The hamstring muscle group is located in the back of the thigh, extending from the buttock down to the back of the knee.  There are 3 hamstrings:  biceps femoris, semimembranosus, and semitendinosus.

Function of the hamstrings – as a group they act to bend the knee and extend the hip.  They also act by elongating to control the lower leg’s ability to straighten while running and walking.

Why do hamstring strains occur?

Most hamstring strains occur during sprinting, cutting or aggressive, burst-like activity.  The location of the injury may be felt anywhere throughout the length of the muscle.  If there isn’t an event that immediately results in pain along the hamstring region, the muscle may become injured due to more repetitive overuse.  There is usually a breaking point when the muscle will strain and pain will become more prominent.  Proper rest and healing times need to be allowed in order for the tissue to heal, otherwise, this type of continued stress can lead to more severe, long lasting issues.

Grading of strains –

Grade I strain – Symptoms are usually located to one specific region, stiffness, weakness may be present.  Grade I strains usually don’t limit activity, but will result in soreness following the activity.  Mild stretching, ice to the region will assist in decreasing inflammation.

Grade II strain – Symptoms will cover a more broad area along the hamstring muscle.  A grade II strain involves moderate tearing of the muscle fibers.  There will be notable weakness, altered ability to walk, possibly bruising in the hamstring region.  Mild stretching, rest and ice are common treatments.  If symptoms are not improving within 2 weeks of self treatment, then consultation with your physician may be advised.

Grade III -  A complete tear of the muscle fibers.  There is usually broad discoloration of the back of the thigh, weakness, altered ability to walk and diffuse pain.  You may also see a “balling up” of the tendon in some cases.  Seeking the care of your physician is recommended.

There is a fairly common form of headaches called “cervicogenic headaches”, which means that the headache is actually originating from a problem in the neck.  This can be from a joint in the neck not moving correctly and causing referral up to the head but it is most commonly from one or more muscles in your neck having a “knot”, or hypertonic area, in them and the knot referring symptoms up to your head.

What is significant about this kind of headache is that a person does not have to have neck pain at the same time of the head pain (but they also can).  This type of headache is significant to me because it happens to be something that I personally have 1-2 times per month.

I am going to focus on the muscular cause of headaches and typical pain patterns you see as well as why you might get them in the first place.

Common referral patterns and the muscles involved:

1.  Suboccipital Headaches – the suboccipital muscles are located at the base of your neck, where your neck and the back of your head meet.  These muscles tend to cause headaches that radiate from the back of your head, around the side or over the top and onto your forehead.  They can also skip any portion and just cause pain at the back of your head, side of your head or in your forehead only.

2.  Sternocleidomastoid Headaches – These are large muscles in your neck that run from the bone behind the base of your ear down to your sternum and collarbone, on each side.  They will tend to cause headaches that are located at your temple and wrap around your eye.

3.  Upper Trapezius Headaches – This muscle runs from the back side of your head down onto the top of your shoulder, on each side.  These muscles cause headaches that wrap around your ear, from the back, around the top and to the front, like a large fish-hook.

4.  Temporalis Headaches - This muscle sits right at the temple area of your head, which is just to the lateral side of your eye, on both sides.  Headaches from this muscle will stay right at the side of the head, where the muscle is located.

5.  Occipitofrontalis Headaches -the occipitofrontalis muscles are located at the back of your head, near the base.  These muscles tend to cause headaches that radiate from the back of your head, over the top and onto your forehead.  They can also skip any portion and just cause pain at the back of your head, top of your head or in your forehead only.

This is not a complete list of every muscle that can create a headache but what I see most commonly in my practice – Probility Physical Therapy.  If you ever have a headache in the areas described above, try massaging the muscles around the “X” points indicated for each one.  If you find a very tender spot which reproduces your pain, you’ve got a Trigger Point which is causing a cervicogenic headache!  Gentle massage to that spot will often relieve the headache, at least somewhat.  Good luck!