Knee Injury - VMO muscle

Discussion in 'General Training' started by alam906, May 29, 2013.

  1. alam906

    alam906 New Member

    Hi guys,

    Left knee been hurting for a few years now when I'm in a deep squat position (past parallel). Finally decided to go see a PT since I got insurance now and they're suspecting my left VMO in the quad is delayed when contracting, which causes the knee cap to shift out slightly. It may also be from my flat foot and extra pronated left feet, my knees also appear to collapse in slightly when I squat down. Still didn't really find out the main cause of the problem.

    Anyways, PT recommended some exercise to strengthen my VMO to create some balance and hopefully bring me back to a normal state.

    Has anybody else here experienced this problem? If so, how long did it take you to heal before you can squat again? I can't even deadlift right now, nothing that works out the quads.
  2. Sci

    Sci Well-Known Member

    I haven't had that specific problem, but I had knee surgery when I was 18, and my right quadriceps atrophied to a tiny, pathetic state during the healing.
    I did heavy leg extensions to rehabilitate my quadriceps, and within a couple months, my quads like tripled in size. Just do the rehab, it will get better. What worked for me was doing single-leg isometrics and negatives with leg extension machine. I would choose a heavy load, then contract my quads to hold the load up with my leg straight, and as fatigue set in, I would very slowly lower the load. Doing this twice/week stimulated insane hypertrophy of my quads.
    Obviously without seeing you in person, there is no way of knowing what caused it for you, but you should do the rehab work on whatever the PT advises.
    Good luck.
    Last edited: May 30, 2013
  3. mikeynov

    mikeynov Super Moderator Staff Member

    Do you have video of you squatting? This would be the most helpful thing. In this case, either directly behind or in front would be helpful. Bear in mind, however, that everything I'm saying will apply after the acute inflammation goes down. If you can't even deadlift due to knee cap pain, it's possible the first part of what you actually need is time off, a good couple of weeks. Some massage/stretching could be helpful to get everything to calm down.

    I am willing to bet quite strongly that the problem is ultimately your squat form. You say that knee "collapses" a little bit when you squat down and that you have extra pronated feet. Imo this tracks with you probably having tight/weak external rotators at the hip (which would make you walk a little duck-footed and pronate more with your gait).

    I am also willing to strongly bet that you can dissipate the discomfort in squats by doing a few things:

    1) Turn the feet out a LITTLE, but not more than, say, ~15-30 degrees. A lot of people with your problem both walk and squat with feet turned excessively out.

    2) Consciously shove your knees out towards the opposite walls as hard as you can as you sit down/back and descend. It should feel like your weight is balanced evenly on your feet, and that your arch is maintained. Given that you over-pronate, this will feel kind of like your weight is actually on the outside of your feet.

    3) As you ascend out of the hole, KEEP your knees out, don't let them track in.

    4) As an extra, buy a foam roller and foam roll the living **** out of your quads and IT band. I apologize in advance for this, but it's helpful.

    It's obviously possible that there's more to the story than this and that PT exercises may wind up being helpful, but imo a lot of people start going for rehab type exercises as a first measure instead of learning to actually perform the movements correctly
    Last edited: Jun 2, 2013
  4. Lol

    Lol Super Moderator Staff Member

    Everything Mikey said but most definitely this:

    You will have to take a video of your form because even if you think you are keeping your knees out, chances are you aren't. I struggle like crazy to keep my knees from caving in when driving out of the hole once my loads get to around 90% 1RM. I'm not aware that I'm doing it but it shows up any video.

    Having spoken to a few long-time squatters about this they said it took years using ~60% loads to engrain the movement pattern. Some people have no trouble with this from the outset and that's great; but we are all a little different. It is definitely a problem for me. It might well be a problem for you too.
  5. alam906

    alam906 New Member

    Thanks for the information guys. I'll try to get a video once my knees get a little better. It's so weird because after Mikey spoke about the duck foot syndrome, I notice when I stand normally the left foot is pointed outwards alot more than the right. I notice this standing still normally, standing at the urinal, anywhere. I don't really see it sticking out while walking, but I think I'm subconsciously moving it back in.

    Hopefully, I can get a video up so you guys can better help critique my form.

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