#Indoorcycling Instructors & Participants: How to strengthen your Vastus Medialis Obliques (VMO) to prevent knee pain

After several years of teaching indoor cycling, one of the topics that indoor cycling instructors discuss is injury prevention, and in the case of injury, rehabilitation and returning to teaching. In previous posts, I discussed some common “pain points”, such as the IT Band Syndrome, PFPS and TFL.

VMO1 patellofemoral_pain_syndromeOverview

In today’s post, the Vastus Medialis Obliques (VMO) will be the topic of discussion. The vastus medialis (teardrop muscle) is an extensor muscle located medially in the thigh that extends to the knee. The vastus medialis is part of the quadriceps muscle group. The portion of the muscle just above the knee is known as VMO which is critical to stabilizing the knee joint in activities such as jumping, cycling, running, squatting and stair climbing.


Injuries and pain, such as PFPS, are often caused by VMO malfunction. With PFPS, the pain is mostly felt at the front of the knee, which is aggravated by a weak VMO. For new riders in indoor cycling classes (who lack conditioning or are just starting an exercise regimen that includes heavy squats), and for those who ride repeatedly and are experiencing pain, a stronger VMO will enhance the experience of riding indoors and outdoors, improve your endurance on long rides and help you to avoid one of the common debilitating knee injuries. (other injuries also cause the inhibition of VMO function, such as ACL rupture and meniscal tears)

To check the contraction of the VMO, try this: while sitting on a chair, feel the VMO muscle. Slowly straighten you knee while VMO contracts. Feel the contraction as you now fully straighten the knee. Bend your knee and feel the contraction one more time. This is also a good exercise to employ (in addition to the ones described below) to strengthen the VMO – simply repeat the steps of slowly straightening your knew and then fully straightening it 5-10 times, in two sets.

Strengthen Your VMO

There are a variety of exercises ans functional movements  that you can perform to strengthen the VMO and also to help you manage the associated pain. Here is a general list of these exercises (2 sets of 8 reps for each leg):

  1. Knee extension / leg extension using a resistance band to strengthen the thigh muscles.
  2. Foam roller extensions.
  3. Squats and lunges (also ball squats).
  4. Step-ups / Step-downs (try lateral step-ups/downs for modification).
  5. Straight leg raises.
  6. Calf raises

Remember to consult a physician for proper recommendations and specific treatments. The above are simple and personal observations based on my experience, and in no way constitute a course of treatment or medical advice.

Live well, be well.


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