FES for VMO recruitment

[jdslater]

Hi, Sorry if this has been posted elsewhere, (i couldn't see it anywhere)

I am currently looking into the effectiveness of FES on encouraging VMO recruitment and in particular for in the rehab of recurrent patella dislocations (was thinking for use in both recruitment as separate modality along side other strengthening Rx as well as incorporated within other tasks…for example during a squat) . I am also looking at a number of research articles online but was wondering whether anyone had any experiences or opinions they would like to share on the matter.

Thanks, Josh

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[ginger]

Josh, Re PFS and VMO stims,
looking to create permanent improvements to VMO recruitment must start and end with attention to the source of the femoral nerve irritation that produces both the patella area referred pain and the altered recruitment pattern. That being the mid lumbar spine, L3. attention to the ongoing spinal protective control there , to eliminate paravertebral tone and it's consequences, will quickly and permanently eliminate both the altered recruitment and the patella femoral pain. The method with the best prospect of effectiveness is any variant of the maitland method ( mulligan, maitland or Continuous Mobilisation).
The VMO problem is only a symptom of a readily treatable spinal condition , best seen as a non pathological, protective behaviour of the spine.
Cheers

[rod physio]

Just a different approach: I have tended not to directly work on VMO. I am finding that strengthening core and gluts, working on single leg stance stability and progressing to single leg squats (when the person is able to fully control through the core and hips) is having a better effect than trying to directly activate the VMO. Some studies are finding a strong link between the strength of the two areas.

[sarahkelly]

To Ginger,
So in this type of patient would mobilise L3 alone, or combine it with what Rod Physio is suggesting?