Active Care Rehab

VMO Exercises

I have only found one VMO exercise that consistently activates the VMO. Oh, and it does a number of the gluteus as well.

Diagonal Sit Backs








    1. Start with the patient on one knee and heel directly under opposite buttocks. (right knee on the ground with right heel in line with left buttocks)
    2. Now the leg should be at a 45 degree angle, slight hip external rotation.
    3. Instruct the patient to perform a brace & breathe and slow start to sit back onto their heel. Do not have them go into lumbar flexion.
    4. They may not be able to touch their heel.
    5. Return to the starting position and repeat.



  • No flexion or posterior pelvic tilting should be noted.
  • The arms can be raised for balance.
  • This should be felt in the VMO and gluts.



Active Care Rehab

Knee Cap Pain

imagesPatellofermoral Pain Syndrome, also called retropatella pain,  is successfully treated in more than 2/3 of cases with conservative treatments including rehabilitation. The goal of these programs should be to reduce pain and restore function of the foot, knee, and hip. A classic sign of PFPS is pain in the knees while sitting for long periods of time and reduction of pain when standing.

The exact cause of patellafemormal pain syndrome is debated by many different specialists. Many believe that weakness in the VMO or medial/inside quad muscle causes abnormal movement of the knee cap and leads to pain and dysfunction. Exercises to strengthen the VMO are commonly preformed but these exercises only make the underlying dysfunction worse.

Current research shows that the true cause of PFPS is not the abnormal movement of the knee cap but the abnormal movement of the femur under the knee cap. This abnormal movement is caused by weakness in the hip muscles, which allow increased inward movement of the leg. Not only the hip but the foot can increase one’s risk of developing PFPS. Loss of motion of the ankle joint or major excessive pronation or supination of the foot can increase the stress on the knee and lead to pain under the knee cap.
Braces and straps can help decrease symptoms.

For PFPS exercises click here.


Yours in health,


Dr. Justin Hildebrand