CounterStain Review Flashcards
Strain-Counterstain
Type - passive indirect technique
Goal - resolve pain of tender points by placing a joint, muscle, tendon, etc into the most comfortable position by shortening the muscle
End Goal of Treatment - At least 70% reduction in pain
Strain Counterstain
Indications: Somatic dysfunction
Absolute contraindication: Trauma, severe illness, severe spondylitis
Relative contraindication: Patients cannot cooperate, connective tissue disease
Tenderpoints
Small hypersensitive tender nodules caused by dysfunctional neuromuscular reflexes resulting in painful MSK contraction
Dysfunctional neuromuscular reflex causes excessive “gamma gain”
DO NOT refer pain when palpated (vs trigger point)
Muscle spindle
Stretch receptors that normally detect stretching in a muscle and generate contractile signals
Extraffusal fibers eg biceps muscles
Intrafusal fibers detect stretching —> sensory neuron activated synapses with motor neuron of spinal cord —> motor efferent synapses on the outer spindle —> muscle contraction and inhibition of Intrafusal fibers
Alpha motor neuron
Gamma motor neuron
Highly contractile fiber elements in the extrafusal or outer part. Responsible for the power of the muscle
Mildly Motor Neurons Mildly contractile fiber elements in the intrafusal or inner part. responsible for keeping the intrafusal taut & responsive to stretch
2 motor neurons
Alpha motor neuron goes to extrafussal muscle
Gamma motor neuron goes to intrafusal muscle
Imbalance of the gamma and alpha motor neuron signals
gamma Alpha Coactivation and gamma gain causing tenderpoints
Counterstrain technique
Step 1 identify tenderpoint
Step 2 Access pain by asking them to rate the pain on a scale of 1-10
STEP 3 While you palpate the tenderpoint you place the affected area to its ease. Approximate the ease and use small motion arc to get them to comfort
Step 4 Hold for 90 secs while monitoring the tenderpoint
Step 5 Return patient to neutral position
Step 6 reassess the tenderpoint
