Targeting the vastus medialis.

[Dave_E]

After some non lifting related knee injury bother last year, my physio recommended a handful exercises (beside my normal training) to help 'stabilize' the knee and specifically aimed at the vastus medialis.

Externally rotated half squats.
Split squats
Step ups
Lunges
Single leg squats.

He's a nice bloke, so I didn't want to sit there and tell him 'citation needed', so I just nodded and decided I'd ask here. It just sounded a bit...you know...

So my questions are:
A: Assuming the joint was actually, for some reason, in need of it in the first place, wouldn't the squat in and of itself be more than sufficient to stabilize the knee?
B: Is VMO activation greater in (to any significant degree) these exercise variations?
C: Is it even possible to isolate / target the VMO?

[Derek Miles]

Hey Dave,
So there is no good evidence that we can target the VMO or that even if we could it has any specific correlation with symptoms. To your point, if you put enough of a load on a squat, the VMO is going to fire just fine. To point B, the problem is that many of the studies you will hear cited for this narrative use surface EMG which has a whole host of problems when trying to infer any data, crosstalk being the most minor of them. That all being said, the list of exercises he gave are ones that I certainly give out with regularity to people experiencing knee pain. The narrative attached to why is WAY off though. Sometimes we just need to find some movements we can tolerate when others are aggravating. There isn't anything special about building up one muscle to prevent or reduce the risk of knee pain.

[Dave_E]

Hey Dave,
So there is no good evidence that we can target the VMO or that even if we could it has any specific correlation with symptoms. To your point, if you put enough of a load on a squat, the VMO is going to fire just fine. To point B, the problem is that many of the studies you will hear cited for this narrative use surface EMG which has a whole host of problems when trying to infer any data, crosstalk being the most minor of them. That all being said, the list of exercises he gave are ones that I certainly give out with regularity to people experiencing knee pain. The narrative attached to why is WAY off though. Sometimes we just need to find some movements we can tolerate when others are aggravating. There isn't anything special about building up one muscle to prevent or reduce the risk of knee pain.

Thanks mate. Clears it right up.