Whether you’re a seasoned bodybuilder or someone that was just recently diagnosed with a knee injury, there is no doubt that you’ve heard the name “vastus medialis” mentioned at some point.
This is because the vastus medialis is a major portion of the quadriceps femoris; of which is a four-headed muscle group that wraps around the front of the femur and is largely responsible for movement of the legs.
The vastus medialis can be exercised with heavy quadriceps-targeting exercises like lunges and machine leg extensions, or otherwise rehabilitated with resistance band terminal knee extensions - just a few examples of the many exercises targeting this particular muscle group.
The vastus medialis is the “tear-drop” portion of the quadriceps femoris muscle, wherein it attaches to the kneecap at the deepest level and is responsible for the leg extension biomechanic.
Weakness or damage to this particular muscle can result in knee instability and pain - two symptoms that may be remedied with targeted resistance in the form of exercise.
Even if you are entirely healthy and have no existing knee issues however, training the vastus medialis directly is still worthwhile, as it is considered to be essential for developing aesthetically pleasing and functional quadriceps.
The vastus medialis largely governs the stability and extension of the patellar joint, meaning any weakness of this muscle can result in potentially life-altering injuries.
Furthermore, athletes and bodybuilders will wish to target this portion of the quadriceps femoris in particular, as it is essential for improving the thickness and symmetry of the leg muscles, as well as for a variety of athletic movements like sprinting and jumping.
The vastus medialis is an essential muscle for practically any athletic sport, wherein it will play a role in producing power from the legs and stabilizing the knee joint during periods of high-intensity exercise.
In particular, athletes whose chosen sport involves regular extension of the knee - or otherwise regular stabilization of the body in a standing position - will benefit the most from training their vastus medialis.
While regular athletic training is already sufficient for developing strong and effective vastus medialis muscles, performing more targeted activation can occasionally be a necessary step for taking the athlete’s physical abilities to the next level.
A large majority of knee weakness cases are due to weakened vastus medialis muscles - either as a result of acute injury or the natural degenerative effects of age.
Fortunately, injuries as a result of muscular weakness are among one of the easiest to rehabilitate, with these particular cases only requiring a strengthening of the vastus medialis muscles.
Even for individuals who do not have a history of knee pain or similar symptoms, reinforcement of the vastus medialis as a preventative measure can easily reduce the risk of knee injury in the future - be it from acute injury or age.
Regular exercisers in particular will wish to take advantage of this, as injuries of the knee joint are quite common in active individuals and are largely preventable through preventative work and following correct exercise form.
The majority of the vastus medialis is located above the knee, beneath the other muscles of the quadriceps femoris muscle group.
For bodybuilders and individuals wishing to increase the relative size of their legs, direct training of the vastus medialis can greatly improve the thickness of their thighs - especially around the bottom of the leg, where the femur meets the patellar joint, an area that is often narrow in untrained individuals.
Furthermore, at the lower levels of body fat composition, the vastus medialis produces a “teardrop” shape along the inner side of the thigh, a visual considered to be aesthetically pleasing and quite important in competitive bodybuilding.
Considering the fact that the vastus medialis is responsible for stabilization of the knee joint during partial or terminal extension, it is no surprise that reinforcement of this biomechanic can result in greater stability during other forms of exercise.
Heavy movements involving knee extension like the barbell push press, step-up or barbell snatch can all directly benefit from a strengthened pair of vastus medialis muscles, reducing isometric contraction of other muscle groups and allowing for more energy to be driven towards actual force production instead.
In short, training the vastus medialis can result in heavier repetitions of other seemingly unrelated exercises that draw stability from the lower body, especially those of a more explosive nature.
The terminal knee extension exercise is a staple of physical rehabilitation programs, wherein the vastus medialis muscle is targeted with a resistance band so as to reinforce the knee joint and any surrounding structures therein.
Video Credit: Cornell Physical Therapy
Generally, this particular exercise does not see much use in a non-clinical setting due to there being more effective exercises for inducing muscular hypertrophy of the quadriceps femoris muscle group.
The terminal knee extension exercise is solely meant to be used as a rehabilitative exercise for patients with a history of knee instability or pain, wherein the exercise is meant to reinforce the quadriceps femoris muscle as a whole and to reduce the severity of symptoms in a non-invasive manner.
To begin performing terminal knee extensions, the exerciser will wrap a resistance band around a stable object with the other end around the back of the knee.
Facing the object anchoring the resistance band, the exerciser will fully extend the unwrapped knee and slightly bend the other, pulling this knee backwards against the resistance and squeezing their quadriceps muscle of the same leg.
If performed correctly, the exerciser will feel tension along the upper portion of their knee as the vastus medialis is contracted.
After holding this tension for a count, they will then allow the resistance to slowly pull the knee back to its starting position, completing a repetition of terminal knee extensions.
The term “leg extension exercise” refers to a number of different resistance exercises that make use of the leg extension biomechanic to isolate the muscles of the quadriceps femoris.
Most frequently, this equates to the leg extension exercise machine, a resistance machine that applies pressure to the distal part of the lower limbs so as to force the quadriceps femoris to produce counter-resistance, thereby recruiting the vastus medialis to great effect.
Note that there are indeed other forms of leg extension exercises, such as those performed with ankle weights or resistance bands - all of which feature the same general form and biomechanics, and are usually only differentiated by the type of equipment in use.
Leg extension exercises are most frequently performed for the purposes of improving quadriceps femoris muscle mass and strength, though occasionally they may be used as a rehabilitative tool for individuals with poor knee stability or weakened connective tissues in the area.
To begin performing the leg extension exercise with a leg extension machine, the exerciser will hook their ankles beneath the padded surface at the distal end of the machine as they sit within it.
Then, grasping the handles for stability, the exerciser will push their feet upwards as they squeeze the quadriceps femoris - extending the legs to a straight line against the resistance of the machine.
Once the knees are in a state of near full-extension, the exerciser will allow their legs to once again return to the starting position while controlling this descent in a slow and careful manner.
To maximize recruitment of the vastus medialis muscle during a squat repetition, increasing the time under tension and range of action in regards to the quadriceps femoris is vital.
This means altering the standard stance of a barbell squat in such a manner that greater resistance is placed on the knee joint, with the vastus medialis being recruited to a greater degree so as to compensate for this shift in tension.
One easy method of achieving this is to draw the legs closer together while still maintaining an outward knee-pelvis angle, ensuring that the risk of dislocation and patellar damage is minimized while increasing vastus medialis recruitment throughout the movement.
Narrow stance squats are most often performed by powerlifters and similar types of strength athletes in order to maximize time under tension or otherwise correct their squat execution.
Furthermore, individuals who are unable to perform barbell squats can also make use of a narrow stance smith machine squat or leg press, making narrow stance squats a relatively convenient vastus medialis training method.
Performing a narrow stance squat is much the same as performing a conventional squat, only with the feet set somewhat closer together.
Unracking a loaded barbell and stepping into the cleared space of the rack, the exerciser will set their feet as close together as they comfortably can while remaining balanced, prior to bracing their core and descending at the hips and knees simultaneously.
Exercisers should ensure that they are facing forward and that the spine is maintained at a neutral angle throughout the entirety of the repetition.
Once the knees have reached parallel with the pelvis, the exerciser can then press through their heels and return to the original standing position, having completed a repetition of narrow stance squats.
A variation of the famous deadlift exercise with greater focus on the quadriceps muscles, the sumo deadlift is a free weight compound exercise performed with the use of a barbell and very high amounts of weight so as to train the entirety of the body in a single powerful movement.
In terms of vastus medialis recruitment, the sumo deadlift is known for recruiting the quadriceps to a larger extent than the conventional deadlift due to the more outward-facing angle of the knees, as well as the fact that the exerciser’s torso will generally be further forward during the initial pull of the exercise, thereby deriving greater power from the legs as well.
The sumo deadlift is performed by serious weightlifters for the purpose of full-body strength development, as well as inducing significant hypertrophy of the posterior chain.
Furthermore, athletes will often perform the sumo deadlift or conventional deadlift as a major part of the explosiveness training block, with which it also occasionally fills the role of a conditioning tool as well.
To begin performing a sumo deadlift, the exerciser will position themselves facing the loaded barbell with their feet set wider than hip-width apart, the knees as in-line with the feet as possible.
Then, thrusting the pelvis back and pushing the chest out, the exerciser will lower themselves and grasp the bar in a double-overhand grip, ensuring that their spine remains straight and neutral prior to even beginning the repetition.
Pushing through the heels and hips, the exerciser will then pull the barbell from the floor, only stopping once they have reached a near fully extended position.
Holding this position for a count, they will then release the barbell from their grip, thereby completing the repetition.
Another free weight compound exercise meant to target the muscles of the quadriceps femoris with resistance, lunges are particularly effective at training the vastus medialis due to the full range of motion exerted with the knee during each repetition.
In particular, bodybuilders are quite fond of lunge and split squat exercises so as to further develop the size of their quadriceps “tear drop” by inducing muscular hypertrophy of the vastus medialis, further evidence of the effectiveness therein.
Lunges are meant to act as a secondary compound exercise targeting the entirety of the legs, though they are often favored for quadriceps recruitment in particular due to the distribution of resistance throughout the exercise.
To perform a repetition of lunges, the exerciser will begin by standing upright with their feet a natural distance apart. If intending to perform the weighted variation of lunges, the weights should be held in both hands of the exerciser by this point.
Engaging the core and facing the head forward, the exerciser will then make an exaggerated step forward, bending the posterior knee until it is nearly parallel with the floor. The anterior thigh should also be parallel to the floor due to the distance between the two legs.
All that is required after achieving this position is to return to a standing position, and then further repeat the movement in a mirrored fashion.
And there you have it, a few examples of the most effective vastus medialis exercises available.
If you still haven’t found a suitable exercise for your needs, there’s no reason to worry - plenty of other exercises are capable of recruiting this tear-drop shaped muscle, many of which will undoubtedly fit whatever niche requirements your training calls for.
As always, ensure that you are following proper training programming and exercise form.
Even if the quadriceps are considered to be one of the strongest muscle groups in the body, it does not mean that you are safe from injury - always practice safe training methodology, especially if unfamiliar with an exercise.
1. Galtier, B., Buillot, M. & Vanneuville, G. Anatomical basis of the role of vastus medialis muscle in femoro-patellar degenerative arthropathy. Surg Radiol Anat 17, 7–11 (1995). https://doi.org/10.1007/BF01629491
2. Lee TK, Park SM, Yun SB, Lee AR, Lee YS, Yong MS. Analysis of vastus lateralis and vastus medialis oblique muscle activation during squat exercise with and without a variety of tools in normal adults. J Phys Ther Sci. 2016 Mar;28(3):1071-3. doi: 10.1589/jpts.28.1071. Epub 2016 Mar 31. PMID: 27134414; PMCID: PMC4842426.