Chapter 14 - Counterstrain and FPR Flashcards
Counterstrain is (passive/active) and (direct/indirect)
Passive, Indirect
Tenderpoints are typically located where?
Near bony attachments of tendons, ligaments
OR in the belly of some muscles
Why is counterstrain held for 90 seconds?
The time required for the proprioceptive firing to decrease in frequency and amplitude
If a tenderpoint is associated with a V-S reflex, how long will the pain be reduced following a counterstrain treatment?
A few hours at most
Anterior cervical TPs - treatment position?
SB and Rotate AWAY
Tenderpoint 2-3 cm lateral to the SC joint on the clavicle
This point is considered a _____
Treatment position?
C7 (SCM lateral attachment)
Maverick point
Flex, SB toward, Rotate away
Posterior cervical TPs - treatment position?
Extend, SB and Rotate AWAY
PC1 inion - location?
Considered a ____
Treatment position?
Posterior occipital protuberance
Maverick point
FLEXION
T1 - T6 - locations
*AT2 tenderpoint specifically?
Midline on the sternum at the attachment of those ribs
AT2 is on the sternum at the Angle of Lewis
T7-T12 - locations
specifics for AT9-12
*what is special about AT12?
(MOST) In the rectus abdominus muscle, 1 inch lateral to midline on the R or L
AT9 - 1cm above umbilicus
AT10 - 1-2 cm below umbilicus
AT11 - 2 in below umbilicus
AT12- inner ala of ilium in midaxillary line bilaterally (*the only AT tender point with two locations - bilateral)
Anterior thoracic points - treatment position?
Flex thorax, little SB and Rotation AWAY
Posterior thoracic points - treatment position?
Extend thorax, little SB and Rotation AWAY
Anterior rib tenderpoints = ____
Posterior rib tenderpoints = ____
EXHALATION (depressed) ribs
INHALATION (elevated) ribs
AR1 - location
Treatment position?
Below the medial clavicle, where rib 1 attaches to the manubrium
Flex head, SB and Rotation TOWARDS (like rib 2)
AR2 - location
Treatment position?
6-8 cm lateral to sternum on rib 2
Flex head, SB and Rotation TOWARDS (like rib 1)
Ribs 3-6 - location
Treatment position?
Mid-axillary line on the corresponding rib
SB and Rotate thorax TOWARD, slight flexion
Posterior rib points - location
Treatment position?
Angle of the rib
SB and Rotate AWAY, minimal flexion
L1 - location
L2-4 - locations
**L5 - location
L1 = Medial to ASIS L2-4 = Medial, Lateral, and Inferior to ASIS L5 = 1cm lateral to pubic symphysis on superior ramus
Anterior lumbar points - treatment position
Supine, hips and knees flexed and ER (rot away)
Posterior lumbar points - locations
SP or TP of lumbar vertebrae
L3, L4 = maybe iliac crest
L5 = maybe PSIS
Posterior lumbar points - treatment position
Prone, extended, SB away (Rotation toward or away)
Lower pole L5 - location
Treatment position
Caudad to PSIS
Prone, Hip and knee flexed, leg IR and ADD
Iliacus - location
Treatment position
7 cm medial to ASIS
Supine, hip flexed and ER
Piriformis - location
Treatment position
7 cm medial and slightly cephalad to trochanter
Prone, Hip and Knee flexed, thigh abducted and ER
Describe FPR
- Direct or indirect?
- Patient position? Why?
- After positioning?
- How long to hold?
Indirect MFR where body part is placed into a NEUTRAL position to diminish tissue and joint tension in all planes, then adding an ACTIVATING force (compression or torsion). Hold force for 3-4 seconds.
FPR - steps (5)
- Neutral position, straighten the AP curvature
- Apply facilitating force (compression or torsion)
- Shorten muscle
- Hold for 3-4 seconds
- Release and re-evaluate
