Do you suffer from runner's knee?

It seems the past few weeks I have been talking more about the vastus medialis obliquus, or more well known as the VMO.   Runners knee, patellofemoral pain syndrome, patellar tracking disorder, whatever the name, it seems the common factor is the VMO.  If you are a runner, just started running or performed strenuous leg exercises and started feeling knee pain, chances are, the VMO can be part of your problem.

If you are noticing pain on the inside of your knee just above your kneecap, chances are it is a patellofemoral pain syndrome. This disorder is defined as overuse without changes to the cartilage of the patella.  Symptoms may be aching patellar pain, pain with running, weight bearing or active motion. Stiffness relived by activity and sensation of knee giving away or locking. Increased load can such as ascending/descending stairs, long distance running and skiing can increase the pain.

Research has accepted that the VMO is important for patellar stabliziation, mostly thought the last 15 degrees of stabilization. Witvrouw et. al. (2000) evaluated 282 athletes, 24 of whom developed anterior knee pain.  In this study, Witvrouw found there were only 4 possible predictors for anterior knee pain.

  1. A slowed vastus medialis/lateralis response time
  2. A decreased in explosive strength
  3. A shortened quadriceps
  4. A hyper mobile patella.

It was concluded that stress on stabilizing structures, such as the VMO, might be the primary cause.

Now that we know what causes anterior knee pain, can we support the VMO? While researching the VMO, it has been almost unanimously agreed that most exercises do not show a clinical significance in VMO activity over VLO (vastus lateralus obliquus). This does not mean there is no hope to help strengthen the structures that stabilize the knee; it just means you will be strengthening both the VMO as well as the VLO.  One study performed by Laprade et. al. (1994) had patients perform four isometric exercises and found that medial rotation with extension showed some increase in VMO firing over VLO. In conclusion, the exercise would guarantee a good strengthening effect for both muscles.

If you are experiencing pain on the front of your knee, you should consider one of the four predictors above and look for a chiropractic care experts.  And of course, correction for most predictors, after red flags have been ruled out, can be achieved with strengthening exercises and chiropractic modalities.  If simple isometric exercises do not help your knee pain or knee pain worsens, feel free to call Stumpff Chiropractic at 954-368-4054. We look forward to helping you get back to the exercises you love. 

Witvrouw, E., Lysens, R., Bellemans, J., Cambier, D., & Vanderstraeten, G. (2000). Intrinsic risk factors for the 
development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med., 28(4); 480-489.

LaPrade, R.F., Burnett, Q.M. 2nd, Veenstra, M.A., & Hodgman C.G. (1994). The prevalence of abnormal magnetic resonance 
imaging findings in asymptomatic knees. With correlation of magnetic resonance imaging to arthoscopic findings in 
symptomatic knees. Am J Sports Med., 22(6); 739-745.

Huff, L., & Brady, D.M. (2005).Instant Access to Chiropractic Guidelines and Protocols, 2nd Edition. 
Elsevier Moseby; 291-297.

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