND top of the movement)
Some key points in
regards to squats are:
- The knee is
most stable at full flexion and full extension
- At the very
bottom of the squat, if you go all the way down, the glutes and hamstrings
absorb the weight, as opposed to the knee if you only squat to 90 degrees
- The major
ligaments of the knee (ACL, MCL, LCL, PCL) provide the least amount of support
at 90 degrees, or parallel. They are almost completely lax at 90 degrees and
cannot exert much of a protective force at the knee at all.
On top of all the
above exercises and their variations, there are some advanced uni-lateral
movements you can use to further strengthen the VMO, along with other necessary
stabilizing muscles needed in sport.
Advanced step-ups:
1. Lunge step-up
The lunge step-up
consists of doing a front foot elevated step-up, but starting with a lunge
stance (half kneeling)
2. Russian step-up
The Russian step-up
is a front step-up in which you use the front foot on the step to explosively
lift you up, to the point that your foot will almost come off of the step in
the top position
3. Triple jumpers
step-up
The triple jumpers
step-up is the ultimate step-up. The height of the step should be as high as
possible, to the point that your bottom foot can only touch the ground with
your tippy toe.
The progressions,
from easiest to hardest, of these advanced step-ups are:
1. Dumbells in hands
2. Barbell on back
NOTE: To increase
the difficulty of the triple jumpers step up, use a barbell on back only.
All of these
exercises can be used to strengthen the VMO rather effectively, but if done
incorrectly, or taught by someone who doesn’t understand the purpose of
corrective exercise and how to effectively implement it into a program, they
can actually make the imbalance worse, which can lead to a host of undesirable
side effects like “runner’s knee” and so on.
If you have any
questions about the VMO and how to correct the imbalance between the VMO and
vastus lateralis, feel free to contact me at ben@paramounttraining.ca. I'm available for
online consulting and personalized program design, as well as one on one
training if you are located in the Greater Toronto Area (GTA).
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