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For what it’s worth, I’ll further elaborate on the effects of VMO/isometric quad contractions, as these sometimes provide great positive change. There are typically two outcomes when I work these: 1) the muscle group is off tension, I can contract the quad without any restriction and the results are positive – I can see the kneecap being “pulled” with the contraction as it should. 2) the whole area above the knee feels like it’s full of adhesions and is resisting proper contraction – the kneecap doesn’t really move in this case and I know I’m not making positive change.