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Hamstrings - Trigger Point Anatomy

Maintaining healthy, knot-free hamstrings is essential for overall mobility

Maintaining healthy, knot-free hamstrings is essential for overall mobility and injury prevention. The hamstrings—a group of three muscles located at the back of the thigh—play a pivotal role in daily movements such as walking, running, and jumping. When these muscles develop knots or become tight, they can lead to discomfort and increase the risk of injuries. This article delves into effective strategies to keep your hamstrings supple and free from knots, thereby minimizing the likelihood of injury.​

Understanding Hamstring Anatomy and Function

The hamstring muscle group comprises three muscles:

  • Biceps Femoris: Located on the outer part of the thigh, it assists in knee flexion and hip extension.

  • Semitendinosus: Situated at the middle of the thigh, it aids in knee flexion and internal rotation of the leg.

  • Semimembranosus: Found on the inner side of the thigh, it also contributes to knee flexion and internal rotation.

These muscles work collectively to facilitate movements such as bending the knee and extending the hip, making them crucial for various physical activities.

Causes of Hamstring Knots

Muscle knots, or myofascial trigger points, are tight, sensitive areas within a muscle that can cause pain and restrict movement. Common causes include:​

  • Overuse: Engaging in repetitive activities without adequate rest can lead to muscle fatigue and knot formation.

  • Inadequate Warm-Up: Starting intense physical activity without proper warm-up can strain the hamstrings.

  • Poor Posture: Sitting for extended periods, especially with improper posture, can contribute to hamstring tightness.

  • Muscle Imbalances: Weakness in complementary muscle groups, such as the glutes or core, can place additional stress on the hamstrings.

Strategies to Maintain Knot-Free Hamstrings

  1. Regular Stretching

    Incorporate hamstring stretches into your daily routine to maintain flexibility. Effective stretches include:

    • Standing Hamstring Stretch: Stand tall, extend one leg forward with the heel on the ground, and gently bend at the hips to stretch the hamstring.

    • Seated Forward Bend: Sit on the floor with legs extended, and reach towards your toes, keeping the back straight.

    Regular stretching helps in elongating muscle fibers, reducing the risk of knots.

  2. Strengthening Exercises

    Strengthening the hamstrings and surrounding muscles ensures balanced muscle development. Recommended exercises:

    • Nordic Hamstring Curls: Kneel on a soft surface, anchor your ankles, and slowly lean forward from the knees, engaging the hamstrings to control the movement.

    • Deadlifts: With proper form, deadlifts can enhance hamstring strength and flexibility.

    Strong hamstrings are less prone to injuries and knots.

  3. Self-Myofascial Release (SMR)

    SMR techniques, such as foam rolling, can alleviate muscle tightness. To perform:

    • Foam Rolling: Sit on the floor with a foam roller under your hamstrings. Roll slowly from the glutes to the knees, pausing on tender spots.

    This practice increases blood flow and reduces muscle tension.

  4. Proper Warm-Up and Cool-Down

    Engage in dynamic warm-up exercises before physical activity to prepare the muscles. Post-activity, perform static stretches to relax the muscles.

  5. Maintain Overall Mobility

    Incorporate activities like yoga or Pilates to enhance overall flexibility and muscle balance, benefiting the hamstrings.

Preventing Hamstring Injuries

In addition to keeping the hamstrings knot-free, consider the following preventive measures:

  • Gradual Progression: Increase the intensity and duration of physical activities gradually to avoid overloading the muscles.

  • Balanced Training: Ensure that training programs address all muscle groups to prevent imbalances.

  • Adequate Rest: Allow sufficient recovery time between workouts to facilitate muscle repair and growth.

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.

 

 

Hamstring Muscles Trigger Point Therapy

 

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 tibia).


Semitendinosus: upper medial surface of shaft of tibia.

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

Action

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

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

Nerve

Branches of 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.

 

 

Standing Hamstring Stretch 

 

 

Biceps Femoris Trigger Points

Biceps Femoris - Typical Referred Pain Pattern

 

 

Semimembranosus/ Semitendinosus Trigger Points

Semimembranosus/ Semitendinosus - Typical Referred Pain Pattern

 

 

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.

 

 Hamstring Trigger Point Release

Try Using a Lacrosse Ball to Apply Pressure to the Area of the Trigger Point

 

 

 

Trigger Point Release Hamstring

 Move the Muscles Slowly Backwards and Forward Using a Trigger Point Roller

 

 

 

Hamstring Trigger Point Release

Try This Simple Hamstring Stretch - Make Sure to Rest Your Foot on Something Stable That Will Take Your Weight

 

 

 

Hamstring Trigger Point Massage Stretch

This is a Simple Hamstring Stretch That Requires No Equipment

 

 

Trigger Point Treatment Techniques

Spray and Stretch YES
Deep Stroking Massage YES
Compression YES
Muscle Energy Techniques YES
Positional Release YES
Dry Needling YES
Wet Needling YES

 

Conclusion

Maintaining knot-free hamstrings is vital for optimal performance and injury prevention. By integrating regular stretching, strengthening exercises, self-myofascial release, and proper warm-up routines, you can promote hamstring health and reduce the risk of injuries.

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. Consult a healthcare professional before starting any new exercise regimen.

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