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Semitendinosus Muscle: Buttock, Thigh, Knee, Calf Pain

Semitendinosus trigger point pain is centered at the top of the thigh close to the gluteal fold. Pain often travels down the thigh and can extend down into the top of the calf. The pain is an aching pain that often increases over time. Sudden sharp pain may be experienced with some movements of the thigh and knee.

If you strain the semitendinosus muscle, you will feel a pulling, tearing, or popping sensation when the injury happens. Strains most commonly occur in the upper thigh but can occur anywhere along the length of the muscle. Semitendinosus strains at the knee are rare.

Contents of Article

    Where Is The Semitendinosus Muscle?

    Semitendinosus Muscle Showing Trigger Point Locations

    The semitendinosus is one of three hamstring muscles located in the back of the thigh. It attaches to the pelvis (ischial tuberosity), traveling down the thigh to connect to the head of the shin bone (tibia).

    What Movements Does It Control?

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

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

    The semimembranosus muscle lies alongside the semitendinosus. The muscles have similar muscle attachments and pain patterns.


    Semitendinosus Trigger Points Symptoms:

    Semitendinosus Referred Pain Pattern

    Trigger point pain in the semitendinosus muscle tends to concentrate in the upper thigh just below the buttock. Pain may radiate down the back of the thigh into the knee and top of the calf.

    Other symptoms:

    • Running, jogging, and sometimes walking increases pain
    • Pain intensifies when lifting or carrying moderately heavy objects
    • Standing after sitting produces a deep aching pain in the back of the thigh and/or knee
    • Pain in the back of the thigh is often felt while sleeping
    • The muscle may be prone to 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 Semitendinosus?

    • When you sit for long periods, the semitendinosus muscle remains in an extended stretch fatiguing the muscle.
    • Hard-edged chairs or benches that push into the back of the thigh.
    • Allowing your lower legs and feet to dangle when sitting on high seats
    • Squats and other activities that require frequent deep bending and straightening of the knee
    • Being out of shape or poorly conditioned for sports and exercise taxes and fatigues the muscle
    • Trigger points often develop after muscle strains

    How To Avoid Development of Trigger Points In The Semitendinosus

    • Sitting for hours at a time keeps the hamstring muscles elongated while shortening the quads, the muscles in the front of the thigh, which contributes to the development of trigger points. Make sure to get up and move a few minutes each hour. If you work at a desk, consider a standing desk to alternate sitting and standing throughout the day.
    • Hard edges on chairs and benches that put pressure on the back of the thigh will cause trigger points in the semitendinosus. Cushion the seat with a rolled-up towel or a seat cushion to reduce pressure on the back of the legs.
    • Letting your legs dangle when sitting on high seating like bar seats also can cause trigger points. Use a footstool or the rungs to support your feet and legs.
    • Fatigue and a feeling of weakness in the legs while exercising or playing sports is a sign to stop and rest. Trying to push through can cause strains, sprains, and the development of trigger points.
    • Don’t skip warm-ups before exercise and sports! Muscles that are not adequately prepared for increased workloads are injury-prone.

    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.

    Semitendinosus Trigger Point Treatment

    The easiest way to learn how to treat specific trigger points is to find a massage therapist, physical therapist, or chiropractor trained in trigger point therapy. A trained professional will help you find the TrPs and show you how to self-treat at home.

    With patience and practice, you can learn to treat trigger points throughout the body.  The Trigger Point Therapy Workbook is one of the best publications to learn about trigger points and their effects. It features diagrams and instructions that will teach how to find and treat many muscular trigger points.

    Trigger points respond best to several short treatments of 1-2 minutes throughout the day. Consistency is essential for successful treatment.

    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?

    The good news is a reduction in pain, discomfort, and tightness is often felt after a few treatments. Consistent treatments several times a day until the trigger points are gone will provide the best outcome.

    Interesting facts:

    • Pain and stiffness in the semitendinosus are often diagnosed as hamstring tendinitis or sciatica.
    • A braking action of the semitendinosus muscle along with the other hamstring muscles stops the body from falling forward when standing upright.
    • Tightness in the hamstring muscles contributes to low back pain.

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

    • Strained hamstring muscle
    • 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 semitendinosus muscle:

    If you find trigger points in the semitendinosus muscle, 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

    TWD Recommends

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

    Semitendinosus Strain

    If you strain the semitendinosus muscle, you know immediately. You will feel a pulling, tugging, tearing, or popping sensation when the injury occurs. The muscle tear most often happens in the stride, just before your foot hits the ground.

    Muscle strains have three grades:

    Grade 1 strains are mild strains in which a small number of muscle fibers tear. When the tear happens, you will feel a pulling, tugging, or cramping sensation. After resting, you likely will be able to return to whatever activity you were engaged in when the injury occurred, though there will be discomfort. Mild strains usually have little effect on daily activities other than soreness and tightness in the muscle.

    Grade 2 strains are moderate strains and involve the tearing of many muscle fibers. When a Grade 2 strain occurs, you will feel a tearing or popping sensation. A sharp stabbing type of pain may also occur. The pain will make you stop whatever activity you were doing. Daily activities may be affected because of pain and stiffness in the leg. Mild to moderate bruising and swelling usually occurs.

    Grade 3 strains are severe strains in which more than half of the muscle tears. A muscle rupture in which the muscle is ripped from the bone or completely torn in half is also considered a Grade 3 strain. The pain is so debilitating that you may fall to the ground. A tearing or hard popping sensation is felt when the muscle tears. Redness, heat, and swelling are evident soon after the injury. Pain and weakness in the thigh will make walking extremely painful. Grade 3 strains should be examined by a doctor.

    Symptoms of a Semitendinosus Strain:

    • A pulling, tearing, or popping sensation felt in the back of the thigh
    • A severe strain can cause excruciating pain so that putting weight on the leg to walk is difficult or impossible
    • The back of the thigh is extremely tender to touch, and pressure
    • Swelling and bruising are present
    • A feeling of mild to extreme weakness in the thigh
    • Muscle spasms

    What Causes Semitendinosus Strains?

    Hamstring strains occur when the muscle is stretched beyond its capacity.
    Some examples are:

    • Overextending your stride when running
    • Pushing off the ball of your foot or your toes too quickly to accelerate while running
    • Planting your foot and making a hard pivot or sudden turn
    • A misstep that twists the thigh at the hip and/or knee
    • Poor conditioning
    • Muscle fatigue
    • Not warming up before sports or exercise
    • Sudden acceleration or deceleration when sprinting
    • Sudden acceleration or deceleration when speed walking, jogging, or running

    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.

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    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

    Semitendinosus Strain Treatments

    The P. R. I. C. E. Protocol is a 5 step treatment to be used immediately after a muscle strain injury. The steps are:

    • Protect – Stabilize the thigh with a Velcro wrap or elastic bandage: Limit movement and weight-bearing on the affected leg.
    • 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. Apply cold treatments for the first 48-72 hours after the injury to reduce swelling. Do not use cold packs longer than 20 minutes per treatment as longer times may damage soft tissues.
    • 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 of the injury start to subside, you can then begin to alternate cold and heat treatments. Start with a cold pack treatment for 20 minutes, then wait 1-2 hours and apply a warm pack for 20 minutes. Alternating cold and warm packs help with circulation, inflammation, and pain. Do this several times a day.

    Most mild strains are treated with cold packs and, if needed, light compression/or support. If the pain subsides after 24 hours, begin alternating hot/cold treatments.

    Moderate strains should follow the PRICE protocol. If pain, bruising, and swelling are not manageable or increase after 48 hours, you should see a doctor.

    If you suspect a Grade 3 severe strain, you should see a doctor. If you have suffered a muscle avulsion where the muscle is torn away from the bone or a muscle rupture, surgery may be required.

    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 Semitendinosus 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 Semitendinosus Strains

    • Cold muscles are more vulnerable to injury during exercise, sports, and other strenuous activities. Take a few minutes and do a proper warm-up.
    • Pushing too far past your fitness and conditioning can cause muscle strains and sprains.
    • Do not try to stretch muscles past their capacity.
    • Recovery days are important! 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