The vastus medialis tendon is the medial component of the quadriceps expansion, inserting into the medial border of the patella and the tibial tuberosity via the medial patellar retinaculum. The oblique fibres of the vastus medialis (VMO) insert at an angle of approximately 50-65 degrees to the long axis of the quadriceps, making them particularly effective at resisting lateral patellar subluxation. The most distal VMO fibres attach directly to the superomedial patella.
The vastus medialis tendon and specifically its oblique portion (VMO) is a primary target in physiotherapy for patellofemoral pain syndrome and patellar instability, where VMO atrophy contributes to lateral patellar tracking. Selective VMO strengthening using terminal knee extension and leg press at limited range is the cornerstone of non-surgical patellofemoral rehabilitation. The VMO insertion is also the proximal attachment of the medial patellofemoral ligament complex, making VMO strengthening doubly effective for medial patellar restraint.
Inhibition and atrophy of the vastus medialis oblique from knee pain or injury reduces medial patellar restraint and allows lateral patellar tilt and subluxation, managed with targeted VMO strengthening and hip external rotator exercises alongside patellofemoral bracing.
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