Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 Have you tried any Electronic Muscle Stimulation (EMS). Following from Charlie Francis' lead, I've used EMS on my athletes to help with VMO firing problems - and it has worked very well. Of course, the intensity is very high, and takes time for the athlete to get used to. Charlie recommends 10 seconds on, with 50 second rest intervals. Check the following link for more info: http://www.charliefrancis.com/board/philboard_read.asp?id=23 The EMS has helped my athletes to actively recruit their VMO when doing other activities, such as squatting, running, jumping, etc., which in turn help to condition the VMO. [Ch 4.2 of ny " Supertraining " textbook is devoted to the theory and application of electrostimulation in sport. Mel Siff] Hansen Vancouver, BC ----- Original Message ----- From: " kkruse89 " <kkruse@...> Hello I am having a little trouble with the firing of my VMO. I had a very deep bruise playing football about a year and a half ago. Ever since then my vmo has not been firing or pulling its load when I squat. This has cause my patella to drift laterally which cause my knee to get inflammed whenever I squat. The vmo has some atrophy which I assume is from the pain and not working it as hard. I have tried deep tissue massage to get rid of the scar tissue but it really hasnt helped the problem that much. I have read of a surgery where the vmo is reattached to the patella allowing it to pull correctly and therefore getting the patella back on track. Could anyone tell me what the success rates are with this surgery. Or could they give some ideas to help my vmo fire properly. All help is greatly appreciated. Kruse Carmel IN USA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 , We've had a lot of success with climbers and hikers who have problems with knees --particularly women -- due sometimes to weak VMO's and other times to hip strength (or lack thereof). See other references on the VMO in the Supertraining archives. Also feel free to check out our article at Body Results' website on strengthening the VMO for descents (either mountains or stairs) at http://www.bodyresults.com/E2kneetest.asp which we call the reverse step-up (or step down, though the emphasis is on slow and controlled lowering and backwards raising, rather than dropping onto the floor.) It has done wonders for several clients who've been through knee surgery, including me (lateral release; I'd suggest trying ANYTHING and everything else before surgery, as it really sets you back on training!) Give it a try and let us know how it works. Courtenay Schurman court@... Body Results Seattle, WA USA VMO weakness Hello I am having a little trouble with the firing of my VMO. I had a very deep bruise playing football about a year and a half ago. Ever since then my vmo has not been firing or pulling its load when I squat. This has cause my patella to drift laterally which cause my knee to get inflammed whenever I squat. The vmo has some atrophy which I assume is from the pain and not working it as hard. I have tried deep tissue massage to get rid of the scar tissue but it really hasnt helped the problem that much. I have read of a surgery where the vmo is reattached to the patella allowing it to pull correctly and therefore getting the patella back on track. Could anyone tell me what the success rates are with this surgery. Or could they give some ideas to help my vmo fire properly. All help is greatly appreciated. Kruse Carmel IN USA Modify or cancel your subscription here: mygroups Don't forget to sign all letters with full name and city of residence if you wish them to be published! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 I know charles poliquin says that the vastus medialis is primarily activated during the bottom 1/4 of the full close stance high bar squat, and therefore reccomends to build it up you do 1 and 1/4 squats with this exercise. [Yet, EMG studies show that vastus medialis is strongly activated during the last phases of knee extension. Did he supply any scientific studies to support his contention? As another list member wrote, electrostimulation has been reported in several therapeutic studies to be very useful in rehabilitating this muscle. Mel Siff] A 1 and a 1/4 squat is down to the floor, up 1/4 down to the floor again, then up completey. Do a search in testosterone.net and you might find this. I found that (i too also had a weak VMO which caused the same problems) with fixing this weakness this way, as well as addressing all my other firing pattern problems (glut med, TFL, Glut Max, Hamstring) I am stronger and more powerful than ever. joe cole dunedin, New Zealand __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Initially the VMO was probably inhibited through a combination of the pain and swelling. The VMO has been described in some of the literature to be similar to the multifidus in the spine (a tonic, primarily stabilizing muscle). It undergoes atrophy quickly in the type I muscle fibers and may undergo problems in contraction via a dysfunction in motor control. Getting the VMO to fire again can be tricky. Early in rehab. it is common to see people perform an open chain short-arc extension of the knee. This is done in long-sitting with the knee flexed about 15 degrees over a bolster and having the person perform a knee extension, focusing on contraction of the VMO. A method I like is to have the person in standing with a cable attached above the knee with the line of pull parallel to the ground. The foot of the involved leg is placed near the heel of the uninvolved leg, with the involved heel elevated. At this point the knee is flexed about 15 degrees. Take the heel on the involved leg and press it into the ground, extending the knee and tightening the quadricep. This is now a closed chain knee extension, which may help activate the VMO through compression of the joint mechanoreceptors. EMG as a form of biofeedback can be very useful to help " learn " how to contract the VMO again. The resistance should be low and repetitions high as you are working with a tonic muscle and trying to facilitate Type I fibers. Isometric holds can also be useful. Also check the iliotibial band for tightness as it will pull the patella laterally. If you haven't had a physio. look at the knee yet, look into plica irritations, as an irritated plica often causes medial knee pain. Bettendorf Portola Valley, CA -----Original Message----- From: " kkruse89 " <kkruse@...> Hello I am having a little trouble with the firing of my VMO. I had a very deep bruise playing football about a year and a half ago. Ever since then my vmo has not been firing or pulling its load when I squat. This has cause my patella to drift laterally which cause my knee to get inflammed whenever I squat. The vmo has some atrophy which I assume is from the pain and not working it as hard. I have tried deep tissue massage to get rid of the scar tissue but it really hasnt helped the problem that much. I have read of a surgery where the vmo is reattached to the patella allowing it to pull correctly and therefore getting the patella back on track. Could anyone tell me what the success rates are with this surgery. Or could they give some ideas to help my vmo fire properly. All help is greatly appreciated. Kruse Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 , I have an exercise for you to try. It's designed for the problem that you have. I originally learned this exercise from the former Detroit Red Wings head physical therapist, Kirk Vickers. This exercise works best using the Cybex horizontal leg press(the older version). Take a slightly deflated four square ball and place it inbetween your knees. Your feet should be placed about four inches apart. Perform full range motion leg presses while constantly squeezing the ball hard. You must squeeze the ball HARD all the way up and all the way down. Also, make sure that you control the movement during the eccentric portion(I usually use a 3 second count). On the last rep hold for 10 seconds in the down position. On a side note there USED to be several snickering bodybuilders when they watched me show this exercise. After performing just two sets of this exercise they wanted no more. Now they tremble when they see me bringing that ball in:) I have no scientific studies to back up my opinion. But, give it a try and let me know! Dave Barry AAU Mr. America NABBA Mr. USA Park, MI --- kkruse89 <kkruse@...> wrote: > Hello I am having a little trouble with the firing > of my VMO. I had > a very deep bruise playing football about a year and > a half ago. > Ever since then my vmo has not been firing or > pulling its load when I > squat. This has cause my patella to drift laterally > which cause my > knee to get inflammed whenever I squat. The vmo has > some atrophy > which I assume is from the pain and not working it > as hard. I have > tried deep tissue massage to get rid of the scar > tissue but it really > hasnt helped the problem that much. I have read of > a surgery where > the vmo is reattached to the patella allowing it to > pull correctly > and therefore getting the patella back on track. > Could anyone tell > me what the success rates are with this surgery. Or > could they give > some ideas to help my vmo fire properly. All help > is greatly > appreciated. > > Kruse > Carmel IN > USA > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Another possibility could be that it isn't the VMO weakness but it is being inhibited by tight lateral structures. Is this person tight in their ITB or TFL? Start from the bottom of their bodies and work your way up? How are their feet positioned? Pronation? Supination? High arch? Flat arch? How do they walk? Locomotion.Testing them statically and dynamically can give a lot of answers. The point I am trying to make is that this tight VMO could be the effect of some other dysfunction going on at other parts of the body. Maybe looking to other body parts can reveal answers to the weakness. Unfortunately, all the EMG biofeedback you do on this person will not work if they have something else going on with another part of their body or have muscle imbalances. Jon Cohen Menlo Park, CA ---------------------- " M. Hansen " <dmhansen@...> wrote: Have you tried any Electronic Muscle Stimulation (EMS). Following from Charlie Francis' lead, I've used EMS on my athletes to help with VMO firing problems - and it has worked very well. Of course, the intensity is very high, and takes time for the athlete to get used to. Charlie recommends 10 seconds on, with 50 second rest intervals. Check the following link for more info: http://www.charliefrancis.com/board/philboard_read.asp?id=23 The EMS has helped my athletes to actively recruit their VMO when doing other activities, such as squatting, running, jumping, etc., which in turn help to condition the VMO. [Ch 4.2 of ny " Supertraining " textbook is devoted to the theory and application of electrostimulation in sport. Mel Siff] Hansen Vancouver, BC ----- Original Message ----- From: " kkruse89 " <kkruse@...> Hello I am having a little trouble with the firing of my VMO. I had a very deep bruise playing football about a year and a half ago. Ever since then my vmo has not been firing or pulling its load when I squat. This has cause my patella to drift laterally which cause my knee to get inflammed whenever I squat. The vmo has some atrophy which I assume is from the pain and not working it as hard. I have tried deep tissue massage to get rid of the scar tissue but it really hasnt helped the problem that much. I have read of a surgery where the vmo is reattached to the patella allowing it to pull correctly and therefore getting the patella back on track. Could anyone tell me what the success rates are with this surgery. Or could they give some ideas to help my vmo fire properly. All help is greatly appreciated. Kruse Carmel IN USA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Dr. Siff Wrote: <Yet, EMG studies show that vastus medialis is strongly activated during the last phases of knee extension. Did he supply any scientific studies to support his contention?> ### I don't know if Poliquin has studies to back this up or not. However, after extensive research of current literature on the subject I can say I have not seen any. I have seen several corroborating your assertion about the VMO's activity in the latter phase of knee extension. However, the problem with several of those studies that do find this (forgive my lack of references, as this is coming off of memory alone) is some are open chain movements which does activate the VMO " preferentially " to a degree, while others use closed chain, but do not take into account the relative contribution of the VMO with the Vastus lateralis or the other two knee extensors. The VMO may be active in the final 15 degrees or so of extension, but the Vastus lateralis is highly active as well. Also, I have not seen one study that addresses the contribution of the VMO to knee extension from a position of great (i.e., greater than 90 degrees) knee flexion. In other words, while there is no evidence supporting movements like full squats to be superior in activating the VMO, there are certainly none that suggest otherwise. At least that I have seen! [incidentally, my EMG studies of the different quadriceps muscles were carried out on full depth back squats. The relative contribution actually differs from rep to rep, with different loads and with different styles of squatting, so one indeed has to examine all references relating to VMO activation. One obvious example - many researchers do not even adequately know the difference between the Weightlifting (deep knee bend) squat, and the different types of narrower and wider powerlifting squat. Mel Siff] However, from an empirical stand point I have found that full squats, lunges and other movements that require knee extension from a fully flexed or nearly fully flexed knee position bring about greater hypertrophy and strength to the VMO relative to other movements that are considered " quad " exercises. In addition to movements that require extension from a position of full flexion; movements that require extension from a position in which the knee extends/potrudes past the toe seems to recruit the VMO extensively as well. Movements such as step ups, Step ups (stepping onto a bench behind you), backwards running or jumping. All cause the knee at some point to extend/protrude past the toe. I imagine this strikes fear into the heart of many fitness " experts. " [Yet those experts say very little about the high rate of knee injury among distance runners whose knees do not protrude beyond the toes. Mel Siff] A PT friend of mine has demonstrated this somewhat via EMG in some unpublished research using backwards walking, forwards walking, and backwards walking on an inclined treadmill with a population of healthy and knee rehab patients. He found the greatest VMO activation in the backward walking on the incline. Obviously backwards walking on a treadmill is very different from lunges, step ups, full squats, etc. > As another list member wrote, electrostimulation has > been reported in several therapeutic studies to be > very useful in rehabilitating this muscle. Mel Siff] ### To add to this discussion, I would question whether or not the individual who originally posted the question was sure the problem was weakness of the VMO. Flexibility, neural, or technique issues could also be causing the porblem. However, again from an empirical stand point, I have seen many knee " problems " cured indefinitely via incorporating movements in which the hamstrings cover the calves prior to knee extension. Todd Hattiesburg, MS Quote Link to comment Share on other sites More sharing options...
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