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How Can I Strengthen My Vastus Medialis Oblique?
I am a 41 year old male. I hurt my left knee playing freshman football. I have two questions. Is the concrete floor of a garage good for knees when jumping rope and doing leg work? Also, in your "Weak Link" article you talked about a muscle called the Vastus Medialis Oblique (VMO). The symptoms you write about in the article sound just like mine. Plus my chiropractor says that my kneecap gets out of place sometimes and must be adjusted. She also recommended to do no exercises where my knee goes over my toes. Could step-ups and split squats cure this? I'd like to be able to do some squat work and really strengthen my legs.
Well, the good news is that your problem is not even close to being impossible to solve. The whole myth of the knee tracking over the toes is just that, a myth. Of course if you experience pain you should avoid that range of motion, but this is the same advice for anyone with any sort of injury. I am constantly amazed that therapists recommend people strengthen their VMO, yet are against deep squatting. This is mysterious considering one of the best ways to strengthen the VMO is to perform the deep Olympic style squats. What usually limits people though is flexibility in their hips or ankles.
Yes, split squats and step-ups can be very useful exercises to improve the strength around the knee. I often suggest to push the knee not only down, but forward when performing split squats. You will get much greater activation of the VMO. Step-ups can also be fantastic for strengthening the hamstrings and glutes which also stabilize the knee, yet not too many people mention this all important fact. This is why I spend a considerable time on people's glutes and hamstrings when rehabbing knees.
If you are having this pain you might also be suffering from a tight ITband. This bundle of connective tissue connects at the hip and knee on the side of the leg. It is very common to have this area tight which will pull on the knee cap. Usually it is extremely difficult to stretch so soft-tissue work is extremely helpful. If you don't want to go to a massage therapist you can simply take a rolling pin and apply some force on the outside of your leg from the hip down to the knee. Simple, yet effective!
I don't suggest anyone jump rope on concrete. Eventually the stress would take a toll on the joint or reaggravate a pre-existing condition. You can simply buy a few squares of rubber tiling from any fitness store and this would easily solve your problem. It would not be as much of a problem for leg exercises unless you were performing Olympic lifts.