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

The pain of a muscle is sharp and felt immediately when the strain happens. A pulling, tearing, or popping sensation is felt when the muscle fibers tear. Semimembranosus strains can occur anywhere along the length of the muscle. Semimembranosus strains are most common at the top of the muscle toward the top of the thigh. Strains down toward the knee are rare.

Contents of Article

    Where Is The Semimembranosus Muscle?

    Semimembranosus Muscle Showing Trigger Point Locations

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

    What Movements Does It Control?

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

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


    Semimembranosus Trigger Points Symptoms:

    Semimembranosus Referred Pain Pattern

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


    • Pain starts just below the buttock and travels down the back of the thigh, going into the back of the knee and the top of the calf.
    • Walking, jogging, and running increases pain
    • Lifting and carrying heavy items intensifies the 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 backside of the thigh is often felt
    • The muscle may spasm

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

    What Causes Trigger Points To Develop In The Semimembranosus?

    • Sitting for long periods 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
    • Poor conditioning and being out of shape taxes the muscle
    • Trigger points often develop after a muscle strain

    How To Avoid Development of Trigger Points In The Semimembranosus

    • If you sit for hours at a time, whether it be at your desk or home watching T.V., you will have aches and pains. You need to get up every so often 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.
    • Avoid sitting on hard seats with hard edges that push into the back of the thigh. The pressure 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 stools, stress the hamstring muscles. Rest your feet on the rungs and get up and stand periodically.
    • While exercising or playing sports, if your legs begin to tire and feel weak, it is time to stop and rest. Fatigued and out-of-shape muscles are a primary contributor to injury and the development of trigger points.
    • It is important to warm up before exercise and sports to get muscles and other soft tissues ready for increased workloads. Don’t skip this!

    TWD Recommends

    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.

    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 you can treat TrPs in muscles throughout the body once you learn.

    You can also seek out professional help. Many physical therapists, chiropractors, and massage therapists have certification 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.

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

    One 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.

    TWD Recommends

    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?

    Trigger points are annoying and painful, but the good news is reduced 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.

    Interesting facts:

    • The semimembranosus is the largest of the hamstring muscles.
    • Trigger points cause pain and stiffness in the back of the thigh. These symptoms are often diagnosed as hamstring tendinitis.
    • The semimembranosus, along with the other hamstring muscles, prevents 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 pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Strain/pain
    • L5 radiculopathy
    • 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 semimembranosus muscle

    If trigger points are found in the semimembranosus muscle you need to check these muscles for additional TrPs:

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

    TWD Recommends

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

    Semimembranosus Strain

    The pain caused by a semimembranosus strain is sudden, sharp, and is felt in the back of the thigh. It usually happens while walking or running. You feel the pain just before your foot hits the ground.

    Mild strains are 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 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 a Grade 3. A severe strain produces a sharp and 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.

    Symptoms of a Semimembranosus Strain:

    • Sensations of pulling, tearing, or popping is felt in the back of the thigh
    • A mild pull or strain will cause moderate pain, but you can put weight on the leg though you will limp
    • 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

    What Causes Semimembranosus Strains?

    Semimembranosus strains usually occur during activities that require stretching and extension (straightening) of the muscle. Other contributors are:

    • Poor conditioning
    • Muscle fatigue
    • Not warming up before sports or exercise
    • 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

    TWD Recommends

    The CW-X Endurance Pro Tights were made specifically to support quads, hamstring muscles, and knees. Highly recommended for runners, cyclists, and other athletes. Men's Tights and  Women's Tights

    Mild strains are best treated with ice packs and rest for 24-48 hours. After 48 hours, you can alternate treatments with ice packs, 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.
    • 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 the 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. A great 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 Semimembranosus 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 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.

    Muscles with similar pain patterns

    Adductor Magnus