Anterior Lumbar and Pelvis Counterstrain

Question 1

If there are multiple tenderpoints, which one do you treat first?

Answer 1

• the most painful one

- if there are multiple tenderpoints at the same pain severity, treat the most central or proximal first

Question 2

Which would you treat first, a thoracic tenderpoint or a rib tenderpoint?

Answer 2

-thoracic

Question 3

In supine counterstrain, what body part is used to induce rotation, flexion/extension, and sidebending?

Answer 3

• rotation = hips
• flexion/extension = knees
• sidebending = ankles

Question 4

What are some absolute contraindications to counterstrain?

Answer 4

• traumatized tissues
• severe illness w/ positional restrictions
• instability of the area being positioned
• vascular or neuro syndromes (basilar insufficiency)
• spondylosis w/ local fusion at level of Tx position

Question 5

Where is the AL1 tenderpoint and what is the Tx position?

Answer 5

• medial ASIS

- F StRa

Question 6

Where is the AL2 tenderpoint and what is the Tx position?

Answer 6

• medial AIIS
• F SaRt

–emphasize rotation

Question 7

Where is the AL3 tenderpoint and what is the Tx position?

Answer 7

• lateral AIIS

- F SaRt

Question 8

Where is the AL4 tenderpoint and what is the Tx position?

Answer 8

• inferior AIIS

- F SaRt

Question 9

Where is the AL5 tenderpoint and what is the Tx position?

Answer 9

• lateral to the pubic symphysis

- F SaRa

Question 10

Where is the Psoas Major tenderpoint and what is the Tx position?

Answer 10

• -two-thirds from ASIS to midline, deep pressure

- -F St

Question 11

Where is the Iliacus tenderpoint and what is the treatment position?

Answer 11

• medial to ASIS, deep in iliac fossa

- F ER

Question 12

Where is the low ilium tenderpoint and what is the treatment position?

Answer 12

• superior pubic ramus, where psoas passes pelvic rim

- F

Question 13

Where is the inguinal ligament tenderpoint and what is the treatment position?

Answer 13

• lateral pubic tubercle

- flex hips, cross contralateral leg over, pull ankles towards the tenderpoint (F IR)

Question 14

What is coccydynia?

Answer 14

-pain associated w/ the coccyx; pain worsens with sitting or in transitioning from sitting to standing

-possibly following sacral trauma
(fall, childbirth, posture)

Question 15

Where is the High Ilium Flare Out tenderpoint and what is the treatment position?

Answer 15

• lateral ILA
• E Add (some external rotation)

-associated w/ coccygeus m.

Question 16

Where is the piriformis tenderpoint and what is the treatment position?

Answer 16

• halfway from ILA to greater trochanter (muscle belly)

- F Abd ER