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:
on the medial posterior knee for the tendon of the semitendinosus, proximal to the tendon for the semitendinosus muscle,
medial and lateral to the tendon of the semitendinosus for the wide semimembranosus muscle, and
distal to the ischial tuberosity for the combined tendon of all the hamstring muscles.
Guide the patient to flex the knee. For a more direct line of pull of the muscle, guide the patient to medially rotate the knee before flexing the knee. With unclear muscle activity, increase the contraction of these muscles 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 medially rotate the knee before flexing the knee. With unclear muscle activity, increase the contraction of these muscles by asking the patient to flex the knee while you provide a push on the calf in the direction of knee extension.
VH - Semitendinosus and semimembranosus