Show me photographic proof that you can correct your patella alignment by strengthening the VMO.
November 9, 2011 1:26 PM Subscribe
For patella alignment and tracking issues where the patella is too far to the outside of the knee the standard treatment is to strengthen the inner quad muscle (VMO) to pull the patella closer to the center. That makes nice sense in theory providing you can find a way to strengthen the VMO side of the quad significantly more than the opposite side...
I would really like to see someone who has posted before and after pictures of their efforts to strengthen the VMO and what it did for their patella alignment. If this is what every doctor is recommending where is the photographic evidence that this actually works?
I don't have photographic evidence, but my wife has patellar chondromalacia and physical therapy to strengthen the appropriate muscles helped her out immensely.
posted by Jacob G at 2:22 PM on November 9, 2011
posted by Jacob G at 2:22 PM on November 9, 2011
Jacob G is correct; I had chondromalacia for years that PT kept controlled. Every doctor recommends this course of treatment because it is noninvasive and it works.
That said, after 12 years of PT the exercises stopped working and I had a lateral release surgery about three years ago. I strongly encourage you to do the PT; the surgery itself is arthoscopic and minor, but the recovery will debilitate you for several years.
posted by workerant at 2:28 PM on November 9, 2011
That said, after 12 years of PT the exercises stopped working and I had a lateral release surgery about three years ago. I strongly encourage you to do the PT; the surgery itself is arthoscopic and minor, but the recovery will debilitate you for several years.
posted by workerant at 2:28 PM on November 9, 2011
Response by poster: Why are you looking for photographic evidence, rather than actual measurements of the strength of each muscle? Is it intrinsically necessary that the strength development is going to cause visible muscle growth?
The photographic evidence I am looking for is not of the muscle but of the position of the patella (bone). If a misalignment has been corrected this should be visible to the naked eye.
posted by GleepGlop at 2:38 PM on November 9, 2011
The photographic evidence I am looking for is not of the muscle but of the position of the patella (bone). If a misalignment has been corrected this should be visible to the naked eye.
posted by GleepGlop at 2:38 PM on November 9, 2011
Patellar maltracking is kind of a misnomer. Theoretically, the patella is pulled in a lateral direction, thus rubbing against tendons, cartilage, and tissues that are gradually worn away causing pain and dysfunction. But it's my understanding that in most patella alignment issues you don't really see a dramatic difference in where the patella is situated at rest between someone with pain and someone without. The issues come during movement, where muscle imbalances and poor biomechanics cause pulling on the patella laterally and back, and it's this repeated pulling and rubbing that leads to pain. So VMO strengthening and fixing the biomechanical issues are designed to counteract and dissipate these forces rather than physically move the patella itself.
What I'm trying to say is I don't think you're going to find photographic evidence of the patella moving, because it's not the location of the patella that's the issue in patellofemoral syndrome, it's how the body acts on it.
posted by Anonymous at 3:01 PM on November 9, 2011
What I'm trying to say is I don't think you're going to find photographic evidence of the patella moving, because it's not the location of the patella that's the issue in patellofemoral syndrome, it's how the body acts on it.
posted by Anonymous at 3:01 PM on November 9, 2011
As schroedinger said, I don't believe the misalignment is visible to the naked eye- for instance, it doesn't get diagnosed this way (although I've heard xrays can be used as evidence in diagnosis). If there were a simple visual indicator I think it would be used for diagnosis.
posted by jacalata at 3:08 PM on November 9, 2011
posted by jacalata at 3:08 PM on November 9, 2011
Response by poster: Hmm, well I guess I am thrown off by the knee braces with butresses that physically act on the patella and taping techniques of the knee that are supposed to directly pull your patella inward, and surgeries that correct alignment and whatnot.
I guess I will have to work on isolating and strengthening my VMO's regardless and see for myself...
posted by GleepGlop at 3:49 PM on November 9, 2011
I guess I will have to work on isolating and strengthening my VMO's regardless and see for myself...
posted by GleepGlop at 3:49 PM on November 9, 2011
GleepGlop, patellorfemoral syndrome, like most biomechanical injuries, is actually not well-understood. If you do some deeper research you'll find that there is considerable debate over whether those taping techniques work or the surgery is useful, or whether the VMO strengthening helps everyone or why. Many treatments are based off of what seems to work for most people. I mean, for a long time physical therapy and surgical treatments for sports injuries was less "This is what science says works" and more "My gut feels like this is a good idea so let's try it." Physical therapy and exercise science are striving for more evidence-based practice these days, but because the interaction of biomechanical forces at any one point in the human body is so damn complex there is still a long way to go before anyone can say for sure what works and what doesn't.
The taping--is it actually moving the patella, or is it simply helping to release the forces that irritate the area and cause pain? Same with the knee brace. Or the surgeries. The VMO strengthening, are we pulling the patella over or are we teaching our muscles to fire in a more biomechanically advantageous way (one argument is that patellofemoral pain is due to the VLO firing before the VMO).
Another example of the confusion in sports science: "stretching" the IT band. People LOVE to "stretch" the IT band. Knee pain? Stretch your IT. Hip pain? Stretch your IT. Thing is, the IT is a huge, thick tendon. You can't actually lengthen it with the small forces applied through stretching. In all studies done of the IT band, no one has ever observed lengthening. But it's apparent that a lot of the treatments that people find help IT band tightness, like myofascial release and stretching, are doing something. But what is that something? We're not sure, there's still a ton of debate.
Anyway, my point is if you're trying to look for The Truth and The Facts it is a lot more complicated than you think. Your best bet is to find a doctor and/or physical therapist who is highly experienced in treatment of your syndrome and follow their advice. Try the VMO stuff, hopefully it works for you.
posted by Anonymous at 6:09 PM on November 9, 2011
The taping--is it actually moving the patella, or is it simply helping to release the forces that irritate the area and cause pain? Same with the knee brace. Or the surgeries. The VMO strengthening, are we pulling the patella over or are we teaching our muscles to fire in a more biomechanically advantageous way (one argument is that patellofemoral pain is due to the VLO firing before the VMO).
Another example of the confusion in sports science: "stretching" the IT band. People LOVE to "stretch" the IT band. Knee pain? Stretch your IT. Hip pain? Stretch your IT. Thing is, the IT is a huge, thick tendon. You can't actually lengthen it with the small forces applied through stretching. In all studies done of the IT band, no one has ever observed lengthening. But it's apparent that a lot of the treatments that people find help IT band tightness, like myofascial release and stretching, are doing something. But what is that something? We're not sure, there's still a ton of debate.
Anyway, my point is if you're trying to look for The Truth and The Facts it is a lot more complicated than you think. Your best bet is to find a doctor and/or physical therapist who is highly experienced in treatment of your syndrome and follow their advice. Try the VMO stuff, hopefully it works for you.
posted by Anonymous at 6:09 PM on November 9, 2011
Consider treating trigger points in all the quad muscles. This can both strengthen muscles, and allow them to loosen and correct imbalances.
Even if it is not the only factor there's a good chance it will help.
posted by Not Supplied at 6:11 PM on November 9, 2011 [1 favorite]
Even if it is not the only factor there's a good chance it will help.
posted by Not Supplied at 6:11 PM on November 9, 2011 [1 favorite]
They told me I had that issue about 10-15 years ago. I did a little PT and they recommended surgery, but after I started wearing orthotics in my shoes, the problem cleared up right quick.
posted by callmejay at 4:59 PM on November 11, 2011
posted by callmejay at 4:59 PM on November 11, 2011
« Older Android Media Player alternative to smartphone? | every employee tends to rise to his level of... Newer »
This thread is closed to new comments.
posted by jacalata at 1:59 PM on November 9, 2011