The REHAB DEPARTMENT => General rehab issues and pain problems => Topic started by: kscope09 on January 11, 2010, 01:57:52 PM

Title: Is cycling good for the vmo
Post by: kscope09 on January 11, 2010, 01:57:52 PM
I've been having knee problems since February 2008 and have had several pts and a scope with a very highley respected OS.  Before my surgery I was seeing a pt who told me to cycle and said it would help my vmo as well as squeezing a ball between my knees.  After 3 months of this I had a huge vmo, but symptoms still persisted, the physio told me the pain was in my head and I saw an OS who reccommended the scope since the mri showed nothing.  I had a chrondoplasty on the mfc, plica exism and debridement of acl.  5 months later I don't have my old symp[toms but I'm not treally any better off, I still can kneel, run or do stairs and I could at least do stairs before the op.  My pt at the moment gives me slow squatts to do for the vmo.  Everytime I see him he just gives me the same exercise to do over and over again and I'm sicjk of them.  I asked aobut cycling and he said it couldn't help strengthen the vmo.

What I want to know is can it strengthen the vmo.  I had a much better vmo pre-op than I do now and I think it really made a difference, but this pt doesn't think it will.
Title: Re: Is cycling good for the vmo
Post by: Dad3 on January 11, 2010, 07:21:52 PM
The VMO is used to extend the leg that last 10%, so if your sitting on a bike and can get the leg to straighten as you do the rotation then i cant see how it wont help.

My OS told me to stand upright, stretch my foot out to the side and then bend my knee, this helps the VMO.
My PT said, straight leg lifts with a small amount of weight (such as leg weights) help. Also whilst doing these, bend the knee very slightly and straighten it - all helps the VMO.
My Pt also said that whilst watching TV/relaxing and i've got my leg out - put a small roll of material (towel/pillow etc) under my knee/calf/thigh etc and straighten and relax the knee - all helps with the VMO.

I've also just invested in a side-stepper - to help with my quads/hamstrings etc - i've found the action of doing this is also helping my VMO.

However, i tried today to make it down the stairs ala what a 'normal' person can - i ended up falling down the last half dozen as my knee gave way, so take it easy and be carefull - says me sitting here with a bag of ice on my knee  ::)  as i too am desperate to get my VMO back to pre-op conditions.
Title: Re: Is cycling good for the vmo
Post by: kscope09 on January 11, 2010, 07:45:01 PM
I'm lucky enough to live in a bungalow, do have a fews stairs, which i go up and down one at a time good leg up bad leg down.  I'm going to make sure I can go upstairs properly and get really confident with that before I tacle downstairs.  My pt has me stepping on and off copies of the yellow pages, but these are too easy and the few steps I have have no banister, so there is nothing in between too easy and two hard.
When I cycled pre-op it seemed to do me a world of good and I actually lost a few pounds, the problem is I broke the bike whilst trying to adjust the seat height so it means buying a new one.  (I'm talking about a stationary bike)
One other question about exercise bikes - When you have bad knees how do you get on and off them if the seat is high?  My pt is really highly respected but he doesn't seem to think much of swimming either, he just gives me the same squatts and tells me I'm doing everything right every time.

Sorry to hear about the fall, from posts i've read in the past it seams really common for people to re-injure themselves going down stairs, that's why I'm not even thinking of trying that yet.
Title: Re: Is cycling good for the vmo
Post by: Dad3 on January 12, 2010, 10:57:19 AM
Wow you are lucky to live in a bungalow, wish i did with my dodgy knee. ::)

I've kind of decided the same as you; get really good at going upstairs properly, before considering coming downstairs in the proper manner. At the moment it hurts like hell to go upstairs, but no pain, no gain as they say.

Have you tried a couple of catalogues - Argos catalogues are cheap (they give'em away!) you can sellotape 3/4/5/6/7 etc on top of each other/side by side and use these as a makeshift step. Just a thought.  ;) They've got a catalogue change in a week or so, so they'll be more than happy for you to take handfulls. ;)

Yep, cycling for me made me lose a few pounds, which is another reason why i've now restarted after the Xmas excess  ;D.
As for the exercise bike, i only have one bad knee, so its fairly easy for me to get on the bike first with my good knee at maximum flex (at the top of the rotation) and then i can just slide my right foot into the strap/loop of the pedal. The first few revolutions hurt the knee and calf, but its worth it.

As for swimming, cant help on that one just yet - my OS and PT have both recommended and booked me in for hydrotherapy - which i have weekly for the next 4 weeks. I can then attend any other pool in between and do the same exercises, at my own pace. As i understand it there are certain strokes which should be avoided, but i'm sure i'll find out more tomorrow. 
Title: Re: Is cycling good for the vmo
Post by: kscope09 on January 12, 2010, 12:25:13 PM
officially I have only the one bad knee but with all the extra work my left leg has been doing it has suffered.  An mri showed a sprain of the ACL.  Throughout most of my post op rehab on my right knee the left has felt really bad, sometimes worse, but it has not been so bad for the last month as apart from stairs I can walk quite evenly now and my left leg is not doing all the work anymore.  Basically I had a sprain, but because of the extra work the leg had to do it never got a chance to rest.  I'm not too worried about it at the moment, just keeping an eye on it.

As for cataloges I use a couple of old phone books and can step up and down onto them without any bother, this is my main exercise for getting me ready for stairs.  I'm going to use a third this week to simulate a deeper step.  TYhough I don't have too many steps to worry about at home there are steps everywhere else I go so I need to get them right just llike everyone else.

Would a brace help get me more confident with steps or would a brace seem like a step backwards in my case?
Title: Re: Is cycling good for the vmo
Post by: Dad3 on January 12, 2010, 02:02:59 PM
I had a brace fitted after my MFX and then a second one after my ACL and OATS. Both times they were locked into a straight leg position, as dictated by the OS. And to be honest both times it was a severe pain in the ass, sorry strike that, pain in the leg.  ::)

The brace would either slide down - (your leg is a triangle, wide at the top, thin at the bottom )- so you can guess where it ended up after a little movement.
Even after fitting by PT at the hospital, by the time i had crutch walked 30-40 yds down the corridor on the way home, it was already round my ankle. This may be the type of brace that caused it, but it never truly helped me, just hindered.

Officially, i have only one bad knee, as well. However my other knee hurts and crackles, but i want to get right leg sorted before i have to worry about the left.

IF your OS or PT has advised it then a brace is a good idea, it will provide support for the knee, but i wouldn't go willy-nilly splashing out lots of cash on a brace unless someone (a professional) had advised me to.

One last thing i found with a brace, probably not applicable to you in a bugalow, but i'll mention it anyway - i found the brace to be really cumbersome on stairs to the point that coming down stairs for instance, my brace would catch on the previous step, which would force my leg and therefore foot to be kind of 50/50 on step and off step. The brace just seemed so bulky, that i always felt like i was going to slide down the stairs  as my foot was never truly planted. But this just could of been me.  ;)
Title: Re: Is cycling good for the vmo
Post by: kscope09 on January 12, 2010, 02:44:46 PM
braces have never ocne been mentioned to me but I've noticed so many people using them that I wondered if I could benefit ffrom one.  I wouldn't use it at home, I don't use anything at home, but I thought if might be good for when I have to stand for a long time or walk a long way.  When I go out I always wear an elasticated support or the tubigrip I got after the op, but my os told me not to use anything.  Then again he said I'd be back into my normal activities after 8 weeks.  Now I'm 5 months and I feel like I can only dream of being back to normal.
Title: Re: Is cycling good for the vmo
Post by: Daemon on January 19, 2010, 09:55:43 PM
I had a discussion with someone just last night about a patella tracking issue he had
due to an under developed VMO.   In his case cycling was the *cause* of it.
He is an avid cyclist and was riding hundreds of miles a week, with a perfectly
sorted bike (custom built to his dimensions).  Cycling apparently works
the Rectus Femoris more than the Vastus Medialis (VMO), which makes
sense as you can't apply as much force during the last 20 degrees of
leg straightening (if you even get into that range much on a bike). 

His doc gave him a bunch of different exercises, many of them are
the same that I'm using for rehab following my patella fracture. 
Some are mentioned above, here's a couple others:
Mini-squats - stand sideways on one foot  on a small step (3-4 inches) with the other
foot hanging, and lower yourself down until the other foot touches the ground and raise again,
repeat 3 sets of 15-20 or so.  Basically it's working the VMO just in that 0-20  degree range.   

Leg straightening against a stretchy band - Stand upright with a stretchy band
around something stationary in front of you, and then behind the knee (with some padding)
then back up half a step to put tension on it.  Then bend and straighten the knee
under this constant tension, while making sure to fully tense the quads while
the leg is straight.   3 sets of 15 or whatever feels comfortable.   

Title: Re: Is cycling good for the vmo
Post by: Bazzak on April 27, 2010, 09:18:37 PM
backwards step ups... then add dumbells... that will hit your VMO.

backward tyre drags also hammer your vmo
Title: Re: Is cycling good for the vmo
Post by: smillie on April 29, 2010, 09:22:37 PM
My PT has me doing SLRs with ankle weights, but to specifically recruit the VMO, he has me set my quad and then angle my toe inward before lifting. 
Title: Re: Is cycling good for the vmo
Post by: Silkncardcrafts on May 18, 2010, 12:12:45 PM
Hi there,

Riding an exercise bike will definitely help strengthen your VMO and muscles around your knee. It is probably the best thing for building up your quads. Other things that may help are hydrotherapy and clinical pilates.

It really annoys me when physios or doctors say it is in your head. You wouldn't be seeking treatment if it wasn't real. What is wrong with these people ?

Good luck with your recovery.
Title: Re: Is cycling good for the vmo
Post by: jhchadwick on March 06, 2017, 05:06:12 AM
I was just told by Dr. Anthony Galea ( that cycling will change how the VMO versus lateral muscles fire. Cycle 1 hour per day for 6 months and the VMO will fire before the lateral muscles and lateral knee pain will be gone. After only one week I already have noticed a difference. After 30 years of seeing people, I conclude he is the best. He said we can hook me up to a machine to record muscle contraction to prove this. He was good enough for Tiger Woods, so he is good enough for me. I am so glad he never moved to the United States.