How your Vastus Medialis Oblique (VMO) could be contributing to your hip pain!

The human body is a fantastic and highly organised machine. However, it also inherently lazy, if something isn’t working instead of fixing the problem it will just make something else do the work for it. For some people this isn’t a problem, unfortunately for others it can become a right pain in the backside…. literally a pain in the backside wrapped up and presented to you in the form of hip pain.

In this article we are talking about the VMO or Vastus Medialis Oblique, if you’re fortunate enough to have fairly defined legs or know someone who does then it’s easily identifiable as the tear drop shaped muscle on the inside of the leg just above the knee it has an important job to do in stabilising the knee joint. But if it is weaker than it should be it can contribute to Hip Pain as well as many other symptoms some of which we will explore.

The VMO and Hip Pain

As we said this tear drop shaped muscle on the inside of the leg just above the kneecap or patella, is one of the muscles responsible for keeping your kneecap tracking centrally over your knee during movement and exercise such as running, cycling, walking or squatting. If your VMO hasn’t got enough strength to do this important job then you may develop some compensation patterns straining the hip joint. If this happens over a period of time it could develop in to a real pain in the bum!  

A study by Tang et al. (2001) highlighted that individuals with VMO weakness often experience altered knee mechanics, leading to increased stress on the hip muscles as they compensate for the instability in the knee joint. Over time, this compensation can lead to overuse injuries and pain in the hip area.

Furthermore, femoral internal rotation, often caused by poor VMO activation, may increase the likelihood of hip pain. Ireland et al. (2003) found that women with hip pain often exhibited increased femoral internal rotation and weakness in the quadriceps, particularly the VMO, leading to a cascade of biomechanical issues throughout the lower limb.

A weakened VMO fails to support the knee properly, causing excessive lateral movement of the patella. This, in turn, disrupts the natural alignment of the lower limb, placing the hip abductor muscles under additional stress.

When your VMO can not cope with the work load and you have this increased lateral movement of the kneecap the whole knee and leg could become rotated laterally or to the outside so your right leg would rotate to the right, placing more tension or load into your hip abductor muscles into a position of load and stress. Studies such as that by Willson et al. (2006) have suggested that hip pain is often accompanied by hip abductor weakness and improper activation of the lower limb stabilisers.

So, if we can strengthen your VMO you will not only end up with a happier knee but a happy hip as well. So here is my favourite exercise to improve VMO strength.

Staircase Step Ups

If you stand sideways on a stair with a foot on a higher step and one on a lower step, with your uppermost foots toes inline with the heel of your lower foot. So you will be in a staggered stance, then press up with your highest foot until you are standing on one leg with your leg straight, you should be able to really feel the VMO working so the inside of your knee will be where you feel it.

Repeat this exercise for 10 reps and be sure to do both legs, you can’t over do this exercise, no one has ever moaned about their knee being too strong!

A slight adjustment if you find this too difficult would be to do it in reverse, get your feet set the same but with the start position being stood up with your leg straight and then lower your self slowly down until the lower foot is on the stair.

If this exercise isn’t working for you then get in touch and I have a few alternatives which I would be more than happy to help you with.

Final Thoughts

Don’t let your VMO weakness develop into hip pain, early stages of this may present as knee discomfort so even if you’re unsure then give the exercise a go and see if it helps your situation or if you would like some assistance then book an appointment and I will do my best to help you.

References:

1. Tang, S. F., Chen, C. K., Hsu, R., Chou, S. W., Hong, W. H., & Lew, H. L. (2001). Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: An electromyographic study. Archives of Physical Medicine and Rehabilitation, 82(10), 1441-1445.

2. Ireland, M. L., Willson, J. D., Ballantyne, B. T., & Davis, I. M. (2003). Hip strength in females with and without patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy, 33(11), 671-676.

3. Willson, J. D., & Davis, I. S. (2006). Lower extremity mechanics during running in females with and without patellofemoral pain syndrome. Clinical Biomechanics, 21(2), 203-210.