Acupuncture for Semitendinosus Muscle Pain
Hamstring pain can be caused by semitendinosus trigger points
If you’re having hamstring pain or pain down the back of your leg, including sciatica type pain, you may be dealing with semitendinosus trigger points or muscle pain. In this post we will talk more about this muscle and explore how acupuncture and dry needling can alleviate semitendinosus pain.
What is the Semitendinosus Muscle?
The semitendinosus muscle is part of the hamstrings, which also include the biceps femoris and semimembranosus muscles. Together, these muscles make up the hamstring muscle complex, crucial for both walking and running as they extend the hip and flex the knee.
Originating from the ischial tuberosity and extending to the medial surface of the tibia, it aids in knee flexion, hip extension, and knee rotation.
Trigger points in this muscle can cause discomfort, radiating pain from the buttocks to the knee and even the lower leg. Overuse, improper exercise form, and prolonged sitting are common triggers.
Hamstring injuries are often seen in athletes and are typically caused by high-speed or explosive movements.
Indications for Semitendinosus Pain
Posterior Thigh Pain
Posterior Leg (Calf) Pain
Posterior Knee Pain
Muscle Action
The primary actions of the semitendinosus muscle are to flex the knee and extend the hip. It also works to medially rotate a flexed knee, tilt the pelvis posteriorly, and help to medially rotate the hip. Additionally, the semitendinosus muscle has a unique role in aiding the popliteus muscle to internally (medially) rotate the leg.
Flex the knee
Extend hip
Medially rotate flexed knee
Assist to medially rotate hip
Tilt pelvis posteriorly
Origin and Insertion
The semitendinosus origin is at the posterior aspect of the ischial tuberosity (sit bone). It attaches there via a common tendon with the biceps femoris or lateral hamstring muscle.
The semitendinosus insertion is at the proximal, medial shaft of the tibia at the pes anserine tendon.
Semitendinosus muscle
Signs and Symptoms of Semitendinosus Trigger Points
Pain when walking
Pain when sitting or getting up from a chair - especially when knees are crossed
Perpetuating Factors of Semitendinosus Muscle Pain
Excessive sitting
Pressure on posterior thigh from ill-fitting chair
Uncomfortable chair or furniture
High speed or explosive motions in sports
Semitendinosus Trigger Points
Semitendinosus trigger points
Acupuncture and Dry Needling for Semitendinosus Trigger Points
Acupuncture and dry needling are highly effective treatments for trigger points in the semitendinosus muscle. These treatments can be particularly beneficial for those experiencing symptoms like sciatica-like pain, posterior thigh pain, and posterior knee pain. A skilled practitioner will use the needle to probe for trigger points that may not be evident on initial palpation and exam.
A 2023 study found that acupuncture can help improve flexibility and reduce pain to help in preventing hamstring muscle injuries.
Another 2020 study found that after one dry needling session of the hamstrings there was improved flexibility, muscle compliance, and stretch tolerance in the hamstrings without added stretching.
A 2021 study found that releasing hamstring tightness with dry needling could also help with chronic low back pain. There were improvements in pain, function, and flexibility of the hamstrings after just one session.
Trigger Point Referral Pattern
Travell and Simons refer to the hamstrings as the “chair seat victims” since their trigger points are commonly caused by excessive sitting.
Trigger points in the semitendinosus muscle primarily cause "high hamstring pain," referring pain upwards to the sit bone or buttock crease. Pain can also radiate downward to the medial posterior thigh and the medial calf.
Associated Trigger Points
Adductor magnus (posterior)
Gluteus maximus
Quadriceps group
Differential Diagnosis
Sciatica pain
Trigger points in muscles with overlapping referral zones - obturator internus, piriformis, gluteus medius, posterior gluteus minimus, , popliteus, plantaris, gastrocnemius muscles.
Knee osteoarthritis
Pain in the semitendinosus can mimic pain from true low back type sciatica. The pain can radiate from the buttock area down to the lower leg and be relieved by releasing trigger points in the semitendinosus muscle.
Corrective Actions
It is important to address the factors that may have led to semitendinosus pain include sitting posture, and exercise habits. Incorporating a semitendinosus stretch into your daily routine can be an effective way to alleviate discomfort and improve flexibility in the hamstring area. Stretching this muscle can help in preventing injuries and reducing the activation of trigger points that cause pain. Whether you're an athlete or someone who sits for extended periods, a targeted semitendinosus stretch can offer significant benefits for your overall muscle health.
Semitendinosus Stretches
Standing Hamstring Stretch: Stand upright and place one foot on an elevated surface, such as a chair or step. Keep your leg straight and gently lean forward until you feel a stretch in the back of your thigh.
Seated Hamstring Stretch: Sit on the floor with one leg extended and the other bent. Reach toward the toes of your extended leg while keeping your back straight.
Lying Hamstring Stretch: Lie on your back and lift one leg, keeping it straight. Use a towel or strap to pull the leg toward you while keeping the other leg flat on the ground.
Supine Hand-to-Big-Toe Pose: Lie on your back and extend one leg up towards the ceiling, holding your big toe with your hand or a strap. Gently pull the leg towards you while keeping the other leg flat on the ground.
Semitendinosus Exercises
Hamstring Curls: Lie flat on your stomach and curl your legs towards your buttocks, then slowly lower them back down.
Swiss Ball Hamstring Curl: Lie on your back with your heels on a Swiss ball. Lift your hips and roll the ball towards you by curling your heels, then roll it back out.
Single-Leg Deadlift: Stand on one leg while holding a dumbbell in the opposite hand. Lower the dumbbell towards the ground while keeping your back straight, then return to the starting position.
Nordic Hamstring Curl: Kneel on the ground with your heels secured under something stable. Lower your torso towards the ground as slowly as possible, using your hamstrings to control the movement.
Remember, always consult a healthcare provider before starting a new exercise or stretching routine, especially if you're dealing with an existing injury or medical condition.
Final Thoughts
In conclusion, understanding the semitendinosus muscle and its functions can provide valuable insights into the causes and treatments of pain in the posterior thigh and leg.
As part of the hamstring muscle complex, the semitendinosus plays a critical role in daily movements like walking and running. It's also particularly susceptible to injuries, especially in athletes or individuals engaged in high-speed activities.
Acupuncture and dry needling offer promising avenues for treating trigger points in this muscle, providing relief from pain and improving overall muscle function.
If you're experiencing symptoms related to the semitendinosus or other hamstring muscles, consider scheduling an appointment with us for a comprehensive treatment plan.
Over to you
If you liked this article, please share with friends and family who may be suffering with hamstring pain.
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).
Mathew K, Pillarisetty LS. Anatomy, Bony Pelvis and Lower Limb: Thigh Semitendinosus Muscle. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539862/
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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