At 09:22 29/03/99 -0800, you wrote:
>I attended the Combined Sections Meeting and took a one day course on
>patella femoral pain. The presenters emphasized that research has failed
>to show any exercise to strengthen the VMO more than the rest of the
>Quads.
In my opinion, this conception of selective "strengthening" of VMO is
conceptually flawed. In patients with PFJ pain syndrome, it is not the
strength, but activation pattern of the VMO/VL that is at fault. If the VMO
is not being activated early enough during weightbearing flexion then the
VL (larger xs area) will cause lateral maltracking. Standard rehab for this
in Australia is to retrain selective timing/activation of VMO by using dual
channel biofeedback in functional, weightbearing positions (eg lunge, 1/4
squat, stepdowns), progressing to in-place plyometrics. Patellofemoral
taping (a la McConnell) is vital if maltracking of glide or tilt variety is
present.
I cannot see how "strength" of the different components of the quads could
be measured in isolation. Rather, EMG can be measured, which as we know
does not measure force or torque but amount and timing of central
activation of the muscle
Matt McEwan
B App Sc (Physio)
M App Sc (Sports Physio)
Sydney, Australia
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