May 07, 2021
Have you ever seen those lifters with an excellent pair of quadriceps, and they have that little teardrop muscle right above their knee? That’s the vastus medialis muscle; one of four muscles that make up the quadricep. And yes, it’s often referred to as the “teardrop muscle.” Having a developed vastus medialis muscle is essential for strength and aesthetics but also is plays a primary role in maintaining a healthy and pain-free knee. Having this muscle developed is a true sign of one who doesn’t skip leg day. In this article, we will go over the:
Let’s get into it…
Before we get into the vastus medialis as a solitary muscle, we must look at it as just one muscle that compromises the quadriceps. This is because the vastus medialis never works alone and is always in unison with these other muscles. As mentioned, the quadriceps actually comprises four different muscles (quad=4) that function together to manipulate the legs.
All four of these muscles collectively lay on the upper thigh on top of the femur bone. The main function of the quadriceps is to extend the knee. However, it also plays a role in flexion of the hips, mainly acting by bringing the leg upwards which is seen during sprinting. This makes it essential in developing this muscle for athletic performance.
1) Vastus lateralis muscle: The vastus lateralis is the largest and most powerful muscle that makes up the quadricep. It sits on the outside of the leg and comes together inward towards the knee. This is the muscle that appears as a lump on the outside of the leg across from the “teardrop”.
2) Rectus femoris muscle: The rectus femoris is a large muscle that lays in the middle of the upper thigh between the vastus lateralis and vastus midialis. It’s shape is what’s known as “fusiform” in that it expands out into a cylindrical form and then tapers back. In addition to extending the leg, it it is also involved in the flexion of the hip/
3) Vastus medialis: The vastus medialis gets its name as it sits medially on the thigh or, toward the middle. Its main job is to help extend the knee and aid in tracking the patella.
4) Vastus intermedius muscle: The vastus intermedius lays underneath the rectus femoris on the upper two-thirds of the thigh. It is the deepest muscle that comprises the quadriceps and hardest to stretch.
These are the four muscles of the quadriceps. None of them work in unison, yet all have slightly different roles. Together, they make up one of the most powerful muscles in the human body. While each is unique, we’re now going to dive a little deeper into the vastus medialis.
The vastus medialis originates from the backside of the femur and traverses down the entire bone. It eventually reaches the bottom where it attaches to the middle of the “knee bone” or patella. While it works with all four quadricep muscles, it’s relationship with the vastus lateralis (which sits on the opposite side of the patella) is most dynamic. This is because the two of them act together by pulling the patella in opposite directions. By doing so, this keeps the patella in proper alignment.
Regardless of your goal or sport, training the vastus medialis is going to make a drastic impact on your development. It’s important to remember that it is impossible to specifically isolate this muscle as all exercises will be strengthening the quadriceps as a whole. Being that the quadriceps are the primary extensor of the lower leg, it plays a critical role in the vast majority of movements.
However, this article will try to isolate the specific importance that this solitary muscle plays. Even as part of the quad, it has a few specific attributes to the game.
1) Aesthetics: “Don’t skip leg day” is a meme in the fitness world which is generally aimed at trainees who are sporting legs that possess less than desirable development. That and “chicken legs”. That in itself is enough to illustrate that small legs aren't aesthetically pleasing. Having developed quads is a sign of time and commitment in the gym and is actually desirable by both men and women. Aesthetically, speaking the bulk of the thigh from the front comes from developed vastus lateralis and the vastus medialis.
If you were to do a quick google search, you would find that many trainees specifically look how to develop that “teardrop muscle above the knee”. They are talking about the vastus medialsi. This muscle really accents the entire thigh when you have spent the time to beef it up
2) Improved Performance: As mentioned, the quadriceps as a whole are critical to human performance. Athletes from all sports, even dancers who need to jump, benefit from having stronger quadriceps muscles. More so, if you are wanting to stay injury free during athletic events, you’ll also want developed quadriceps. Along with the hamstrings, the quadriceps make up a good portion of injuries seen in athletes.
Again, the vastus medialis is part of the quadriceps, so even if you are only concerned with the aesthetics, you will still receive the performance benefits.
3) Knee Stability: Providing a solid structure for the knee joint and mitigating knee injury is what makes the vastus medialis really stand out from the other muscles of the quadriceps. People who have a more developed vastus medialis have been found to be less likely to develop knee pain (study).
Specifically, a weak or imbalance in the vastus medialis has been found to be the primary cause of what’s know as patellofemoral pain syndrome. This makes it the main muscle that is examined and addressed in patients suffering from this pain.
So you know why you need a developed teardrop. Now let’s look at some of the best exercises (and modifications) you can use to specifically hit it. For example, some studies have shown that performing exercises with either a neutral foot position or externally rotated will result in the best activation of the vastus medialis.
Other studies have suggested that performing squat variations with isometric hip adduction will create higher activation as well. This is because the fibers at the bottom of the vastus medialis are connected to the adductor muscles. This means that their activation causes a greater base for the vastus medialis to contract from.
Hip adduction is when you bring your knees in towards each other.
One thing to keep in mind with exercise selection is that the vastus medialis has greater activation with greater flexion angles from 60-90 degrees. Therefore, selecting movements that create greater amounts of flexion will cause greater firing of the muscle fibers.
This should give you a better idea of the function of vastus medialis and some factors to employ to target it.
The wall sit with hip adduction is a great exercise for beginners or as a finisher to your leg workout. The wall sit effectively utilizes an isometric contraction in your legs to support the body in a sitting position against a wall. It burns but is a very efficient way to build strength in the legs. Still, it can be used for those just beginning their weightlifting journey or can also be used for rehab or those who have issues that don’t allow them to do squats. To create hip adduction, place an object in between the legs (i.e. medicine ball or wide foam roller) that requires the trainee to squeeze their legs together. Be sure it is of an appropriate diameter.
Tip: Sit down on the wall so that your legs are parallel with the floor. Often, trainees will “cheat” by sitting too high. Use time to adjust your load (i.e. 3x 0:30 seconds).
The squat is the king of legs. It’s the best multi-joint exercise for maximal leg development. The squat alone works excellent as you are able to put maximal load on your legs which is needed for muscle growth. However, if you want to try and activate your vastus medialis a bit more, do the same as the exercise above and add in hip adduction by placing a ball between your legs. When you begin, use lighter weight (i.e. either bodyweight squats or light dumbbells in each hand) until you become familiar with the movement.
Tip: Start with body squats until you become familiar with the movement AND you find an appropriate apparatus for hip adduction.
More squats. Just another variation of this awesome exercise. When performing squats, everyone’s foot position will vary according to their specific body structure. When wanting to focus on the vastus medialis, set up your feet with your feet rotate outwards a little more, around 40-45˚. Keep in mind that some trainees can’t do this because of their joints. Never force a movement that feels uncomfortable.
In order to activate the quadriceps to a higher degree, there needs to be a larger range of motion and flexion. This is done by using a narrow stance. The same concept applies to either a squat or leg press, making it easy to utilize in both exercises. You want to aim at getting your feet as close together while being able to still maintain balance. There is no need to have your feet actually touch, but they should be pretty close.
Having the heels elevated while extending the leg may cause higher activation in the vastus medialis. This can easily be done with squats and is actually often seen to assist trainees who have mobility issues. To perform this, simply place two small plates behind you when you squat. Once you un-rack the bar, place your heels on the plates to elevate them. Now perform squats as normal.
Tip: Be sure to also implement normal squats so that you do not overdevelop the quads while minimizing hamstring activation.
Related: Heel Elevated Squat Exercise Guide
Remember that the vastus medialis will have more activation at the lower end of the squat when there is more flexion. Therefore, you can take advantage of this by performing 1.25 squats or pulse squats.
A 1.25 squat is basically just a squat. However, with each rep, you go down, then come up 1/4th the distance then go back down before coming back all the way up (and that's one rep).
A pulse squat is the same idea but may contain 2-5 1/4th reps (within the one main rep) before coming back up.
This is a favorite exercise to do, and you definitely feel the burn right where you want it. The sumo deadlift with dumbbell or pile squats are amazing exercises to focus on the vastus medialis. You can perform this by holding two dumbbells but using one seems to work better as it’s easier to hold and allows you to use more weight. As for your stance, a sumo squat has a wide stance (approx. 1.5x shoulder width with your feet rotated outward) and a plie squat is even a little wider than the sumo (approx. 2x shoulder width with your feet rotated almost all the way out to the sides).
Tip: Use a large dumbbell and start by flipping it on one end. You can then grab the upper end with both hands. This works great with high reps.
Related: Best Dumbbell Exercises for Quads
The leg press is one of the best machine exercises that are used extensively among the best bodybuilders and lifters in the world. At the same time, it’s also a great supplemental exercise for beginners to use heavier loads while they learn the biomechanics of the squat. This is because sitting position essentially mitigates the complex biomechanics seen in a barbell squat. When performing this exercise, use a stance with externally rotated hips (feet pointing outward at about 45˚).
The Bulgarian squat is infamous for causing intense activation of the quadriceps. Due to the body's positioning, it places a tremendous stretch on the vastus medialis, making it a prime pick for those wanting to grow this muscle. If you don't know what a Bulgarian squat is, it is a split squat that has your back foot up on a weight bench (or platform of similar height).
Tip: Start sloooowly with these as they are intense. If you are a beginner, start with normal split squats before you progress.
The split squat is another great exercise for overall quad development. To increase the stretch of the vastus medialis, elevate the forward leg slightly. The range will depend on the trainee, but 2-4” would work for most people. Again, this will create a larger ROM, which is what’s needed for growth of the vastus medialis as it has more activation during ranges with a smaller joint angle.
Tip: Start with a lower ledge and then progress to increasing the height
Everyone should be doing lunges regardless of their goal as it’s great at isolating the quads. It’s a similar motion to the Bulgarian squat and split squat so you should probably see a pattern with these. Where the lunge is especially important in strengthening the vastus medialis is that it adds an element of instability as you walk. This extra stimulus will go a long way in preparing the muscle to be able to stabilize the knee during real world activity.
Still, lunge variations like stationary lunges (aka split squats) and reverse lunges can both play a role in the overall development of your quadriceps.
Tip: These work great as a finisher with only bodyweight. When you do want to add load, dumbbells are a bit safer PLUS it increases the need of stability.
If you have bad knees, you'll want to check out these lunge alternatives.
For this movement, you will need a somewhat special implement known as a slant board. This is basically a wedge that you place your foot on. This allows you to stand with the weight on the balls of your foot. To set this up, place a couple plates on the ground so that the total height is around 6 inches. Then place the slant board (or variation of it) on top. Place one foot on the board and then bring up the rest of the body. It is more or less a single leg squat with a very small range of motion and your weight towards the ball of your feet.
Because the Poliquin step-up has such a small ROM, these are done with high reps. Keep in mind that these can be used as a rehabilitation exercises or as a transition exercise to The Peterson Step Up below..
The Peterson step up is essentially the Poliquin step up but rather than a slant board you have a flat platform. It also may have a larger ROM. This is a very hard exercise but will improve the function of vastus medialis greatly. Again, this is not an exercise to use heavy loads with and your own body weight will most likely be sufficient (more than sufficient) to start.
The drop lunge involves standing on a platform (can be just several inches high) and then doing a forward lunge (or reverse lunge) so the working leg comes down to the floor from the platform while the stationary leg stays on the platform. What this does is effectively increases the eccentric portion of the movement when a footsteps comes forward. This is important as it creates more time under tension. The eccentric portion of a movement has actually been found to be more responsible for muscle hypertrophy.
Tip: Do not use a load when you first do this exercise regardless of how strong you are, especially if using a large drop (a high platform). The difference in the drop can throw you off so spend some time using body weight only.
Step ups are great to hit the vastus medialis as they can allow a very large ROM. This obviously will differ depending on how high the step is. Remember that you will get more activation when there is 60-90 degree flexion. Some people want to do these loaded but often times, it's better to just do volume with body weight. This is because a common “error” is that a trainee will push off with the back leg. This is normal and will happen to an extent. However, when the intensity is increased, the propensity to push off is increased which ruins the point of the load. (There are some versions of step ups that this is actually a part of the movement).
Now that you have a list of the exercises to use, let’s look at the best way to set up a workout routine to maximize strength and hypertrophy. The same concepts are going to apply to training your vastus medialis as to any other muscle. As you saw, the exercises above range in their specificity. Some are all-around great quadricep exercises while some are specific to hit the vastus medialis. You will train the vastus medialis whenever you involve leg extension, so don’t fall into the trap where you think you need to prioritize it every single exercise. That being said, here’s a couple of examples of great lower body workouts that’s also centric to developing a huge teardrop.
Notice that this specific workout starts with bigger exercise and then begins to utilize “smaller” exercises as the session progresses. Further, it utilizes a wide range of reps of 5-20 while mostly staying in the hypertrophy range of 8+ reps. It’s always a good idea to train for strength and hypertrophy, but since you are wanting to make the muscle more visual, you should focus on hypertrophy training.
When trying to maximize growth, the vastus medialis responds very well to volume. In a study looked at the effect of a volume equated program divided into two sessions and four sessions. Interestingly, the vastus medialis was specifically found to grow using both frequencies (study), albeit the twice a week actually had more growth. This means that going hard for two days will give you the greatest benefits.
In order to maintain continued growth, always implement progressive overload into your training. This is simply the idea that you need to continually put a greater load on the muscle for it to keep growing (check out a more detailed article on the progressive overload principle here).
One major bonus of vastus medialis training (if you are wanting to focus on it) is that you can easily perform many of the exercises above at home. As mentioned, many of the exercises can be done just utilizing the body for sufficient stimulus. This includes exercises such as:
This can include exercise like:
Still want to work these in the same manner as a normal workout. The primary difference is you will not have as wide of a selection of resistance, so the reps will vary but will generally be higher.
That being said, let’s go over some general guidelines when training at home. Aim to do 3-4 sets of each exercise. However, instead of reps, work up until you hit about an 8 RPE on each set. RPE stands for “rate of perceived exertion” and is basically a scale to judge the intensity used. An RPE of 8 means that you’re working up to about 80-85% of max reps. It’s a bit of a guessing game, but utilizing this with the concept of progressive overload as your overarching guide and you’ll be great.
Time To Make Your Legs Cry
Similar to any muscle, if you want to make it grow, all you need to do is give it a little extra attention. The above exercises now give you the tools to do that for your vastus medialis during your next leg day. Now go make your quads tear up! On your legs...
Related: Best Quadriceps Exercises
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