Counterstrain
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Counterstrain is a technique used in
osteopathic medicine Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
,
osteopathy Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
,
physical therapy Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
,
massage therapy Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet or a device. The purpose of massage is generally for the treatment of body stress or pain. In Eu ...
, and
chiropractic Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudosci ...
to treat somatic dysfunction. It is a system of diagnosis and treatment that uses tender points, which are produced by trauma, inflammation, postural strain, or disease, to identify structures to manipulate. The manipulation uses light pressure to decompress the local nociceptors and mechanoreceptors responsible for the sensation of pain, returning central sensitization to its normal state. This technique extends Strain-counterstrain, a technique inhibits the reflexes by putting the tissues in a position of ease directly opposite to that of the reflex. Strain-counterstrain is also known as the Jones technique, (correction spontaneous by position), and spontaneous release by position. Counterstrain was developed by Lawrence Jones in 1955 and was originally called “Spontaneous Release by Positioning,” before being termed “strain-counterstrain.”


Strain-Counterstrain

In this technique, the practitioner identifies a point of musculoskeletal pain, called a tender point. Tender points are small, discrete,
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
tous areas on the body that elicit pain when palpated. Monitoring the tender point, the practitioner positions the patient such that the tenderness at the counterstrain point is minimized when pressed. The practitioner holds the patient in a maximally relaxed position for 90 seconds and then slowly returns the passive patient to a neutral body position. Success of treatment is evaluated by reassessing both the tender point and any accompanying change in range of motion. Over 200 tender point locations have been identified to correspond to strain in different muscles and joints. The technique has developed to include variations of manipulations and methods to identify tender points.


Conceptual basis

The idea behind counterstrain states that tender points result from reflexive muscular spasm that correspond to dysfunctional motor segments, due to the compensation of an antagonist muscle responding to agonist muscle over-lengthening.


References


Sources

* Ward, Robert C. et al.; ''Foundations for Osteopathic Medicine'' (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. . {{Osteopathic medicine3 Manual therapy Osteopathic manipulative medicine Osteopathic techniques