Lieb and Perry used amputated limbs and cadaveric dissection to directly test the mechanical contributions of each quadriceps head to knee extension — specifically asking whether the VMO is responsible for the final 15 degrees of extension, as widely claimed in the clinical literature of the era.
When a patient after knee injury loses terminal extension and shows VMO wasting, don't target VMO isolation exercises — this paper shows both findings reflect global quadriceps weakness and a mechanical disadvantage in the last 15 degrees that affects all heads equally.
Rehab should focus on overall quadriceps strength, with VMO training reserved for its actual role: preventing lateral patellar subluxation.
Lieb and Perry used amputated limbs and cadaveric dissection to directly test the mechanical contributions of each quadriceps head to knee extension — specifically asking whether the VMO is responsible for the final 15 degrees of extension, as widely claimed in the clinical literature of the era.
When a patient after knee injury loses terminal extension and shows VMO wasting, don't target VMO isolation exercises — this paper shows both findings reflect global quadriceps weakness and a mechanical disadvantage in the last 15 degrees that affects all heads equally.
Rehab should focus on overall quadriceps strength, with VMO training reserved for its actual role: preventing lateral patellar subluxation.