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(Last Updated On: November 4, 2018)

Biceps Femoris Pain: Differences of  Overuse/Trigger Point Pain and Muscle Strain Injury

Biceps femoris pain is felt in the back of the thigh. Pain can occur at any point from the bottom of the buttock to the outside of the knee. The pain ranges from aching and persistent to sharp and debilitating. Aching persistent pain occurs after an injury, overuse of the muscle, and the development of small "knots" aka trigger points in the muscle. Sharp and debilitating pain is most often caused by a muscle strain during an activity such as running or simply taking a misstep.



Biceps Femoris Trigger Point Signs and Symptoms

Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body.

Biceps femoris trigger point pain is felt in the back of the knee toward the outside of the thigh. Pain often extends up into the thigh and down to the top of the thigh.

Signs and Symptoms:

  • Dull aching pain toward the outside of the back of the knee
  • Pain can extend into the bottom of the 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
  • Sleeping is uncomfortable because of persistent pain

Other muscles with similar pain patterns:

Biceps Femoris Pain Pattern: Pain in the back of the knee going up the outside of the thigh that worsens when walking can

Satellite trigger points associated with the biceps femoris:

A muscle trigger point often produces trigger points in other muscles. These are called satellite trigger points.

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
  • Quadriceps
  • Quadratus Lumborum
  • Rectus Abdominis
  • Gastrocnemius

Recommendations for  Biceps Femoris Trigger Point Pain

Sombra Warm Therapy Gel is an 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)

The PhysixGear Knee Sleeve is recommended for those who that 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.

The Simple Spectra Hot/Cold Wrap provides compression with warm/cold treatments. Compression provides support and reduces the pain of trigger points and sore muscles. The wrap is adjustable and can be used on many areas of the body.

Biceps Femoris Trigger Points: The Causes and Prevention

What causes trigger points to develop?

  • Sitting for prolonged periods of time
  • 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 ie. squats, gardening
  • Trigger points often develop while recovering from a muscle strain

Trigger point recovery

A reduction of pain and tightness is noticeable after a few treatments. To fully treat trigger points treatment should be done several times a day until the trigger point is gone. The good news is that you can learn to do the treatment yourself and it takes only 1-2 minutes per treatment.

The Trigger Point Therapy Workbook is an excellent resource to learn how to find and treat trigger points.


Sitting for hours a day will cause pain in the biceps femoris and other hamstring muscles. Sitting on a hard edged chair that pushes into the thigh puts more stress on the muscles.

Tips To Avoid Trigger Points/Muscle Overuse

  • 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 that has 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.

Learn To Treat Trigger Point Pain

The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.

If you are buying the Trigger Point Workbook to self-treat the biceps femoris you will need a hardball for treatment. The Kieba Massage Lacrosse Balls are a good choice to use on the thighs and other areas throughout the body.

The Tiger Tail Foam Roller Stick is recommended for people who have sore tight leg muscles. You can roll the muscle in multiple directions, up, down and even diagonally to relieve pain and stiffness. Easy to use and does not require a lot of upper body strength.

Biceps Femoris Muscle Strain Signs and Symptoms

A biceps femoris strain occurs when the muscle is stretched beyond its limit or the exertion of movements or actions go beyond what the muscle is capable of handling causing tears in the muscle and/or tendon fibers.

Biceps femoris strain pain is felt in the back of the thigh and is sharp and sudden. It occurs during activities such as running, jumping, and thigh or knee twisting missteps.


Strain Injury Signs:

  • 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 leg at the hip or bending the leg
  • Pain and stiffness when bending over to touch the toes
  • Swelling and bruising occurs

A biceps femoris strain can occur anywhere along the length of the muscle.

How To Treat A Biceps Femoris Strain:

Follow the PRICE protocol:

  • Protect - Protect and stabilize thigh. Limit movement and putting weight on the leg.
  • Rest  -  Stay off the leg. Get your sleep, take extra naps.  Rest is important for the healing process.
  • Ice -  Apply ice or cold packs every 2 hours for 20 minutes per treatment the first 24-48 hours, longer can cause soft tissue damage.
  • Compression -  Applying pressure using an Ace bandage or Velcro wrap will reduce swelling and provide support.
  • Elevate: Use pillows to elevate the leg.

Recommendations for Biceps Femoris Strain Treatment

The Simple Spectra Clay Hot/Cold Wrap provides a consistent temperature and compression which can help reduce swelling and aid healing. The pack can also be warmed. It is adjustable and can be used on many other areas of the body.

BioFreeze Cold Therapy Gel cools the injured area. It can be applied after an ice/cold pack treatment to prolong the cold treatment and reduce pain. Highly recommended many medical professionals for muscle strains.

The Thigh Brace by Vive provides support and compression to injured hamstring muscles. It has two Velcro straps which are adjustable for compression. A good supportive brace for injury support or as a support for sore tight thigh muscles.

Biceps Femoris Strain Causes and Recovery Time

Actions that can cause a strain:

  • Poor conditioning, not taking time for a proper warm up, and muscle fatigue are contributing factors to strains.
  • 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
  • When walking, jogging, or running over-extending your stride
  • Pushing off your foot to quickly accelerate while running
  • Taking a misstep and twisting the thigh at the hip or knee

How long does it take a muscle 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 and Grade III should be monitored by a medical professional.


Sports and activities that contribute to biceps femoris strains:

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

Recommended Supports For Biceps Femoris Muscle

The Odofit Support Brace is one of the best supports for hamstring and quadriceps pain, injury and recovery. It is highly recommended for active people because the waistband keeps the support in place.

The brace has 3 adjustable straps that allow you to adjust the compression to your needs. It is also long enough to cover most of the upper thigh which is important for support and compression.

Another option for support is a thigh sleeve. Look for a sleeve that provides compression as well as support. I use Sparthos Thigh Compression Sleeves. I like the support and compression of this brand. It also stays in place, it does not slide down, the top doesn't roll down and the bottom does not roll up during movement. Be sure and use the size chart for instructions on measurements so you get the right size.

The CW-X Endurance Pro Tights were made specifically for the hamstrings. The tights provide compression and support to both muscle attachments, the one at the pelvis and the other that is just below the knee. Highly recommended for athletes.

Biceps Femoris Location, Functions, and Actions

Biceps Femoris Location

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.

Functions and Actions

The primary function of the biceps femoris is bending (flexion) of the knee. It also twists (rotates) the knee out away from the other leg. The long head of the muscle is involved with straightening (extension) the thigh at the hip.

Biceps Femoris origin, insertion, actions, innervation

You use the biceps femoris muscle when you bend your knee, twist your knee away from your body and straighten your thigh.


Biceps Femoris Anatomy Info

Looking for detailed muscle anatomy? The Biceps Femoris Anatomy page has origin, insertion, innervation and blood supply information. It also lists agonist and antagonists for each muscle action.


Other Interesting Information About the Biceps Femoris Muscle

Interesting facts about the biceps femoris:

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

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

  • L5 radiculopathy
  • Bruised ischial tuberosity
  • Cauda equina syndrome
  • Deep vascular thrombosis (DVT)

Other muscles that should be considered and examined in conjunction with the biceps femoris muscle:

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