Month: December 2020

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VMO Specific Strengthening/Activation – not possible or necessary for rehab, performance, or aesthetics!

Intro (0:00)
Anatomy (0:12)

Patellofemoral Pain (1:28)
In the rehab world, the VMO became very popular in the treatment of patellofemoral pain because the thought was that patellar malalignment or maltracking was contributing to wear and tear of the patella leading to pain and dysfunction. So in order to treat this, the things pulling laterally on the patella like a “tight” IT Band had to be released while the things pulling medially like the VMO needed strengthening and neuromuscular re education. This theory hasn’t panned out.

And a lot of this is based on trying to find and change a 10ms difference in activation of the VMO. That’s .01 seconds. 1. Who cares? 2. It’s the chicken or egg scenario. Is maltracking causing your pain or is pain changing the way you move a bit?

To close the case on VMO specific training for patellofemoral pain, Smith and colleagues state “it is therefore recommended that clinicians should not focus on VMO strengthening” since it likely cannot be preferentially activated.

Performance/Aesthetics (3:57)
What about performance or aesthetics? Bodybuilders aspire to have that nice tear drop on the inside of their thigh.

Bodybuilders don’t just pick one exercise to train their lats. Instead, they have a rotation of several exercises because muscles might respond differently to different ranges of motion, contraction types, rep ranges, etc.

And how we perform an exercise can make a difference.

For example, Nunes and colleagues concluded that “head specific muscle hypertrophy may be obtained for the gastrocnemius” based on the foot positioning of the participants.

And the exercises we choose can make a difference.

Schoenfeld et al reported that the hamstrings can be regionally targeted through exercise selection – it matters if you’re doing a lying leg curl vs a stiff legged deadlift.

The rectus femoris doesn’t respond well to compound exercises that involve simultaneous hip and knee extension which I talked about in our reverse nordic video.

There’s not any good research, as I already mentioned, that shows that we can preferentially activate the VMO or that it would make any difference in the long run.

Chris Beardsley suggests larger ranges of motion “may cause slightly more vastus medialis growth due to longer working sarcomere lengths and stretch-mediated hypertrophy”

Takeaway (5:25)
So what’s my main takeaway? Whether it’s for pain, performance, or aesthetics, you shouldn’t be focusing on trying to strengthen or “re-educate” the VMO because it’s likely not possible to isolate or preferentially activate.

Patellofemoral pain responds to comprehensive hip AND knee strengthening and including a variety of exercises is likely best for performance and aesthetics as well. There are a lot of compound and isolation, weight bearing and non weight bearing exercises to choose from including single leg stepdowns, split squats, back squats, heel elevated squats, sissy squats, reverse nordics, leg extensions, etc.

Be consistent, use a large range of motion, and incorporate progressive overload and the vastus medialis will get worked plenty.
___
Research:
https://pubmed.ncbi.nlm.nih.gov/32735428/
https://pubmed.ncbi.nlm.nih.gov/19212898/
https://pubmed.ncbi.nlm.nih.gov/19090000/
https://pubmed.ncbi.nlm.nih.gov/24978835/
https://pubmed.ncbi.nlm.nih.gov/21487120/
https://pubmed.ncbi.nlm.nih.gov/19997004/
https://pubmed.ncbi.nlm.nih.gov/28264631/
https://pubmed.ncbi.nlm.nih.gov/28210658/
—–
Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only. If you are experiencing pain, please seek the appropriate healthcare professional.

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In today’s video I share a full day of training in Miami. Starting with a gym routine from a new strength program I’m working through, followed by a pitch session with some other pro’s who are also getting ready for next season. Enjoy!

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Soldiers assigned to the 25th Infantry Division and U.S. Army Hawaii, within the medical career field competed to earn the Expert Field Medical Badge on Schofield Barracks.

🎥 ➡️ Sgt. Gabriel Davis

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Chris Hitchko BS Kinesiology, CSCS, Teacher of trainers at Show Up Fitness (10 years total, 7 at National Personal Training Institute and 3-years at Show Up Fitness Personal Training Internship.) Show Up Fitness has private personal training studios in West Hollywood, Santa Monica, and San Diego. California. We’ve helped over 1,000 people pass the NASM-CPT with our study guide. You don’t need to read the textbook or read it from cover to cover. Pass the “best” personal training certification and then spend your time learning anatomy, movement, nutrition, programming and training clients to gain experience. The average certified personal trainer gets hired at Equinox, Lifetime Fitness, 24-hour Fitness, Crunch Fitness and quits within 12-months because they don’t understand the business side of training, programming or how to sell. At Show Up Fitness we teach the key movement patterns: Squat, Hinge, Push, Pull, Jump, and uni-lateral which translates into the main exercises in the gym: Bench Press, Squat, Deadlift, Military Press, Lunge, Hip Thrust, Pull-Up, Push-Up, Turkish Get-up, and dumbbell rows.

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Most Soldiers count the days until they become noncommissioned officers.

However, sometimes being in the “E4 Mafia” has its benefits.

Like in this case here at the Home of Champions. Specialists Alison Weisz, Sagen Maddalena, Kade Jackovich and Emily Stith recently got a rare treat: a ride with an aviation unit while they were training over Fort Benning, Ga.

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