Chiropractor Chandler AZ

Hamstring Pain from Semimembranosus Trigger Points

The hamstring muscles originate on the ischial tuberosity and run on the posterior aspect of the femur inserting below the knee. Biceps femoris muscle runs along the lateral aspect of the leg and inserts on the fibula. Semimembranosus and semitendinosus insert on the medial aspect of the proximal tibia. These muscles are responsible for knee flexion and hip extension.

They are very active in walking, running, jumping, and squatting movements. As a result of the tremendous amounts of stress transferred through the muscles, they often are injured and chronic repetitive activities along with acute trauma. The faster or harder we run up and down hills the more forces that are applied to the muscles. Likewise the more often we are jumping and the harder we are exploding with fast dynamic motion the more likely we are to injure the semimembranosus muscle.

The semimembranosus trigger point radiates pain along the medial aspect of the hamstring down towards the knee. The pain can travel past the knee and into the proximal calf. Patients often have increased pain with resisted knee flexion.

semimembranosus trigger point

Palpation of the semimembranosus trigger point increases symptoms down the posterior aspect of the femur. While relieving pressure on the trigger point reduces the symptom intensity.

As with any muscle and soft tissue injury treatments are very effective at relieving pain intensity, frequency, and duration in the early stages. Early treatment prevents more serious muscle sprains and strains from developing.

Differential diagnosis for semimembranosus trigger points include lumbosacral sprains, ischial tuberosity bursitis, sacroiliac sprains, and tendinosis of the hamstring muscles tendon origin at the ischial tuberosity. Some patients may believe they are having sciatica from lumbar disc injuries because of previous low back pain. However reproduction of the symptoms validates the proper diagnosis of semimembranosus trigger point.

Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.

Sciatica is the term for radiating pain down the leg. Most commonly it comes from the back and radiates down the leg. Several back injuries and nerve entrapment injuries can cause sciatic pain in the leg. The pain patterns from a lumbar disc, lumbar joint sprain, sacroiliac sprain, or piriformis syndrome produces different patterns of radiating pain than trigger points. Proper identification of the pain pattern, along with reproduction of pain from palpation of the trigger point allows the provider and patient to feel comfortable with the diagnosis.

Likewise many trigger point injuries are associated with poor joint stabilization in the foot, knee, or hip. This leads to poor alignment and excessive forces being placed onto muscles and tendons. Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. These runners will also have multiple trigger points in the quadriceps, psoas, gastroc, soleus, and gluteus medius.

Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.


The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for hip, knee, and ankle; flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.