The biceps femoris tendon is the distal continuation of the biceps femoris to the fibular head, where it forms the lateral hamstring cord palpable in the popliteal fossa. It inserts on the lateral fibular head and styloid, splitting around the fibular collateral ligament, and is a key part of the posterolateral corner, resisting varus stress and external tibial rotation. The common peroneal nerve runs immediately posterior and medial to the tendon as it rounds the fibular neck.
| Muscle | |
|---|---|
| Attachment | Fibular head insertion (lateral surface and styloid), splitting around the fibular collateral ligament; proximal origin from ischial tuberosity (long head) and linea aspera (short head) |
Knee flexion and external tibial rotation force transmission; fibular head stabilisation
Proximal hamstring strains at the long head musculotendinous junction are the most common hamstring injuries in sprinting sports, producing posterior thigh pain with a palpable defect in severe cases. Distally, avulsion from the fibular head, sometimes with a bony fragment (arcuate sign), indicates posterolateral corner injury and must be repaired in combined ACL and posterolateral corner injuries to prevent ACL graft failure. The dial test and external rotation recurvatum test assess the resulting instability, and the common peroneal nerve is at risk both in the injury and during reconstruction.
Proximal musculotendinous junction tear during sprinting producing posterior thigh pain graded I to III by severity, with complete avulsions requiring surgical repair.
Fibular head tendon disruption from a varus and external rotation injury producing posterolateral knee instability with common peroneal nerve injury risk, managed with repair or posterolateral corner reconstruction.
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