Secondary Logo

Institutional members access full text with Ovid®

Regional Vastus Medialis and Vastus Lateralis Activation in Females with Patellofemoral Pain


Medicine & Science in Sports & Exercise: March 2019 - Volume 51 - Issue 3 - p 411–420
doi: 10.1249/MSS.0000000000001810

Introduction This study aimed to investigate whether regional activation patterns in the vasti muscles differ between females with and without patellofemoral pain (PFP), and whether muscle activation patterns correlate with knee extension strength.

Methods Thirty-six females with PFP and 20 pain-free controls performed a standardized knee flexion–extension task. The activation of vastus medialis (VM) and vastus lateralis (VL) was collected using high-density surface EMG and analyzed using principal component (PC) analysis. Spatial locations and temporal coefficients of the PC, and the percent variance they explain, were compared between groups and between the concentric and the eccentric phases of the movement. Correlations were assessed between PC features and knee extension strength.

Results The spatial weights of PC1 (general vasti activation) and PC2 (reflecting vastus-specific activation) were similar between groups (R > 0.95). Activation patterns in PFP were less complex than controls. Fewer PC features were necessary to reconstruct 90% of the signal for PFP participants in the concentric phase (P < 0.05), and the difference in bias of activation to VM (concentric phase) or VL (eccentric phase) was less between phases for PFP participants (P < 0.05). Smaller difference in vastus-specific activation in concentric and eccentric phases (less task specificity of VM/VL coordination) was related to greater maximal knee extension strength (P < 0.05, R < −0.43).

Conclusion These data suggest PFP involves a simpler control strategy of VM and VL. The inverse association between task specificity and maximal knee extension strength suggests different presentations of PFP: lower knee extension strength but VM/VL coordination task specificity comparable with controls, or knee extension strength comparable with controls but lower VM/VL coordination task specificity.

1Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, CANADA;

2Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, CANADA;

3School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, St. Lucia, AUSTRALIA;

4Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, CANADA; and

5Faculty of Health Sciences, University of Western Ontario, London, Ontario, CANADA

Address for correspondence: S. Jayne Garland, Ph.D., P.T., Faculty of Health Sciences, University of Western Ontario, 200 Arthur & Sonia Labatt Health Sciences Bldg., 1151 Richmond St., London, ON, Canada N6A 5B9; E-mail:

Submitted for publication April 2018.

Accepted for publication October 2018.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2019 American College of Sports Medicine