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Back of Thigh Pain Trigger Points


Trigger Point Therapy for Back of Thigh Pain and Back of Knee Pain

Tension in the muscle groups on the back of the thigh is extremely common. If left unaddressed, this tension will often lead to painful stiffness that is experienced in the back of the thigh region. Occasionally this muscle group will suffer "charlie horse" cramping episodes. The abnormal tension that inflicts these muscle groups will often predispose athletes to hamstring strains or tears.


The three muscles groups that are frequently involved with back of the thigh pain and back of knee pain are:

  • The Hamstrings (the Semitendinosus, Semimembranosus, and the Bicep Femoris)

  • The Gluteus Minimus

  • The Gastrocnemius

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The Hamstring Trigger Points that Cause Back of Thigh and Back of Knee Pain

The Hamstring muscle group is composed of three muscles; the Semitendinosus, the Semimembranosus, and the Biceps Femoris. 

The Semitendinosus and Semimembranosus muscles attach to the lower pelvis and run downward to attach to the lower leg just below the inside of the knee. These muscles function to keep the trunk erect when standing, and to flex the leg at the knee.


Trigger points in these muscles refer pain to the back of the thigh, lower buttocks and back of the knee regions. People with active trigger points usually experience pain while walking, causing them to limp. Trigger points in these muscles may also contribute significantly to knee pain disorders.

The Biceps Femoris attaches on the pelvic bone and the femur (thigh bone), and extends downward to attach to the smaller lower leg bone (the fibula) just below the outside aspect of the knee joint. When the Biceps Femoris muscle contracts, it flexes the knee to bend the leg. It is heavily used in walking, running and other activities.


Trigger points in this muscle refer pain to buttock, back of the thigh, and back of the knee regions. Additionally, they may cause "charlie horse" type cramping episodes. The pain is felt during walking, sitting, and may disturb sleeping. The muscle weakness created by these trigger points, will frequently cause the other thigh muscles to become overloaded and develop their own trigger points.

Hamstring Trigger Point Symptoms

Patients with active hamstring trigger points will complain of posterior thigh pain and/or posterior knee pain that is worse when walking and often causes a limp. The pain may disturb their sleep at night and may concentrate in the buttocks when sitting.

Patients may also have symptoms related to quadriceps femoris trigger points, such as front of thigh and knee pain. The hamstrings and the quadriceps muscle groups share a strong biomechanical relationship and thus will often share trigger point activity.

The Hamstring trigger points also play an indirect, but important role in low back pain disorders. Though they do not refer pain to the low back region, any overload of the hamstring muscles predisposes the low back muscles to overload and trigger point development.

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The Gluteus Minimus Trigger Points that Cause Back of Thigh Pain

The Gluteus Minimus is a small, fan-shaped muscle group that lies deep in the buttock region, just above and behind the hip joint. It attaches to the pelvic bone and runs downward to attach to the thigh bone (the femur) near the hip joint.


Like the larger Gluteus Medius muscle group that lies over it, the Gluteus Minimus functions to stabilize the pelvis during walking and other upright activities. Gluteus Minimus trigger points can refer pain to the hip joint, buttocks, down the back of the leg to the calf, and down the outside of the leg to the ankle.


These trigger points can be activated by trigger points in the Quadratus Lumborum muscle group, by long periods of immobilization, or by the abnormal body mechanics that are created when a person must limp for any reason. Additionally, men may activate these trigger points by sitting on a large wallet that is kept in the back pocket.


The posterior trigger points, typically three or four in number, refer pain to buttocks, back of the thigh, and calf regions

Gluteus Minimus Trigger Point Symptoms

Patients with trigger point activity in the gluteus minimus muscle group may report buttock pain, hip pain and pain down the back of the leg to the calf. The buttock pain and the pain down the leg together can make a convincing case of sciatica.

The hip pain is produced by the lateral trigger points in this muscle. These trigger points may also refer pain down the outside of the thigh and lower leg and is termed "side-sciatica". This hip pain will cause the patient to limp while walking. and have difficulty getting out of a chair.

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The Gastrocnemius Trigger Points that Cause Back of Knee Pain

The Gastrocnemius muscle attaches in the back of the knee region and runs downwards to connect to the Achilles tendon. Contraction of this muscle will lift you up onto your toes (plantar flexion).


Trigger points in this muscle cause pain in the calf region  and also on the bottom of the foot. Additionally, the trigger points can cause the muscle to cramp, frequently at night. People with Gastrocnemius trigger points will have difficulty walking upstairs or on steep slopes.

Gastrocnemius Trigger Point Symptoms

Patients with active gastrocnemius trigger points will complain of calf cramps, typically at night (these may also occur with gastrocnemius trigger points that aren't active).


They may also complain of back of knee pain, especially when walking uphill or upstairs, and pain in the instep region on the bottom of the foot. The foot pain can mimic plantar fasciitis.​

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Related Instructional Videos from Dr. Perry

While the videos below were created to teach therapists how to locate and release these trigger points, many non-professionals have used them to learn these techniques successfully.

If you have a partner, a little time, you can use these videos to learn how to treat your own trigger points.

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Related Articles from Dr. Perry

More extensive articles on these muscles and trigger points are available from Dr. Perry on our sister website Click on the titles below to read them:

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