Start by sitting against a wall with legs extended in front, and with a blanket or sticky mat rolled up under the knees (see photo). The roll under the knees is very important as it prevents hyperextension while contracting the quadriceps muscles, and is helpful in initially locating the vastus medialis (the VM).
Place your fingertips about one inch above your knee caps, then move your fingers about one and a half inches medially (to the inner thigh). Contract the quadriceps muscles and try to feel the muscle underneath your fingertips contracting. It may take a while to find and contract this muscle. Try pressing the knee into the roll, or turning the thighbone in or out a little from the hip. (If students find it difficult to locate this muscle, take the time to help them find it, so they will be able to practice on their own.)
Once the muscle has been found, contract and hold it for about eight seconds. Release and repeat three times. As long as the symptoms of knee pain or discomfort are still present, repeat the sets at least three times a day. Do not exceed 3–4 repetitions at one time, or else you may fatigue the muscle. A fatigued muscle is unable to support the joint properly, and the idea is to create more stability, not less! However, you may repeat the sets more often throughout the day, up to fifteen times. The muscle should feel “rock hard” under the fingertips; that may be difficult to achieve at first, but is necessary to strive for as the VM needs to feel at least as strongly contracted as the other quadriceps muscles.
As you gain more control and can easily contract the VM, you can practice these contractions in other positions: sitting in a chair, in bed before rising in the morning, even while sitting at a stoplight while driving your car. Gradually you should be able to consciously contract the VM during other activities, such as practicing yoga or hiking.
See Keeping on Track with Knees for tips on anatomy, prevention of injuries and rehabilitation of knees..