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These references courtesy of Adam Meakins - The Sports Physio - via twitter [@AdamMeakins] bringing a nice other side to the discussion on the existence and role of the Vastus Medialis Oblique (VMO) muscle. Historically thought to be "weak" or key in patellofemoral symptoms and/or maltracking issues these references are worth a read:

 

Did I miss the news? Since when did anyone think that VMO ( the portion of vastus medialis with oblique orientation of the fibers) was a separate muscle?

 

Apparently still often taught this way at undergrad

 

Thanks for that Ian.

You are right as it is still a common mythical belief and standard protocols insist on strengthening VMO as a major component of the management of the knee pain diagnosed as patello femoral dysfunction.

You will hoefully pardon me indulging in an anecdote. I saw a young elite female athlete with 3 months of knee pain and treatment for PFD. I intervened with temporary inserts and local knee treatment. On her return a week later she was pain free and advised me that the physio had advised her that finally all the exercising had paid off.

I think we all can finish the sentances of the patients describing the cause of their knee pain and what need to be done to fix it.

Cheers
Shane

 

There has been many attempts over the last 25 years to get it taught as a separate muscle. The argument is analagous to those of us in the fossil world - to lumpers and splitters. Its the same muscle, get over it and move on. Bloody clever muscle though. Rob

 

Continuing my interest in this, just a follow up after I attended an excellent lecture recently from a Physiotherapist who only treats patellofemoral pain. Picked up on these further references:

 

Furthermore, there is recent data out there confirming that VMO fibre angle varies (and this may have an effect on the mechanical ability of it to medialise the patella) and also that the insertion ratio varies (again suggesting some people may have a more 'anatomically favourable' VMO than others). Refs below:

More work in the pipeline from this team of researchers which may suggest that both fibre angle and insertion ratios can and do change with training/activity... cool.

 

Clinically, this seems to make sense. I'll be interested to hear more on the subject. Thanks Griff

 

Came across this the other day regarding muscle force production:
http://rspb.royalsocietypublishing.org/content/280/1766/20130697.abstract

Here's the media release: http://www.sciencedaily.com/releases/2013/07/130712102844.htm