What the hell is a VMO???? That was exactly my reaction when Doc Randy Molo (an avid cyclist and budding multi-sport athlete) explained to me what my problem was.
Rewind to 12 years ago... Back in college I was playing both UAAP tennis and soccer for Ateneo. During soccer practice one day, I was slide-tackled and what happened next, even I have a hard time explaning. My left leg got caught behind with the tackle but the rest of my body kept moving forward. Eventually, I was in a full split (hurdler style) and my knee landed head first into the ground, just under my ass. It's very difficult to explain how I sat on my knee.
I could not walk off the field, and my cousin had to drive me home. The next day, I went to see a sports doctor. Almost instantly the doctor said I had torn both my ACL and my miniscus. He suggested I undergo surgery right away. I was not ready for that. I had never undergone surgery ever (well, ingrown toenail surgery doesn't really count does it?). I wanted a second opinion. I saw Dr. George Canlas, and he said the exact same thing. However, he said if I opted for no sugery, I would be able to somewhat strengthen the muscles around my knee and function somewhat normally.
I did not undergo surgery, and also did not return to competitive soccer and tennis. From then til March of 2008, I avoided sports wherein there was alot of lateral and quick movement, as my knees were not up to it. I would play the occasional company basketball, volleyball and badminton tournaments, with my 'robocop' hinged knee brace. I stuck to golf, and kept telling myself my knees would not let me run.
Last march 2008, however I accompanied my wife to her first 5km race, and have been running since (See story here). However I was not pain free. My knees would give way at around the 6-7km mark of each run, most especially over concrete. It came to a point where I could not even bike pain free.
Rewind to 12 years ago... Back in college I was playing both UAAP tennis and soccer for Ateneo. During soccer practice one day, I was slide-tackled and what happened next, even I have a hard time explaning. My left leg got caught behind with the tackle but the rest of my body kept moving forward. Eventually, I was in a full split (hurdler style) and my knee landed head first into the ground, just under my ass. It's very difficult to explain how I sat on my knee.
I could not walk off the field, and my cousin had to drive me home. The next day, I went to see a sports doctor. Almost instantly the doctor said I had torn both my ACL and my miniscus. He suggested I undergo surgery right away. I was not ready for that. I had never undergone surgery ever (well, ingrown toenail surgery doesn't really count does it?). I wanted a second opinion. I saw Dr. George Canlas, and he said the exact same thing. However, he said if I opted for no sugery, I would be able to somewhat strengthen the muscles around my knee and function somewhat normally.
I did not undergo surgery, and also did not return to competitive soccer and tennis. From then til March of 2008, I avoided sports wherein there was alot of lateral and quick movement, as my knees were not up to it. I would play the occasional company basketball, volleyball and badminton tournaments, with my 'robocop' hinged knee brace. I stuck to golf, and kept telling myself my knees would not let me run.
Last march 2008, however I accompanied my wife to her first 5km race, and have been running since (See story here). However I was not pain free. My knees would give way at around the 6-7km mark of each run, most especially over concrete. It came to a point where I could not even bike pain free.
Forced to wear my knee braceWith Hannah, Jody & Jaymie (theBullrunner) @ the Happy Run
Photo courtesy of Jaymie Pizarro
I was desperate, and seeked the help of doctor once again. Upon examination and X-rays, the doctor said that I was suffering from PFO (Patellofemoral arthritis). In short, my knees had aged much faster than I have. I was a 30 year old man with 50 year old knees. There was good news and bad news. The good news was that I could swim, bike run and not further 'damage' my knees. The bad news was there was no cure.
Several weeks later, I encountered a cyclist and Sports Doctor Randy Molo in the Pinoy Roadies forum. I went to see him at his clinic, and upon examination, he was surprised to notice that despite my old injuries, my knees were quite stable. He then lectured me about VMO strengthening and how it might help me.
Several weeks later, I encountered a cyclist and Sports Doctor Randy Molo in the Pinoy Roadies forum. I went to see him at his clinic, and upon examination, he was surprised to notice that despite my old injuries, my knees were quite stable. He then lectured me about VMO strengthening and how it might help me.
Taken from www.sportsinjuryclinic.net:
"VMO stands for Vastus Medialis Oblique (sometimes called obliquus). This is part of the Vastus Medialis muscle which is one of the four Quadriceps muscles of the thigh.
The fibres of VMO have a more oblique alignment than the other fibres of Vastus Medialis (hence the name!). It arises from the tendon of Adductor Magnus and converges to join the other Quadriceps muscles inserting via the patella tendon, to the tibial tuberosity at the top of the tibia (shin bone). The picture on the right shows the relative position of VMO, just above and to the inside of the knee cap.
VMO is an active and dynamic stabiliser of the patella. In healthy, pain free individuals the fibres of VMO are active throughout the range of movement. In patients with Patello-Femoral Knee Pain (Chondromalacia Patella) the fibres contract in phases, inconsistently and fatigue easily.
The specific role of VMO is to stabilise the patella within the patella groove and to control of the 'tracking' of the patella when the knee is bent and straightened. Mis-firing and weaknesses in the VMO cause mal-tracking of the patella and subsequent damage to surrounding structures and aching pain."
Finally, some hope! I googled more and found exercises to do... (Courtesy of http://www.ualberta.ca)
VMO Leg Lift - Sit holding the unaffected knee to the chest, with the affected leg straight forward. Turn the foot out at a 45 degree angle, lift the toes to the shin and contract the quads hard
VMO Leg Lift - Sit holding the unaffected knee to the chest, with the affected leg straight forward. Turn the foot out at a 45 degree angle, lift the toes to the shin and contract the quads hard
VMO Leg Lift Start Position
VMO Leg Lift End Position
VMO Leg Lift End Position (Front View)VMO Wall/Ball Squat - Lean against a sturdy wall with feet shoulder width apart and about 12 inches from wall. Squeeze a ball, roll or other firm object of similar size between the thighs.
VMO Ball Squat Start Position
VMO Ball Squat Start Position
VMO Ball Squat End Position
In the last few months, I have been virtually pain free! Thanks Doc Randy, you're a savior :)
Trivia - between my cousins and I, we have over 10 torn ACLs, 8 reconstructive surgeries, and a ton of knee stories.
Trivia - between my cousins and I, we have over 10 torn ACLs, 8 reconstructive surgeries, and a ton of knee stories.
10 comments:
Javy, I've always felt bad about that tackle and how much it took away from you. I'm really very glad to see you getting past the injury, years later. More power to you.
Hey Pippo!
All good buddy! Accidents happen :)
Thanks :)
Hi Javy, wow so inspiring to hear that you have worked your way into such great shape coming off an ACL. My buddy from DLSU, he won the MVP for UAAP Volleyball one year, tore his ACL and was never the same again. Very nice post man, I'm glad there is now a process where the VMO can actually be strengthened. Hope it works out for you. BTW was at Gold Loop last night, first run since Botak. SLow mo 5k :)
Cheers,
Luis
The ball squat helped me a lot in treating my knee injury 2 years ago. The PTs in the gym say it's good for the inner leg muscles. I was working out my outer leg muscles too much that it made my right patella rub against the bone beneath (which causes excruciating pain when running and stretching).
If you're not aware of it, some leg stances on squats, or inadequate training could result in leg muscle imbalance.
I hate spending the leaves in seeing the doctor. But I hate being away from my training more.
Hi Sir Javy, my name Quincy Reyes. I am the the account executive for adidas of Green Bulb Public Relations, the PR agency of adidas. We'd like to invite you for our event this coming August 7. It's our adiZero running launch. I can't seem to find your e-mail address so if you don't mind posting it here so as he can send you a formal invite and the details of the event.
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So that's what IT's called! I have chrondomalacia on my right knee and my ortho showed me several exercises to strengthen that particular muscle above the inner side of the knee. He said it's the one that tracks the patella. Good to know more about VMO, will try those exercises as well.
I had a quads rupture, then three months later I did it again. I've struggled the second time around though as severe wastage set in. But not one doctor could identify that my knee was weak and give me anything to focus on the VMO.
My physio kind of proved how weak my knee still was.
When looking at the VMO, despite the fact I could lift 35kg on the leg extension, my VMO was just not firing. Some websites, Doug Kelsey etc, will say that the quads are only controlled by one nerve therefore all muscles of the quad fire at the same time and VMO focussed exercises are a load of rubbish.
Only thing I know, since focussing harder on the VMO and getting it to fire, there are times I can actually move my knee and do leg extension without the horrible sounding crepitus.
Anyone any views on this?
Cya
Simon
Hi Javy. Thanks for posting this. My best friend is suffering from chondromalacia. He's having a terrible pain on his knee while sitted. It's been 4 months. Did you experience that? Would you have a tip to share? He's 46yrs old. Thanks = )
@Hazel,
Unfortunately I'm not a doctor. My injuries are all sports related. I would suggest he have himself checked. Good Luck!
I have chondomalacia, and it used to cause inexpressable pain when sitted. What I did was I googled some exsercizes on the net to strengthen VMO, and also I worked 2 days roofing doing extremely labourous work, extensive squatting with shigles, prolonged bent sitting, lifting weight, it voila it became like 70% better for me. Just 2 days. Oh, the rehab at clinic got it even worse.
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