This is a great example of how trigger points can create a confusing referral pattern that leaves you chasing the wrong muscle.
These people grab their hamstring and talk about how painful it is. They are often quite careful about not stretching their ham too aggressively. They may spasm easily when the knee is flexed to touch the heel to their hip.
I’ve seen a lot of this problem over the years, especially from runners. This seizing hamstring can really shut down their activity and confuse them. Their hamstring goes into painful spasm even though they continue to stretch it as directed. This can be debilitating and discouraging.
Sometimes, this produces cramped hamstring during driving. People are focused on having a leg room where they can really stretch out. This generally slides th hip forward in the seat and actually makes the trigger point more active and the pain worse. It is tough to convince them differently.
The problem is that the seizing hamstring is a referral pattern of another muscle, the gluteus minimus. The gluteus minimus is located on the side of the hip. Right where the asterisk is in the illustration. I’ll help you to see that seizing hamstring pain is really the referral of the gluteus minimus and not the lateral hamstring itself.
Let’s elicit the pattern for the hamstring first. One easy way to elicit trigger point referral is to stretch the muscle. Lay on your back, straighten your knee and stretch your hamstring by pulling your leg back toward your chest while keeping the knee straight.
You can focus the stretch on the outside hamstring by turning the toe out with a strap and pulling the foot a little toward the opposite shoulder.
That’s right! You feel it behind the knee!
This is the referral pattern for the lateral hamstring. when this trigger point is active, it creates pain behind the knee.
You can probably elicit this pattern by pressing into those spots with a foam roller or tennis ball. When you hit the trigger points, You’ll feel it in the knee.
This aggravation can create what is called a satellite trigger point in the hamstring, so I offer a stretch for that in the self-care post.
Now, let’s elicit the pattern from the gluteus minimus. Look at the picture above to see where you should place the ball. Take a tennis ball and lay it on the floor. Now, lay on the tennis ball so that it presses into this spot. You may need to squirm around on it a bit to find the specific spot. Most people guess too far back and need to turn onto their side a bit more with the ball farther forward. There are several trigger points in this area that produce different pain patterns into the hip and down the leg.
You can watch me do this in the self-care video.
This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.
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This post is about the watershed moment that changed the direction of my bodywork. People would say that it is about treating at the source. I’d say that it is about understanding the governors and accessories in a pattern. This gives the therapist and client choices on how to plan on treating for relief or treating to create a body that is self-correcting.
Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.
*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.