The vastus medialis oblique, or VMO, is one of the four quadricep muscles. The other three muscles in the quadriceps group are the vastus lateralis, the rectus femoris and the vastus intermedius. Together these muscles make up the front portion of the thigh. Located in the front of the thigh, towards the inner part of the leg, the VMO runs from the top of the femur at the hip right down into the inner part of the knee. Its functions include extension of the leg at the knee joint, and keeping the kneecap tracking correctly. This movement created with the help of the VMO assists in activities involving squatting, walking up and down stairs, moving from a sitting to standing position and many more.
Symptoms of VMO pain include:
- Pain along the inner thigh and at the front and inside of the knee
- Constant pain at the knee joint
- Buckling of the knee
- Cramping or tightness
- Tenderness when touching the area
The pain associated with VMO spasm or injury is often described as an ache that can be felt at rest and during activity. If the VMO is severely injured it may elicit sharp pain, which will subside after several weeks and result in knee weakness during movement.
Causes of VMO pain:
A weak VMO can develop through poor training habits, however, it often occurs due to underlying problems in the knee. The VMO is usually one of the first muscles to show signs of an underlying knee problem and therefore VMO pain should not be ignored.
Main causes of VMO pain include:
- Overtraining and loading of the quadricep muscles
- Unaddressed trigger point activity in the quadricep muscles
- Frequent participation in quadricep heavy movements, such as skiing, soccer, football
- Pronation of the foot when walking or running
2 Ways To Get VMO Muscle Pain Relief
- Visit a Soft Tissue Occupational Therapist…
A visit to a Soft Tissue Occupational Therapist can assist in the treatment of your VMO pain. A soft tissue occupational therapist will conduct an assessment to determine the cause of the pain and then provide hands-on neuromuscular techniques, such as trigger point therapy, dry needling or myofascial release to improve functioning of the muscles, tendons, ligaments and fascia. These neuromuscular techniques work to break down fibrous adhesions, releasing tight muscles and correcting improper muscle functioning and postures. Soft tissue occupational therapists will also work to develop and recommend stretching and strengthening regimes to assist in alleviating symptoms and prevent recurring of your VMO pain. A soft tissue occupational therapist may employ or recommend a number of treatment techniques to help relieve your TFL pain, these may include:
Trigger Point Release
Trigger point therapy involves the application of firm pressure to a hyperirritable spot or taut band, known as a trigger point. This pressure works to release tension in the muscle, by decreasing the blood flow to the area, and decrease the pressure felt. As the pressure is removed, blood flows back to the area and flushes any toxins released by the muscle. These points and can often refer pain to other parts of the body, lasting a few seconds.
Dry needling is a technique that can be used to reduce muscle restriction by releasing trigger points (see above) with acupuncture needles. A Soft tissue Occupational Therapist will use individually packed sterilised acupuncture needles to directly ‘needle’ the trigger point and produce a local response within the muscle, which then quickly dissipates and allows the muscle to relax.
Myofascial release is a manipulative treatment that attempts to release tension in the fascia due to trauma, posture, or inflammation. Connective tissues called fascia surround the muscles, bones, nerves, and organs of the body. Points of restriction in the fascia can place a great deal of pressure on nerves and muscles causing chronic pain. A soft tissue occupational therapist will employ long stretching strokes meant to balance tissue and muscle mechanics and improve joint range of motion in order to relieve pain.
Applying heat to your painful VMO muscles through the use of a heat pack may help to alleviate the pain. Heat is an inexpensive, effective form of pain relief that works by increases blood flow to the area, relaxing muscles and increasing range of movement and flexibility. By increasing the circulation and blood flow throughout the area, injury healing properties are delivered to the muscles, aiding in repair, and reducing the symptoms of VMO pain.
- Stretching and Strengthening
Initially the best form of relief from VMO pain includes resting from aggravating activities. Gentle exercise, stretching and strengthening is important in assist to relieve pain and can help speed up your recovery. Gentle stretching may decrease the pain associated with VMO pain by encouraging circulation and blood flow to tissues, reducing muscle stiffness and spasm. Secondly, correcting muscle imbalances and building strength in the quadriceps and knee region is important in helping to reduce the demands and stress on the VMO, and subsequently reducing VMO pain. Your Soft Tissue Occupational Therapist may recommend a stretching and strengthening regime, which you will be able to do at home. It is best to consult your Soft Tissue Occupational Therapist before engaging in this program to avoid further aggravating your VMO pain.
Stretches that may help to relieve VMO pain includes:
The best quad stretches are those that address not just the quadriceps, but all aspects of your leg, from the hip to the thigh, to the foot. These stretches can help to relieve VMO pain
1. The Lying Quad Stretch
- Lie in a face-down position, propping your head on your left hand. Alternatively, you can lie on your side to perform this stretch.
- After a couple of seconds, pull your right foot toward your butt and bend your left knee to stabilize yourself.
- Hold onto your ankle and maintain the position for 30 seconds.
- Switch sides, pulling your left foot toward your back and bending your right knee.
2. The Simple Quad Stretch
- Stand on your left leg, one knee touching the other. You can hold a chair or the wall to keep you steady if needed.
- Grab your right foot, using your right hand, and pull it towards your butt. Be sure to push your chest up and hips forward. Try not to worry about pushing your foot too close to your backside; your focus should be on feeling the stretch in your quad muscle and pushing your hips forward to get a good hip flexor stretch
- Hold the position for 20 to 30 seconds, then repeat, switching from your left leg to your right.
3. The Kneeling Quad Stretch
A slightly different form of quad stretch, this position will help to loosen the muscles just above the knee joint, increasing mobility and preventing knee pain.
- Start the stretch in a high lunge position, with your left foot forward.
- Carefully drop your right knee to the floor and take a moment to find your balance.
- Once you’re ready, reach back with your right arm, and grab your ankle, or toes, depending on what’s easiest.
- Hold the position for 30 seconds, keeping your body steady.
- Gradually come back into the lunge position and switch from your left foot to your right.
4. Lying Pigeon Progression
- Place a mat on the floor and lie face down.
- Secure a resistance band around your left foot, with the excess band in a reachable area.
- Grab the band with your left hand. While keeping your right leg extended, bend your left knee, keeping your toes pointed toward the ceiling.
- Use the resistance band to pull forward until you feel the stretch. Hold for twenty seconds then pull further.
- Repeat on the other side.
5. The Frog Pose
If you’re looking to stretch out the gluteus maximus and the thighs, then this could be the great stretching pose for you. It will also help to stretch your arms, chest, and shoulder blades.
- Begin by lying on your stomach, propping your torso up on your elbows.
- Bend both of your knees, and reach back to hold onto your feet. You should already feel the stretching at this point.
- Adjust your fingers to point the same way as your toes, then carefully lift up your elbows to point to the ceiling.
- Push your chest up as high as you can.
- Stop the pose completely if you feel any pain in your hip or knee.
- Stay here for five breaths, then relax.
At Infused Health our highly trained Soft Tissue Occupational Therapists will use a hands on approach to help treat your injuries, conditions or any concerns you may have. You can make an appointment today by calling 0401 876 623.