Thanks everyone for keeping the great advice coming. The past week has yielded excellent positive change, and for the first time in a while I feel like my quads are alive and working as they should be. I can now contract the VMO with both legs on command without issue, and I no longer have pressure in the knee.
My lower body mobility still has a long way to go; it seems as though once I free up an area, the muscle quickly reverts back to it’s junky state. Trying to reverse years of abuse + lack of mobility work is challenging and intimidating, I wish I knew about this years ago, but better late than never!