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ECOS I Exam 1 > 14: Intro To Counterstrain > Flashcards

14: Intro To Counterstrain Flashcards

1
Q

Counterstrain type of technique

A

Passive, indirect

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2
Q

Use for Counterstrain

A

Musculoskeletal pain

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3
Q

How is diagnosing for Counterstrain unique?

A

Focus on tenderness, not preference of motion

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4
Q

When and by who was counterstrain started?

A

1955, Dr. Lawrence Jones

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5
Q

Story of how counterstrain started

A

Pt came in with 2.5 months of psoas syndrome, couldn’t get comfortable while sleeping. Physician helped him find a comfortable spot on the table -> left and came back and pt was much improved

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6
Q

What happens to tenderpoint TART findings during counterstrain treatment?

A

They soften and reduce in pain

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7
Q

Amount of time to hold for counterstrain

A

90 seconds

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8
Q

Dr. Travell and Dr. Jones

A

Published about tenderpoints and trigger points

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9
Q

Trigger point vs tenderpoint: location

A

Trigger point: in muscle only

Tenderpoint: in muscle, tendon, ligaments, or fascia

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10
Q

Pain pattern in trigger pt vs tenderpoint

A

Trigger point: characteristic pain pattern with local radiation
Tenderpoint: no characteristic pattern and no radiation

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11
Q

Tautness of tissue in trigger point vs tenderpoint

A

Trigger point: have a taut band of tissue that will twitch when palpated
Tenderpoint: no taught band or twitch response

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12
Q

Only requirement to do counterstrain on a patient

A

Must be able and willing to be positioned and relax

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13
Q

Two ways to name tenderpoints

A
  1. Using laterality + the vertebrae (ex: L PC4)

2. By anatomic structure being treated (ex: L Psoas)

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14
Q

Counterstrain treatment nomenclature steps

A
  1. Flex or extend
  2. Sidebending away or towards tenderpoint
  3. Rotating away or towards tenderpoint
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15
Q

What would the counterstrain treatment be for R PC6?

A

E, SaRa

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16
Q

Uppercase vs lowercase letters in counterstrain treatment

A 
Lowercase = a little
Uppercase = a lot
17
Q

Maverick

A

Tenderpoint with treatment position opposite of the rest of the tenderpoints in its region (doesn’t follow patterns of those around it)

18
Q

Stoic

A

Distinct palpable TTA without tenderness

19
Q

Two perspectives behind counterpoint

A

Nociceptive perspective, proprioceptive perspective

20
Q

Nociceptive perspective of tenderpoints

A

Tenderpoint initiated by nociceptors in strained tissue -> reflexive contraction to protect tissues -> reflex loop

21
Q

Proprioceptive perspective of tenderpoints

A

Muscle spindle fibers monitor length of muscles using the gamma and alpha motor neurons

22
Q

What happens with a sustained contracture?

A

Overwhelms normal nervous regulation of muscles, reduced metabolic recovery, lactic acid causes sensitization of nerve endings -> area becomes TTP

23
Q

Four phases of Counterstrain

A
  1. Relaxation
  2. Normalization of nociceptive and neurologic input
  3. Washout
  4. Slow return to normal
24
Q

Seven steps in counterstrain

A
  1. Find most significant tenderpoint
  2. Physician establishes a tenderness scale
  3. Monitor tenderpoint throughout
  4. Place patient in position of ease of 70%+ improvement
  5. Hold for 90 seconds
  6. Slow return to neutral
  7. Recheck tenderness
25
Q

How does physician establish a tenderness scale?

A

The physician tells the patient that thier most tender spot is a 10/10, and that they will work to get it down to at least a 3/10

26
Q

What three physiological things occur when patient is in position of ease?

A
  1. Muscle tissues shorten and relax
  2. Nociceptive input resolves
  3. Spindle fiber length resets + gamma loop restored to normal input
27
Q

What might be felt while holding the tenderpoint for 90 seconds?

A

A therapeutic pulse associated with metabolic washout (begins about 10-15 seconds after optimal positioning, ends in about 60 seconds)

28
Q

What could happen if you dont slowly return patient back to neutral?

A

Could reactivate muscle spindle cell activity

29
Q

Treatment position for PL 1-5 SP

A

E, Add, ER

30
Q

Treatment position for PL 1-5 TP

A

E, Sa, Rt

31
Q

Treatment for UPL5

A

E, Add, ir/er

32
Q

Treatment for LPL5

A

F, Add, IR (only flexion treatment)

33
Q

Treatment for HSIS

A

E, ABD, ER (one of the two abd)

34
Q

Treatment for PL 3 and 4 Glut

A

E, Abd, er (one of the two abd)

35
Q

Treatment for PT 1-3 TP AND for PT 10-12 TP AND for PL 1-5 TP

A

E, Sa, Ra

36
Q

Treatment for PT4-9 TP

A

E, Sa, RT

ECOS I Exam 1 (22 decks)

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