Vastus Lateralis: Difference between revisions

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== Description  ==
== Description  ==
[[File:Vastus lateralis muscle - Kenhub.png|alt=Vastus lateralis muscle (highlighted in green) - anterior view|right|frameless|500x500px|Vastus lateralis muscle (highlighted in green) - anterior view]]
The vastus lateralis muscle is located on the lateral side of the thigh. This muscle is the largest of the [[Quadriceps Muscle|quadriceps]] which includes: [[Rectus Femoris|rectus femoris]], [[Vastus Intermedius|vastus intermedius]], and [[Vastus Medialis|vastus medialis]]. Together, the quadriceps act on the [[knee]] and [[hip]] to promote movement as well as strength and stability. They provide power for and absorb the impact of daily activities such as walking, running, and jumping.


The vastus lateralis muscle is on the side of the thigh. This muscle is the largest of the quadriceps group (often called quads) which also includes the rectus femoris, the vastus intermedius, and the vastus medialis. Taken together, the muscles of the legs allow strength and stability. They provide power for and absorb the impact of daily activities such as walking, running, and jumping.<ref>http://www.healthline.com/human-body-maps/vastus-lateralis-muscle</ref>
Image: Vastus lateralis muscle (highlighted in green) - anterior view <ref >Vastus lateralis muscle (highlighted in green) - anterior view image - © Kenhub https://www.kenhub.com/en/study/main-muscles-of-lower-limb</ref>  


== Anatomy  ==
== Anatomy  ==
The vastus lateralis is an anterior muscle of the thigh, part of the quadriceps femoris group.


=== Origin  ===
=== Origin  ===


Upper intertrochanteric line, base of greater trochanter, lateral linea aspera, lateral supracondylar ridge and lateral intermuscular septum
Upper inter-trochanteric line, base of greater trochanter, lateral linea aspera, lateral supracondylar ridge and lateral intermuscular septum<ref name=":0">Gray HFRS, Gray's Anatomy 15th edition, New York, NY: Barnes & Noble,2010. p396-398</ref>


=== Insertion  ===
=== Insertion  ===


Lateral quadriceps tendon to patella, via ligamentum patellae into tubercle of tibia<ref>http://www.lumen.luc.edu/lumen/meded/grossanatomy/dissector/mml/vasl.htm</ref>
Lateral quadriceps tendon which attached onto the tibial tubercle.<ref name=":0" />  


=== Nerve Supply  ===
=== Nerve Supply  ===


Posterior division of femoral nerve (L3,4)
Posterior division of femoral nerve (L3,4)  


=== Blood Supply  ===
=== Blood Supply  ===
&nbsp; &nbsp; &nbsp;&nbsp;Lateral circumflex femoral artery&nbsp;<ref>http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/lower-body/vastus-lateralis</ref>


== Function  ==
== Function  ==


=== Actions  ===
=== Actions  ===
1. Extension of the knee


&nbsp;extension at knee
=== Functional contributions  ===
 
can abnormally displaced patella
 
=== Functional contributations ===
 
In everyday life, the quadricep muscle group as a whole functions to allow a person to squat, bend backwards, walk up or down stairs, and move from a standing to a seated position (or vice-versa). These muscles are not active while standing with the knees locked, but become active during the heel-strike and toe-off phases of walking.<ref name="www">http://www.triggerpointtherapist.com/blog/knee-pain-trigger-points/vastus-lateralis-trigger-points-quadriceps/</ref>


<br>
In everyday life, the quadriceps muscle group as a whole allows a person to stand up from sitting, walk up or down stairs along with basic walking and running. These muscles are not active while standing with knees fully extending, but become active during the heel-strike and toe-off phases of [[gait]].<ref>Bohm S, Marzilger R, Mersmann F, Santuz A, Arampatzis A. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864755/ Operating length and velocity of human vastus lateralis muscle during walking and running]. Scientific reports. 2018 Mar 22;8(1):5066.</ref>  


== Techniques ==
== Assessment ==


=== Palpation  ===
=== Palpation  ===


have client supine
In supine:
 
# Place palpating hand distal to greater trochanter  
place palpating hand distal to greater trochanter
# Get the patient to actively and isometrically contract quadriceps  
 
# Palpate the contracting muscle focusing on the lateral side to target vastus lateralis
ask the client to contract quadriceps femoris group&nbsp;
# Continue to palpate distally until the quadriceps tendon
 
continute palpating distally towards patella


=== Length Tension Testing / Stretching  ===
=== Length Tension Testing / Stretching  ===


*'''Standing&nbsp;<ref>http://www.teachpe.com/stretching/laying_quads.php</ref>'''
*'''Standing&nbsp;'''
 
Stand on one leg and pull the other foot up behind your bottom<br>Keep your knees together and push your hips forwards to increase the stretch <br>Hold for between 10 and 30 seconds
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;[[Image:Quad stretch.jpg|150x150px]]
 
*'''Laying'''
 
Lay on your front and pull one foot up to meet your buttocks <br>Hold for between 10 and 30 seconds
 
&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;[[Image:Lying quad stretch.jpg|200x200px]]
 
=== Strengthing ===
 
*'''Leg extension'''
Sit on the leg extension machine with your back against the pad and feet under the pads. Place the pads just above the feet.<br>Curl the legs up until you reach the top position.<br>Lower weight back to starting position. Lower legs should be vertical to the floor.
 
*'''Hack squats'''
Lay back in the hack squat machine with shoulders place on the pads.<br>Place feet about shoulder width apart (or where comfortable) with toes pointed out slightly.<br>Squat down until there is about a 90 degree angle in the knee joint as shown in the illustration.<br>Push back up until you are back in the starting position.<br>Repeat for recommended reps.
 
== Trigger Point Referral Pattern  ==
 
Pain may be felt over the full length of the lateral anterior (outside and front) thigh as well as behind the knee. Pain is also sometimes reported to feel like explosions up and down the thigh.A person with TrPs in the lateralis may have a stuck patella with pain that wraps up and around the lateral border of the patella and even up the thigh. TrPs in this muscle also make it painful to lie on the affected side and if done so, will disturb sleep.<ref>http://www.myofascialtherapy.org/symptom-checker/symptomcheck/symptom_leg_lateralis.html</ref><br>
 
[[Image:Vastus lateralis01.jpg|150x150px]]
 
== Management ==


*A tennis ball may be used by a person to treat their TrPs by laying on the side and placing the tennis ball between the outer thigh and the surface of the bed/floor.<ref name="WWW">http://www.triggerpointtherapist.com/blog/knee-pain-trigger-points/vastus-lateralis-trigger-points-quadriceps/</ref>
Stand on one leg and pull the other foot up behind your bottom<br>Keep your knees together and push your hips forwards to increase the stretch <br>Hold for between 10 and 30 seconds&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;
*Release by massage
*'''Lying'''


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
Lay on your front and pull one foot up to meet your buttocks <br>Hold for between 10 and 30 second
<div class="researchbox">
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1-7FJ7kkHKrOcU4ZsOMeCOgQWJBX0bpQKs7bguYF0-19OYxYtR!!|charset=UTF-8|short|max=10</rss>
</div>


== Resources  ==
== Clinical relevance ==
[[Patellofemoral Pain Syndrome|Patellofemoral pain syndrome]]


== References  ==
Some evidence has shown that in patients with patellofemoral pain syndrome vastus lateralis contracts prematurely when compared with vastus medialis which has been hypothesised to be a cause of knee pain. <ref>Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J. [https://www.sciencedirect.com/science/article/pii/S0003999301747375 Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome]. Archives of physical medicine and rehabilitation. 2001 Feb 1;82(2):183-9.</ref> In more recent studies this theory has not been clinically proven and vastus lateralis/medialis timing has been shown to be uneven in healthy test subjects. <ref>Chester R, Smith TO, Sweeting D, Dixon J, Wood S, Song F. [https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-9-64 The relative timing of VMO and VL in the aetiology of anterior knee pain: a systematic review and meta-analysis]. BMC musculoskeletal disorders. 2008 Dec;9(1):64.</ref>


References will automatically be added here, see [[Adding References|adding references tutorial]].
== References   ==


<references />  
<references />  


[[Category:Anatomy]] [[Category:Thigh]] [[Category:Muscles]]
[[Category:Anatomy]]  
[[Category:Muscles]]
[[Category:Hip]]
[[Category:Hip - Anatomy]]
[[Category:Hip - Muscles]]
[[Category:Knee]]
[[Category:Knee - Anatomy]]
[[Category:Knee - Muscles]]

Latest revision as of 07:38, 1 April 2022


Original Editor ­ Andeela Hafeez

Top Contributors - Andeela Hafeez, Abbey Wright, Evan Thomas, Joao Costa, WikiSysop, Kim Jackson and Lucinda hampton


Description[edit | edit source]

Vastus lateralis muscle (highlighted in green) - anterior view

The vastus lateralis muscle is located on the lateral side of the thigh. This muscle is the largest of the quadriceps which includes: rectus femoris, vastus intermedius, and vastus medialis. Together, the quadriceps act on the knee and hip to promote movement as well as strength and stability. They provide power for and absorb the impact of daily activities such as walking, running, and jumping.

Image: Vastus lateralis muscle (highlighted in green) - anterior view [1]

Anatomy[edit | edit source]

Origin[edit | edit source]

Upper inter-trochanteric line, base of greater trochanter, lateral linea aspera, lateral supracondylar ridge and lateral intermuscular septum[2]

Insertion[edit | edit source]

Lateral quadriceps tendon which attached onto the tibial tubercle.[2]

Nerve Supply[edit | edit source]

Posterior division of femoral nerve (L3,4)

Blood Supply[edit | edit source]

Function[edit | edit source]

Actions[edit | edit source]

1. Extension of the knee

Functional contributions[edit | edit source]

In everyday life, the quadriceps muscle group as a whole allows a person to stand up from sitting, walk up or down stairs along with basic walking and running. These muscles are not active while standing with knees fully extending, but become active during the heel-strike and toe-off phases of gait.[3]

Assessment[edit | edit source]

Palpation[edit | edit source]

In supine:

  1. Place palpating hand distal to greater trochanter
  2. Get the patient to actively and isometrically contract quadriceps
  3. Palpate the contracting muscle focusing on the lateral side to target vastus lateralis
  4. Continue to palpate distally until the quadriceps tendon

Length Tension Testing / Stretching[edit | edit source]

  • Standing 

Stand on one leg and pull the other foot up behind your bottom
Keep your knees together and push your hips forwards to increase the stretch
Hold for between 10 and 30 seconds                                              

  • Lying

Lay on your front and pull one foot up to meet your buttocks
Hold for between 10 and 30 second

Clinical relevance[edit | edit source]

Patellofemoral pain syndrome

Some evidence has shown that in patients with patellofemoral pain syndrome vastus lateralis contracts prematurely when compared with vastus medialis which has been hypothesised to be a cause of knee pain. [4] In more recent studies this theory has not been clinically proven and vastus lateralis/medialis timing has been shown to be uneven in healthy test subjects. [5]

References[edit | edit source]

  1. ↑ Vastus lateralis muscle (highlighted in green) - anterior view image - © Kenhub https://www.kenhub.com/en/study/main-muscles-of-lower-limb
  2. ↑ 2.0 2.1 Gray HFRS, Gray's Anatomy 15th edition, New York, NY: Barnes & Noble,2010. p396-398
  3. ↑ Bohm S, Marzilger R, Mersmann F, Santuz A, Arampatzis A. Operating length and velocity of human vastus lateralis muscle during walking and running. Scientific reports. 2018 Mar 22;8(1):5066.
  4. ↑ Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Archives of physical medicine and rehabilitation. 2001 Feb 1;82(2):183-9.
  5. ↑ Chester R, Smith TO, Sweeting D, Dixon J, Wood S, Song F. The relative timing of VMO and VL in the aetiology of anterior knee pain: a systematic review and meta-analysis. BMC musculoskeletal disorders. 2008 Dec;9(1):64.
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