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(Last Updated On: July 24, 2019)

Semitendinosus Pain: Trigger Point Pain and Muscle Strain Pain

Where Is The Semitendinosus Muscle?

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

What Movements Does The Semitendinosus Muscle Control?

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

Do you need muscle anatomy information? The Semitendinosis Anatomy page has origin, insertion, innervation and blood supply information. It also lists agonist and antagonists for each muscle action.

Semitendinosus Muscle Pain

Semitendinosus trigger point pain is centered at the top of the thigh close to the gluteal fold. Pain often travels down into 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 any where along the length of the muscle. Strains at the knee are rare.

Pain pattern of the semimembranosus muscle

Semitendinosus Pain Referral: Pain centralizes just below the buttock in the upper thigh. Pain may extend down the inside leg to the knee and sometimes the top of the calf.

What Are The Signs and Symptoms of Semitendinosus Trigger Points?

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 to the knee and top of the calf.

Other signs and symptoms:

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

What Causes Trigger Points To Develop In The Semitendinosus Muscle?

  • When you sit for long periods of time 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 Muscle

  • 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 benched that put pressure on the back of the thigh will cause trigger points in the back of the thigh. Cushion the edge 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 foot stool 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 work loads are injury prone.

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 time practicing 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 important for successful treatment.

TWD Suggestions For Semitendinosus 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)

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.

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.

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.

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.

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

Satellite trigger points associated with the semitendinosus muscle:

If you find trigger points in the semitendinosus 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 semitendinosus muscle:

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

Semitendinosus 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

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Semitendinosus Muscle Strain Pain

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

Muscle strains are classified into 3 grades. Grade 1 is mild, Grade 2 is moderate, and Grade 3 is severe.

Grade 1 strains are mild strains in which a small number of muscle fibers are torn. When the strain happens you will feel a mild pulling, tugging, or cramping sensation. Chances are after resting a bit you 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 moderate strain occurs a tearing or popping sensation is often felt. A sharp stabbing type pain may also be experienced. 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 often occur.

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

Some of the signs of a semitendinosus strain are:

  • A pulling, tearing, or popping sensation is 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
  • Swelling and bruising are present
  • A feeling of weakness in the thigh
  • Muscle spasm
high-kick

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

TWD Suggestions For Semitendinosus 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.

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.

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.

What Causes A Semitendinosus Strain?

Strains occur when the muscle is stretched beyond capacity and/or when the weight of the body is suddenly loaded onto the muscle. Some examples are:

  • Over extending your stride when running
  • Pushing off the ball of your foot or your toes to quickly accelerate while running
  • Planting your foot and making a hard pivot or sudden turn
  • A misstep that twists the thigh at 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
  • 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.

Semitendinosus Strain Treatment

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.
  • 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.
  • 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 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.


Most mild strains are simply treated with cold packs and if needed light compression/or support. If pain persists after 48 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 be examined by a doctor. In the event of a muscle avulsion where the muscle is torn away from the bone or a complete rupture of the muscle surgery may be required.

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 Semitendinosus Strain To Heal?

A Grade I (mild) strain can heal in 3-4 weeks.

A Grade II (moderate) strain can take 4-12 weeks to heal depending on the severity of the muscle fiber tears.

A Grade III strain can take several months to a year to heal due to the damage of the muscle fiber and possible tendon tears.

**Because semitendinosus and other hamstring strains have a tendency to reoccur, Grade II and Grade III strains should be monitored by a doctor. 

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.

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

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

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.

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 you 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.

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