Semimembranosus Pain: Trigger Point Pain and Muscle Strain Pain

Contents of Article:

Where Is The Semimembranosus Muscle?

The semimembranosus is located in the back of the thigh. The muscle attaches to the pelvis (ischial tuberosity) running down the thigh to connect to the top of the shin bone (tibia). Muscle fibers extend across the back of the knee blending into the popliteus muscle and into the popliteal ligament both located behind the knee.

What Movements Does The Semimembranosus Muscle Control?

  • Straightens the thigh at the hip (extension)
  • Bends the knee (flexion)
  • Twists the leg inward (internal rotation)

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

Semimembranosus Muscle Pain

Trigger point pain in the semimembranosus is at the top of the thigh near the gluteal fold. The pain can extend down to the inside of the knee and the upper portion of the calf.  Trigger point pain is usually more of an ache that increases over time. Pain can become sharp with certain movements of the thigh and/or knee.

A muscle strain is felt immediately when the injury occurs in the back of the thigh. A pulling, tearing, or popping sensation is felt when the strain occurs. Strains can happen anywhere along the length of the muscle but are most common at the top of the muscle toward the top of the thigh.  Semimembranosus strains down toward the knee are rare.

Referred pain pattern of the semimembranosus muscle

Semimembranosus Trigger Point Pain Pattern: Pain below the buttock traveling down the inside leg to the knee and occasionally into the calf.

What Are The Signs and Symptoms of Semimembranosus Trigger Points?

Semimembranosus trigger point pain is most intense at the top of the thigh near the gluteal fold. The pain sometimes will remain localized but often radiates down the back of the thigh into the inside of the knee and upper part of the calf.

Signs and symptoms:

  • Pain starts just below the buttock and travels down the back of the thigh going into the back of the knee and/or the top of the calf
  • Walking, jogging, and running increases pain
  • Lifting and carrying heavy items intensifies pain
  • Deep aching pain is felt in the back of the thigh and/or knee when standing after sitting
  • While sleeping a deep aching pain down the back of the thigh is often felt
  • The muscle may spasm

What Causes Trigger Points To Develop In The Semimembranosus Muscle?

  • Sitting for long periods of time causes the muscles to stay in an extended stretch fatiguing the muscle
  • Sitting on a chair or bench with a hard edge that pushes into the back of the leg
  • Sitting on a surface where your legs dangle and feet do not touch the ground
  • Activities that require frequent bending and straightening the knee (squatting)
  • Poor conditioning and being out of shape taxes the muscle
  • Trigger points are usually found after a muscle strain

How To Avoid Development of Trigger Points In The Semimembranosus Muscle

  • If you sit for hours at a time whether it be at your desk or at home watching T.V. you will have aches and pains. It is important that you get up and walk around, stretch and move. If your job is at a desk think about investing in a standing desk and alternate sitting and standing throughout the day.
  • Sitting on hard seats with hard edges that push into the back of the thigh will set up trigger points in the hamstrings. Use a rolled towel or seat cushion and place it between your legs and the hard edge of the seat.
  • Unsupported dangling legs when sitting on high seating such as bar seats stress the hamstring muscles. Rest your feet on the rungs or use a footstool for other types of seating.
  • While exercising or playing sports if your legs begin to feel tired and weak stop and rest. Fatigued and out of shape muscles are a primary contributor to injury and development of trigger points.
  • It is important to warm up before exercise and sports to get muscles ready for increased workloads. Don’t skip this!

Semimembranosus Trigger Point Treatment

For trigger point treatment to be successful the trigger points need short treatment several times a day. If you would like to learn to treat your trigger points The Trigger Point Therapy Workbook is an excellent resource that will teach you about trigger points, how to find them, as well as treat them. It takes time and patience to learn the ‘feel’ of trigger points, but once you learn you can treat TrPs in muscles throughout the body.

You can also seek out professional help. Many physical therapists, chiropractors, and massage therapists are trained in trigger point therapy. A trained therapist can locate specific trigger points and show you how to self treat at home. Not all have the training, so be sure to ask before making an appointment.

TWD Suggestions For Semimembranosus Trigger Points

Sombra Warm Therapy Pain Relieving Gel is highly recommended for trigger point and chronic pain relief. It relaxes the muscles without the burning heat of other creams. (not sold in stores)

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The Trigger Point Therapy Workbook is the best resource to learn how to treat and manage your TrP muscle pain. Learn the methods and have the knowledge to relieve muscle pain throughout the body.

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

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The Tiger Tail Foam Roller Stick is recommended for 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 upper body strength like other foam rollers.

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How Long Before I Feel A Reduction In Pain?

Trigger points are annoying and painful but the good news is a reduction in pain and tightness is often felt after a few treatments. Consistent treatments several times a day until the TrPs are gone will provide the best outcome.

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

Satellite trigger points associated with the semimembranosus 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:

  • Long head of biceps femoris
  • Vastus lateralis
  • Vastus intermedius
  • Vastus medialis
  • Rectus femoris
  • Adductor magnus
  • Quadratus lumborum
  • Thoracic paraspinals
  • Rectus abdominis

Interesting facts about the semimembranosus muscle:

  • The semimembranosus is the largest of the hamstring muscles
  • Trigger points cause pain and stiffness in the back of the thigh and are often diagnosed as hamstring tendinitis
  • The semimembranosus along with the other hamstring muscles stop the body from falling forward allowing you to stand upright.
  • Tightness in the semimembranosus as well as the other hamstring muscles can cause low back pain.

Semimembranosus muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

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


Semimembranosus Muscle Strain Pain

The pain caused by a semimembranosus strain is sudden, sharp and is felt in the back of the thigh usually just before your foot hits the ground.

Mild strains are classified as a Grade 1 strain. There is a tugging, pulling, or cramping sensation when the injury occurs. Though there is discomfort, you will probably be able to continue with the activity you were engaged in when the injury happened. Mild strains usually do not affect daily activities though there will be soreness and tightness in the muscle.

A moderate strain is classified as a Grade 2 strain.  A stabbing, tearing, or popping sensation is often felt when the injury occurs. The pain is severe and will cause you to stop whatever activity you were doing. Daily activities are usually affected due to pain and stiffness in the leg.

Severe strains are classified as Grade 3. A severe strain produces a sharp usually debilitating pain that will make you stop all activity immediately.  A ripping, tearing or popping sensation is usually felt when the injury occurs. Swelling, redness, and heat are soon evident after the injury as well as pain and difficulty walking. If you think you may have suffered a severe muscle strain you should see a doctor.

Some of the signs of a semimembranosus strain are:

  • Sensations of pulling, tearing, or popping is felt in the back of the thigh
  • A mild pull or strain will cause moderate pain, you can put weight on the leg
  • A severe strain will make putting weight on the leg excruciatingly painful and walking will be difficult or impossible
  • The back of the thigh is very tender to touch
  • Swelling and bruising appear
  • There is a feeling of weakness in the thigh
  • Muscle spasm is common
Muscle Man High Kick

When the thigh is flexed (bent) at the hip and the knee is extended (straightened) is when the hamstring muscles are most vulnerable to strains.

TWD Suggestions For Semimembranosus Strains

Biofreeze Pain Relieving Gel cools the area much like ice discouraging inflammation. Provides excellent pain relief between cold treatments. Recommended by medical professionals and trainers.

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The Simple Spectra Clay Hot/Cold Wrap can be placed and secured high on the thigh, providing hot or cold treatment as well as compression which is important for recovery. The wrap can also be used on other areas of the body.

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If you are an athlete or exercise aficionado who uses cold treatments a lot, the Freeze Sleeve provides excellent cold compression treatments for thigh and knees. Great to have on hand for fast easy treatments.

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What Causes A Semimembranosus Strain?

Semimembranosus strains are most often caused during sprinting and activities that require stretching and extension (straightening of the muscle.  Other contributors are:

  • Poor conditioning
  • Muscle fatigue
  • Not warming up before sports or exercise
  • Not taking time for a proper warm-up
  • Sudden acceleration when sprinting
  • Sudden acceleration or deceleration when walking or running
  • Stretching the muscle past capacity

Sports and activities that contribute to strains:

  • Runners especially sprinters
  • Hurdlers
  • Football
  • Soccer
  • Rugby
  • Hockey
  • Hurdlers
  • Gymnasts
  • Dancers

Note: Preteens and teens are highly susceptible to hamstring muscle strains as the bones often grow faster than the muscles.

Semimembranosus Strain Treatment

Mild strains are best treated with ice packs and rest for 24-48 hours. After 48 hours, you can alternate treatments with ice packs then wait for 1-2 hours and use a warm pack.

Most moderate strains can be treated at home using the P.R.I.C.E. protocol. Start the protocol as soon as possible and continue until the acute phase of pain and swelling has subsided which is usually 24-72 hours.

  • Protect – Stabilize the thigh with a Velcro wrap or elastic bandage. Limit movement and weight-bearing.
  • Rest  – Rest the leg and get extra sleep. The healing process works best when you are resting.
  • Ice – Use cold packs for a 20-minute treatment every 1-2 hours. Use cold treatments for the first 24-72 hours after the injury to reduce swelling.
  • Compression – Moderate pressure using an Ace bandage or Velcro wrap will help reduce swelling and pain.
  • Elevate: Elevate the leg as much as possible to reduce swelling and throbbing pain.

When the heat and swelling start to subside, you can then begin to alternate cold and heat treatments. Start with a cold treatment for 20 minutes then wait 1-2 hours and apply a warm pack for 20 minutes. This helps with circulation, inflammation, and pain. Alternate treatments throughout the day.

When to see a doctor:

  • Unbearable pain level
  • Excessive swelling and bruising
  • Inability to move leg without extreme pain
  • Unable to put weight on the leg
  • Pain, swelling, redness, and heat have not decreased in 24 hours

How Long Does It Take A Semimembranosus Strain To Heal?

  • A Grade 1 mild strain usually heals in 2-4 weeks.
  • A Grade 2 moderate strain can take 4-8 weeks to heal.
  • A Grade 3 severe strain 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.

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

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The Thigh Brace by Vive provides support and compression to injured hamstring muscles. The two Velcro straps are easily adjusted for compression.

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The CW-X Endurance Pro Tights were made specifically for the hamstrings. They provide support and compression. Highly recommended for athletes.

Mens Womens

The Odofit Support Brace has 3 straps that allow you to adjust the compression to your needs.  The waistband holds the brace in place. One of the best for moderate and severe thigh and groin pain and injury.

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Tips To Avoid Semimembranosus Strains

  • Take time to warm up before sports, exercise and strenuous activities. ‘Cold’ muscles are more susceptible to injury.
  • Be aware of your conditioning and fitness. Pushing too hard too fast is when many injuries occur.
  • Be careful when stretching, do not ask muscles to stretch past their capacity.
  • Take recovery days and if the muscle soreness is more than mildly uncomfortable rest. Give your body time to recover.
  • Wear proper footwear for your activities.


Donna Martin

Massage Therapist Owner: Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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