Biceps femoris pain is felt in the back of the thigh.  It is aching and persistent, easing at times, but seldom gone. Trigger point pain increases over time.

Muscle strains cause immediate pain and are usually accompanied by pulling, tearing, or popping sensations. Pain can range from mild or cramping to severe and debilitating.

Contents of Article

    Where Is The Biceps Femoris Muscle?

    Biceps Femoris Muscle Showing Trigger Point Locations

    The biceps femoris is located in the back of the thigh. The muscle has two heads, the long head and the short head.

    The long head of the muscle attaches to the pelvis (ischial tuberosity) and extends down the leg to connect to the head of the small bone in the lower leg (fibula).

    The short head attaches to the thigh bone (linea aspera of the femur) and also connects to the head of the fibula. The biceps femoris is one of 3 hamstring muscles.

    What Movements Does It Control?

    • Bends the knee (flexion)
    • Twists the leg outward (external rotation)
    • Straightens the thigh at the hip (extension)

    The Biceps Femoris Anatomy page has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.


    Biceps Femoris Trigger Points Symptoms:

    Biceps Femoris Referred Pain Pattern

    Biceps femoris trigger point pain remains localized in the lower back of the thigh and knee. It does not radiate to other areas of the body. Symptoms include:

    • Dull aching pain toward the outside of the back of the knee
    • Pain can extend into the lower thigh or descend into the top of the calf
    • Standing from a sitting position brings awareness of tightness in the back of the thigh and pain in the knee
    • Walking increases pain
    • Sharp pain can occur with a twisting motion of the thigh or knee.

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

    Biofreeze Professional Gel  is recommended for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals and trainers. 

    What Causes Trigger Points To Develop In The Biceps Femoris?

    • Sitting for prolonged periods
    • Seats with hard edges that put pressure on the back of the thigh
    • Sitting with your legs dangling when your feet cannot reach the floor
    • Activities that require frequent bending and straightening of the knee, i.e., squats, gardening
    • Football, soccer, and basketball players are prone to trigger points in the muscle
    • Activities that require fast acceleration and quick turns and pivots contribute to the development of trigger points

    How To Avoid Development of Trigger Points In The Biceps Femoris

    • Don’t sit for hours at a time without getting up. Stand up, walk around and do some simple stretches for a few minutes each hour. If you work at a desk, consider investing in a standing desk.
    • Don’t sit on hard surfaces or seating with a hard edge that pushes into the back of your thigh. Use a seat cushion or roll a towel and place it between your thighs and the hard edge.
    • Don’t allow your legs to dangle unsupported when sitting. Rest feet on the rungs of a high chair/bar stool or use a footstool for other types of seating.
    • Always take time to warm up and do a few stretches before exercise and competitions.
    • If your legs start feeling weak and fatigued, stop and rest. Don’t try to push through.

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    The Sparthos Thigh Compression Sleeve provides compression as well as support for the hamstring and quad muscles. It stays in place, it does not slide down, the top doesn’t roll down, and the bottom does not roll up during movement.

    Biceps Femoris Trigger Point Treatment

    Massage therapists, physical therapists, and chiropractors who have trigger point therapy training can show you the location of specific trigger points and show you how to do self-treatment. Not all have specific training, so be sure to ask before making an appointment.

    If you would like to learn how to treat trigger points,  The Trigger Point Therapy Workbook is an excellent book to learn the skill. The book has diagrams that show you the location of trigger points in various muscles and how to treat TrPs throughout your body. It takes time and patience to learn how to find trigger points, but once you learn you have a skill that will help you locate and treat muscle pain throughout your body.

    Note: The workbook recommends using at least one of two tools to treat hamstring muscles.

    The first is the TheraCane Massager, which is used to apply pressure to the trigger points.

    The second is the Tiger Tail Rolling Stick which is used to roll the muscle.

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    The PhysixGear Knee Sleeve is recommended for those who need additional support for weak, painful knees. The graduated compression helps with circulation as well as support. The lightweight material moves with you while staying in place.

    How Long Before I Feel A Reduction In Pain?

    A reduction of pain and tightness is noticeable after a few treatments. Trigger point treatments should be done several times a day until the trigger point is gone. Treatment consistency and continuing treatment until the trigger point and pain are gone are necessary for successful treatment.

    Interesting facts:

    • Like the biceps in the arm, the biceps femoris splits into two heads, the short and long heads. The short head of the muscle is absent in some people.
    • A braking action of the biceps femoris along the other hamstring muscles helps keep the body from falling forward when standing or moving. It also helps with precision movement when bending or squatting, then straightening or standing up.

    Biceps femoris pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Sprain/Strain
    • L5 radiculopathy
    • S1 S2 nerve compression
    • Bruised ischial tuberosity
    • Deep vascular thrombosis (DVT)
    • Cauda equina syndrome
    • Coxa Plana


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the biceps femoris muscle:

    If you find trigger points in the biceps femoris it is likely you will find trigger points in some or all of these muscles:

    • Semimembranosus
    • Semitendinosus
    • Adductor Magnus
    • Iliopsoas
    • Rectus Femoris
    • Vastus Lateralis
    • Vastus Intermedius
    • Vastus Medialis
    • Quadratus Lumborum
    • Rectus Abdominis
    • Gastrocnemius


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    Doctors and physical therapists often recommend TENS to relax the muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator is highly recommended by professionals and an excellent choice for treating muscle pain throughout the body.

    Biceps Femoris Strain

    Biceps femoris strains occur when the muscle or tendon fibers tear. The pain is felt in the back of the thigh and is sharp and sudden.

    Mild strains may be sharp when the tear happens, but it is usually a tugging or pulling sensation. You will likely be able to resume whatever activity you were engaged in at the time of injury though there will likely be discomfort. Mild strains rarely affect daily activities.

    Moderate strains are usually a sharp and stabbing pain with a tearing or popping sensation when the injury occurs. The pain will make you stop what you are doing. Daily activities may be affected because of pain and limping.

    Severe strains cause extremely sharp pain with a ripping or hard pop sensation and are debilitating. It will be painful to put weight on the leg, and straightening the thigh at the hip will be very painful.

    Symptoms of a Biceps Femoris Strain:

    • Sudden and intense pain in the back of the thigh
    • A tearing or popping sensation is often felt
    • Pain when putting weight on the leg.
    • If the strain is severe, standing on the leg may be impossible due to pain
    • Pain in the lower buttock, down the back of the thigh that may continue into the knee when straightening the thigh at the hip
    • Bending the knee will usually increase pain
    • Pain and stiffness when bending over to touch the toes
    • Swelling and bruising occur with most moderate and severe strains

    What Causes Bicep Femoris Strains?

    Jumping, sudden quick turns, or rapid acceleration when running are the most common cause of biceps femoris strains. Other contributors are:

    • Not taking time for a proper warm-up
    • Poor conditioning
    • Muscle fatigue
    • Over-extension of stride when walking, jogging, or running
    • Sudden acceleration or deceleration when walking or running
    • Planting a foot then doing a hard pivot or quick turn
    • Repetitive jumping in sports like basketball or volleyball
    • Taking a misstep and twisting the thigh at the hip or knee

    Sports and activities that contribute to strains:

    • Runners especially sprinters
    • Hurdlers
    • Cyclists
    • Gymnasts
    • Basketball
    • Volleyball
    • Soccer
    • Football
    • Hockey
    • Swimmers

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    Biceps Femoris Strain Treatments

    Most mild and moderate strains do not require medical help and can be treated at home using the P.R.I.C.E. protocol. The protocol should be started as soon as possible and followed the first 24-72 hours after injury to reduce pain and inflammation.

    • Protect – Restrict movement and limit putting weight on the leg.
    • Rest – Extra rest is needed during the healing process. Limit activities and get extra sleep to jump-start healing.
    • Ice – Ice packs should be used every 1-2 hours until redness, swelling, and pain decrease. Leave the ice in place for 20 minutes per treatment as longer times may damage soft tissues.
    • Compression – Moderate compression applied to the injured area provides support and discourages swelling.
    • Elevation – Keeping the leg and hip propped up on pillows helps reduce swelling, pain and inhibits excess fluids from building in the area.

    Once the swelling, heat, and initial bruising begin to subside, it is time to alternate cold and warm treatments. Start with a cold pack treatment for 20 minutes. Wait 1-2 hours, then apply a warm pack treatment. Alternate these treatments throughout the day.

    When to see a doctor:

    • Intolerable pain levels
    • Rapid and excessive swelling and bruising
    • You are not able to move the leg or unable to put weight on the leg
    • Swelling, pain, redness, and heat have not lessened within 24-48 hours

    TWD Recommends

    TheraICE Rx Hot & Cold Therapy provides 360 degree cold and warm therapy. The sleeve provides compression, which helps reduce inflammation and pain. An excellent choice for hamstring and trigger point pain treatments.

    The Odofit Support Brace has three adjustable straps that allow you to adjust the compression to your needs. The waistband holds the brace in place. One of the best supports for high hamstring strains.

    How Long Does It Take A Biceps Femoris Strain To Heal?

    • A mild strain (Grade I) can heal in 2-4 weeks.
    • A moderate (Grade II) will usually heal in 4-8 weeks.
    • A severe (Grade III) may take several months to a year to fully heal, depending on the severity of the muscle and tendon fiber tears.

    Note: Grade II strains with a lot of swelling and pain and all Grade III strains should be monitored by a medical professional.

    Tips To Avoid Biceps Femoris Strains

    • Warm-up before sports, exercise, and strenuous activities. A few minutes of preparation can help prevent injuries!
    • Do not push past your conditioning and fitness, as this is when most injuries occur.
    • Do not stretch past muscle capacity.
    • Wear proper footwear when participating in sports or exercise.
    • If muscle soreness sets in or you experience an injury, take the needed time off to recover.

    Muscles That May Contribute To These Conditions:

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    Muscles with similar pain patterns

    Plantaris Muscle
    Popliteus Muscle