Hamstring Health 101: Anatomy, Pain Relief, and Treatment Options
Author: Jerry Song
The hamstring muscles are essential for movement and stability, yet they are often overlooked until pain or dysfunction arises. From athletes to office workers, nearly everyone relies on their hamstrings for basic activities like walking, running, and bending. When these muscles become tight, strained, or develop trigger points, they can cause significant discomfort and limit mobility.
Anatomy and Function of the Hamstring Muscles
The hamstring group consists of three muscles located on the back of the thigh:
- Biceps Femoris: Positioned on the lateral side, with long and short heads.
- Semitendinosus: Located on the medial side.
- Semimembranosus: Also on the medial side, lying deeper than the semitendinosus.
These muscles originate from the ischial tuberosity (sit bones) of the pelvis and insert into the bones of the lower leg.
Primary Functions:
- Knee Flexion: Bending the knee.
- Hip Extension: Moving the thigh backward.
- Pelvic Stability: Supporting the pelvis during movement.
- Deceleration: Slowing down the leg during running or sudden stops.
The hamstrings play a critical role in activities requiring power and stability, such as walking, running, jumping, and squatting.
Common Trigger Points in the Hamstrings
Trigger points in the hamstrings can lead to localised and referred pain, often mistaken for other conditions.
Typical Trigger Point Locations:
- Biceps Femoris: Near the attachment on the ischial tuberosity and the back of the knee.
- Semitendinosus and Semimembranosus: Midway along the muscle belly and near the ischial tuberosity.
Referred Pain Patterns:
- Pain radiating to the back of the knee or lower buttock.
- Tightness or discomfort felt deep within the thigh.
- Stiffness that may mimic sciatica or hamstring strain.
Trigger points in the hamstrings are often associated with compensatory muscle patterns, poor posture, or overuse.
Who Is Susceptible to Hamstring Issues?
Hamstring problems can affect a wide range of demographics, but certain groups are more prone:
- Athletes
- Sports involving sprinting, jumping, or quick directional changes (e.g., soccer, basketball, running) can lead to overuse or strains.
- Office Workers
- Prolonged sitting shortens the hamstrings, creating tension and stiffness.
- Older Adults
- Age-related muscle tightness and reduced flexibility increase the risk of hamstring issues.
- Dancers and Gymnasts
- Extreme flexibility demands can overstretch or strain the hamstrings.
- Individuals with Poor Posture
- Forward pelvic tilt or weak gluteal muscles can cause hamstring compensation, leading to tension.
- Recreational Exercisers
- Inadequate warm-ups, stretching, or recovery can make weekend warriors more susceptible to hamstring strains or trigger points.
Myotherapy Treatments for the Hamstrings
Myotherapy offers targeted and effective treatments for hamstring tightness, trigger points, and related dysfunctions.
- Trigger Point Therapy
- Direct pressure is applied to deactivate trigger points and relieve pain.
- Myofascial Release
- Gentle techniques release tension in the fascia surrounding the hamstrings, improving flexibility and mobility.
- Deep Tissue Massage
- Focused techniques address deep-seated tension within the hamstring muscles.
- Dry Needling
- Thin needles inserted into trigger points can relieve tightness and improve muscle function.
- Stretching and Mobility Work
- Assisted or guided stretching helps lengthen the hamstrings and restore proper function.
- Example: PNF Stretching (Proprioceptive Neuromuscular Facilitation) is particularly effective for improving flexibility.
- Strengthening Exercises
- Myotherapists can recommend exercises to improve the balance between hamstrings, glutes, and quadriceps, reducing the risk of future injuries.
- Heat and Ice Therapy
- Heat is applied to relax tight muscles, while ice can reduce inflammation after acute strain.
- Postural Correction
- Addressing underlying issues, such as anterior pelvic tilt, ensures long-term improvement and pain prevention.
Self-Care Tips for Hamstring Health
Maintaining hamstring health requires regular attention and care:
- Stretch Daily: Incorporate hamstring stretches like standing forward bends or seated stretches into your routine.
- Strengthen Supporting Muscles: Focus on glute and core exercises to reduce hamstring compensation.
- Warm Up Before Exercise: Prepare your muscles with dynamic movements like leg swings or light jogging.
- Take Movement Breaks: Stand and stretch if you’re sitting for extended periods.
- Use Ergonomic Workstations: Ensure your chair and desk setup promotes good posture.
Example case study
A patient (F, 36) presented with a history of bilateral anterior cruciate ligament (ACL) reconstructions. The right ACL was reconstructed in 2020 using a hamstring graft, and the left ACL was reconstructed in November 2023 with a quadriceps graft.. She reported previous success with dry needling post-surgery in 2020 but discontinued treatments during COVID-related lockdowns.
Functional movement assessments revealed:
- Noticeable weight shift to the right side during squats, likely compensating for the weaker left leg.
- Hip mobility discrepancies: Reduced external rotation on the left, but increased internal rotation on the left compared to the right.
- Hypertonicity in:
- Glutes
- Hamstrings
The treatment session aimed to address hypertonicity, improve mobility, and support the patient’s recovery from ACL reconstruction:
- Deep Tissue Massage (DTM) and Trigger Point Therapy (TRP):
- Focused on glutes, hamstrings, and adductors to reduce tension and deactivate trigger points.
- Myofascial Cupping (MFC):
- Functional techniques applied to the hamstrings and quadriceps to release fascial adhesions and promote mobility.
- Dry Needling (MDN):
- Applied to the hamstrings, distal quadriceps attachments and rectus femoris to release deep-seated tension and improve knee flexibility.
After the session, the patient reported feeling lighter and looser with noticeable improvements in mobility and tension reduction. This case highlights the importance of integrating myotherapy into post-surgical rehabilitation, particularly for patients recovering from ACL reconstruction. The patient’s compensatory patterns, muscle imbalances, and restricted mobility were effectively addressed through targeted manual therapies such as trigger point therapy, dry needling, and functional myofascial cupping.
Ongoing treatments will focus on balancing muscle strength and flexibility, improving movement patterns, and preventing compensatory overuse injuries. Collaborative care with her physiotherapist will further enhance recovery outcomes and restore functional capacity.
The hamstring muscles are critical for mobility, stability, and athletic performance. However, tightness, trigger points, and overuse can lead to significant discomfort and dysfunction. While we’ve focused on the hamstrings in this article, it’s also important to note that in most cases, pain arises from multiple contributing factors, including other muscles, joints, and overall movement patterns. For this reason, it’s always best to seek a proper assessment from an experienced therapist to identify the root cause of the issue and develop an effective treatment and self-care plan.
If you or someone you know are dealing with a hamstring condition, musculoskeletal pain, or even myofascial trigger points, book an appointment to see Jerry now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain. Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.
