Trigger Point Therapy for the Hamstrings

Because the hamstrings have their origin at the sitting bones - Long periods of sitting may affect their function

We rely on our hamstring muscles for walking, jogging, running and jumping. These are the workhorse muscles that enable us to flex our knees and extend our hips at the beginning of each step that we take. When we are walking, jogging or running, our hamstrings are antagonists to the quadriceps muscles in the action of deceleration of knee extension.

Anatomy

The hamstrings consist of three muscles. From medial to lateral they are the semimembranosus, semitendinosus, and biceps femoris.

Origin

Ischial tuberosity (sitting bone). Biceps femoris also originates from back of femur.

Insertion

Semimembranosus: back of medial condyle of tibia (upper side part of the tibia).

Semitendinosus: upper medial surface of shaft of the tibia.

Biceps femoris: lateral side of the head of bula. Lateral condyle of the tibia.

Action

Flex knee joint. Extend hip joint. Semimembranosus and semitendinosus also medially rotate (turn in the) lower leg when the knee is flexed.

Biceps femoris laterally rotates (turns out) lower leg when the knee is flexed.
Antagonists: Quadriceps.

Nerve

Branches of the sciatic nerve, L4, 5, S1, 2, 3.

Basic functional movement

During running, the hamstrings slow down the leg at the end of its forward swing and prevent the trunk from flexing at the hip joint.

Trigger points in the biceps femoris

Trigger points in the semimembranosus/semitendinosus

Trigger Point Referred Pain Patterns

Semimembranosus and semitendinosus: strong 10 cm zone of pain, inferior gluteal fold, with diffuse pain posteromedial legs to Achilles tendon area.

Biceps femoris: diffuse pain posteromedial legs, with strong 10 cm zone posterior to knee joint.

Indications

Posterior thigh pain sitting/walking (worse at night), tenderness in back of legs may cause limping, pain worse on sitting, post back surgery, hamstring pain cycling/soccer/ basketball/tennis/football.

Causes

Prolonged driving, improper sitting/ work chair that digs into back of thighs, hip surgery, sitting cross-legged, hip/knee/ankle injury/ fracture, leg casts, high-heeled shoes, PSLE, sacroiliac joint dysfunction, improper stretching before/after sport.

Differential Diagnosis

• Sciatica
• Radiculopathy
• Muscle tears
• Osteitis
• Bursitic osteoarthritis of knee
• Knee joint dysfunction
• Tenosynovitis

Connections

• Piriformis
• popliteus
• gluteal muscles
• obturator internus
• vastus lateralis
• plantaris
• gastrocnemius
• thoracolumbar paraspinal muscles

Self Help

Trigger points in hamstrings often occur from improper stretching before and after sports. It is very important to get the stretching techniques down pat. Balls and foam rollers can be very good for relieving pain and stiffness when you are at home.

Trigger point treatment techniques

• Spray and stretch
• Deep stroking massage
• Compression
• Muscle energy techniques
• Positional release
• Dry needling
• Wet needling

Learn more

Anatomy of Stretching (10 CPE)

About the author

Stuart Hinds is one of Australia’s leading soft tissue therapists, with over 27 years of experience as a practitioner, working with elite sports athletes, supporting Olympic teams, educating and mentoring others as well as running a highly successful clinic in Geelong.

Stuart has a strong following of practitioners across Australia and globally who tap into his expertise as a soft-tissue specialist. He delivers a range of highly sought after seminars across Australia, supported by online videos, webinars and one-on-one mentoring to help support his colleagues to build successful businesses.

In 2016, Stuart was awarded a lifetime membership to Massage & Myotherapy Australia for his significant support and contribution to the industry.

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.