Anterior Counterstrain Flashcards
Counterstrain Steps
1) Diagnose the somatic dysfunction
2) Find a significant tender point (TP)
3) Establish a pain scale
4) Wrap around the TP while monitoring
5) Reduce pain at least 70% (patient in a position of comfort)
6) Maintain position for 90 seconds
7) Slowly and passively return patient to neutral
8) Reassess Somatic Dysfunction (tender point) `
AC1 Mandible
SaRa
Location: on the posterior surface of the ascending rams of the mandible
AC1 TP
SaRa
Location: on C1 transverse process found midway between rams of mandible and mastoid process
AC2-6
F SaRa
Location: Anterior aspect of Transverse processes of corresponding vertebrae
AC7
F StRa
Location: Posterosuperior surface of proximal clavicle where SCM muscle inserts (2-3 cm lateral to the AC 8 TP)
AC8
FSaRa
Location: Clavicular insertion of SCM muscle, near the sternal notch
AT1
F
Location: Midline on suprasternal Notch
AT2
F
Location: Midline on the manubrium at sternal angle (Angle of Louis)
AT3 and AT4
F
Location: Midline at the level of the costal cartilage related to the named vertebra
AT5
F
Location: Midline at the level of the costal cartilage related to the named vertebra
(about 1 inch superior to the Xiphoid)
AT6
F
Location: Midline at the level of the costal cartilage related to the named vertebra
(At sternal-xiphoid junction)
Treatment Position for AT1-AT6
Patient- Supine
Physician- at the head of the table, cervical and thoracic flexion to the level of the TP. Doctor can place their knee under the patient’s head/neck or trunk to use as a wedge to flex the patient. More flexion will be needed the further down the TP is located
AT7
F StRa
Location: Can be midline OR lateral to midline
1/4 from the tip of the xiphoid and the umbilicus
AT8
F StRa
Location: Can be midline OR lateral to midline
halfway between the xiphoid and umbilicus
(1.5 inches inferior to the xiphoid)
AT9
F StRa
Location: can be midline OR lateral to midline
3/4 the distance from xiphoid tip to the umbilicus
(1-2 cm superior to the umbilicus)
Treatment Position for AT7-AT9
Patient- seated
Physician- standing behind the patient, place foot on the side OPPOSITE the tender-point then use the leg to sidebend the torso toward and rotate the patient away
AT10
F StRa
Location: Lateral to midline, 1/4 distance from the umbilicus to the pubic symphysis (1-2 cm inferior to umbilicus)
AT11
F StRa
Location: Lateral to midline, halfway between umbilicus and pubic symphysis (3-4 cm below the umbilicus)
AT12
F StRa
Location: Lateral to midline, mid-axillary line on the superoanterior surface of iliac crest
Treatment Position for AT10- AT12
Patient- Supine
Physician- Stand on the same side as the TP; flex the patient’s hip and knees and place them on the physician’s thigh (flex further as needed); pull patient’s knees toward the doctor, causing the pelvis and lower segment to rotate toward the TP while the torso and upper segment rotate away; pull patient’s ankles towards the doctor which sidebends the dysfunctional segment towards the TP
AR1
F StRt
Location: inferior to clavicle on rib 1, literal to manubrium (directly inferior to SC joint)
AR2
F StRt
1.5 inch lateral to manubrium on rib 2, below mid-clavicular line; may also be found deep in axilla
Treatment Position AR1-AR2
Patient- supine
Physician- head of the table
Treats a depressed rib, inhalation restriction
Anterior Rib
Exhalation SD
AR tender points are usually depressed ribs
Posterior Rib
Inhalation SD
PR tender points are usually elevated ribs
AR 3-6
F StRt
Location: Anterior axillary line on ribs 3-6 (slightly anterior to mid-axillary line)
Treatment Position AR3-6
Patient- supine
Physician- behind patient, knee under the arm on unaffected side (OPPOSITE)
Treats a depressed rib, inhalation restriction
PR1 (treatment included)
E SaRa
Maverick Point
Location: posterior margin of rib head beneath margin of trapezius
Find the connection between the rib and the vertebra and then go out to the angle
Treatment: Patient- supine; physician- standing behind the patient or on the same side; may also be done from a seated position
PR2 (including treatment)
F SaRa
Location: superior surface of angles of ribs at medial border of scapula, about 2 1/2 inches lateral to midline
Treatment: Patient- seated; physician- standing behind/ to the side, the doctor places the patient’s arm on the side of the dysfunction (SAME SIDE)
PR3-6 (include treatment)
F SaRa
Location: superior surface of angles of ribs at medial border of scapula, about 2 1/2 inches lateral to midline
Treatment: Patient- seated; physician- standing behind/ to the side, the doctor places the patient’s arm on the side of the dysfunction (SAME SIDE)
