Prone or standing
Ask the patient to wear shorts. Palpation on the skin of the most proximal area is possible by lifting the shorts and placing the fingers distal to the ischial tuberosity.
Posterior to the patient.
Please lie on your stomach (or stand). May I touch the back of your thigh? (or point to the demonstrated area). This muscle attaches near your hip - may I lift the bottom of your shorts to touch the top of this muscle? Please bend your knee (or demonstrate). (If needed, hold this position while I try to straighten your knee.)
Guide the patient to lie on his/her stomach (or stand). With the patient relaxed and with permission, place your fingers:
proximal to the head of the fibula on the posterior knee for the combined tendons of the biceps femoris long and short heads,
on the lateral aspect of the posterior thigh for the biceps femoris long head muscle (the short head is deep to the long head), and distal to the ischial tuberosity for the combined proximal attachment of the two joint hamstring muscles.
Guide the patient to flex the knee. For a more direct line of pull of the muscle, guide the patient to laterally rotate the knee before flexing the knee. With unclear muscle activity, increase the contraction of the biceps femoris by asking the patient to flex the knee while you provide a push on the calf in the direction of knee extension.
Guide the patient to flex the knee. For a more direct line of pull of the muscle, guide the patient to laterally rotate the knee before flexing the knee. With unclear muscle activity, increase the contraction of the biceps femoris by asking the patient to flex the knee while you provide a push on the calf in the direction of knee extension.
VH - Biceps femoris muscle and tendon