Acupuncture for Biceps Femoris Muscle Pain
Hamstring pain can be caused by biceps femoris trigger points
What is the Biceps Femoris Muscle?
The biceps femoris, a pivotal part of the hamstrings (the others being the semitendinosus and semimembranosus), is nestled at the back of the thigh. Comprising two distinct heads - the long head and the short head - it has its origins at two points: the ischial tuberosity of the pelvis and the femur. The muscle extends to converge on the tibia (shin bone) and fibular head at the lower leg.
The biceps femoris muscle is the strongest muscle within the hamstring muscle group and it plays a crucial role in knee flexion, external rotation, and providing posterolateral support to the knee joint.
This muscle comprises two parts: a long head and a short head. It's interesting to note that in certain normal anatomical variations, the short head of the biceps femoris might not be present.
Biceps Femoris Injury
Injury to the biceps femoris might stem from overuse, insufficient stretching, or a deficiency in muscle strength. This can lead to biceps femoris strains and injury to the muscle and tendon which can lead to long term biceps femoris tendinopathy. A shortened muscle leads to tugging on the sit bone and lateral lower leg with can cause inflammation of the tendon.
Symptoms often manifest as pain, swelling, and a noticeable weakness within the back of the thigh. To address the resultant discomfort from biceps femoris trigger points, acupuncture and dry needling can be incredibly effective. These modalities are often supplemented with physical therapy and rehabilitative exercises to bolster strength, enhance flexibility, and augment the range of motion.
Hamstring strains are a common injury among athletes at both elite and recreational levels. These injuries not only occur frequently but also have a tendency to heal slowly and recur. It is estimated that nearly one-third of athletes who suffer a hamstring strain will experience a re-injury within a year of returning to their sport. Such strains are most prevalent in high-intensity activities like sprinting, where sudden changes in speed or direction lead to excessive stretching of the muscle.
Among the hamstring muscles, the biceps femoris is the most commonly injured, followed by the semimembranosus and the semitendinosus. These injuries typically present as pain in the back of the thigh, and this discomfort often intensifies during movements involving bending the knee or extending the hip.
Muscle Actions
The primary actions of the biceps femoris muscle are to flex the knee and laterally rotate a flexed knee. It also helps tilt the pelvis posteriorly. The long head of the biceps femoris also extends the hip and assists to laterally rotate the hip.
Biceps Femoris Actions:
Flex the knee
Laterally rotate flexed knee
Tilt pelvis posteriorly
Long head only:
Extend the hip
Help laterally rotate the hip
Origin and Insertion
The biceps femoris origin has two locations - one for each head. The long head origin is at the ischial tuberosity (sit bone) and the short head origin is at the lateral lip of the linea aspera on the femur.
The biceps femoris insertion is at the head of the fibula and lateral condyle of the tibia for both heads of the muscle.
Indications of Biceps Femoris Pain
Posterior knee pain
Posterior thigh pain
Pain in the muscle can cause pain that irritates the sciatic nerve and mimics true sciatica from the low back.
Signs and Symptoms of Biceps Femoris Trigger Points
Pain during ambulation or walking
Discomfort when rising from a seated position or while sitting, particularly if the knees are crossed
Perpetuating Factors for Biceps Femoris Muscle Pain
Prolonged periods of sitting
Consistent pressure on the posterior thigh due to poorly designed seating
The use of uncomfortable furniture
Risk Factors for Biceps Femoris Injuries include:
Most common in soccer and other sports that involve sprinting.
A previous injury to the biceps femoris tendon can increase the likelihood of a subsequent injury sixfold, often due to weaker scar tissue that heightens the risk of re-injury.
Initiating intense training sessions without adequate warm-up.
Disproportionate strength in the hamstrings compared to the quadriceps.
An imbalance in hamstring strength between the legs, with a discrepancy exceeding 15%.
Restricted hip extension movement.
A difference in leg lengths, where the shorter leg tends to have tighter hamstrings.
Biceps Femoris Trigger Points
Trigger Point Referral Patterns
Trigger points in the biceps femoris muscle can refer pain in distinct patterns:
Distally towards the back of the knee, potentially reaching the upper calf
Upward into the posterior thigh, up to the sit bone or buttock crease, resulting in a deep, achy sensation
Acupuncture and Dry Needling for Biceps Femoris Trigger Points
Acupuncture and dry needling have been shown to be highly effective in treating trigger points in the semitendinosus muscle, offering significant relief for symptoms such as sciatica-like pain, pain in the back of the thigh, and pain behind the knee. These techniques involve a trained practitioner skillfully using needles to target trigger points that might not be immediately noticeable during a standard examination.
Recent research underscores the effectiveness of these methods. A 2023 study revealed that acupuncture can enhance flexibility and alleviate pain, contributing to the prevention of hamstring muscle injuries.
In a 2020 study, it was demonstrated that a single session of dry needling on the hamstrings improved their flexibility and muscle compliance, as well as stretch tolerance, even without additional stretching exercises.
Furthermore, a 2021 study highlighted that addressing hamstring tightness through dry needling can aid in managing chronic lower back pain. The study noted improvements in pain levels, function, and hamstring flexibility following just one dry needling session.
Associated Trigger Points
Trigger points in the biceps femoris may be related to or affect adjacent muscles such as:
The posterior adductor magnus
The vastus lateralis
The gastrocnemius
Differential Diagnosis
Distinguishing between sciatica and pain originating from biceps femoris trigger points is crucial, as both can present with similar symptoms.
Preventive Measures and Corrective Actions
To prevent the onset of biceps femoris pain, attention should be paid to:
Sitting posture
Exercise habits
Incorporating stretches targeting the biceps femoris muscle can alleviate discomfort and preemptively address factors contributing to pain.
Biceps Femoris Stretches and Exercises
A variety of stretches and exercises can be employed to maintain the health of the biceps femoris muscle:
Standing and seated hamstring stretches
Lying hamstring stretches
Hamstring curls
Stability ball exercises
Single-leg movements
Always consult with a healthcare provider before embarking on a new exercise regimen, particularly if you're currently experiencing pain or managing a pre-existing condition.
Final Thoughts on Biceps Femoris Care
Recognizing the role and function of the biceps femoris muscle is pivotal for understanding the origin of posterior thigh and leg pain. As an essential player in the hamstring complex, the muscle is crucial for daily activities and is prone to injury, especially in athletes.
Acupuncture and dry needling present promising treatment options for biceps femoris trigger points, offering pain relief and enhanced muscle functionality.
If symptoms of biceps femoris pain resonate with your experience, we invite you to schedule a consultation with us at Morningside Acupuncture for a tailored treatment plan.
Over to you
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Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.
Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.
Janda, Vladimír. “Muscle Function Testing.” (1983).
Rodgers CD, Raja A. Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle. [Updated 2023 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546688/
Hsu D, Anand P, Mabrouk A, et al. Biceps Tendon Rupture of the Lower Limb. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536969/
Tokutake, G., Kuramochi, R., Murata, Y., Enoki, S., Koto, Y., & Shimizu, T. (2018). The Risk Factors of Hamstring Strain Injury Induced by High-Speed Running. Journal of sports science & medicine, 17(4), 650–655.
Carvalho, R. M., Machado, J., Santos, M. J., & Matos, L. C. (2023). Can Acupuncture Improve the Flexibility of Hamstring Muscles? A Randomized, Blinded, and Controlled Pilot Study. Healthcare (Basel, Switzerland), 11(4), 490. https://doi.org/10.3390/healthcare11040490
Ansari, N. N., Alaei, P., Naghdi, S., Fakhari, Z., Komesh, S., & Dommerholt, J. (2020). Immediate Effects of Dry Needling as a Novel Strategy for Hamstring Flexibility: A Single-Blinded Clinical Pilot Study. Journal of sport rehabilitation, 29(2), 156–161. https://doi.org/10.1123/jsr.2018-0013
Bazzaz-Yamchi, M., Naghdi, S., Nakhostin-Ansari, A., Hadizadeh, M., Ansari, N. N., Moghimi, E., & Hasson, S. (2021). Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study. TheScientificWorldJournal, 2021, 7259956. https://doi.org/10.1155/2021/7259956
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