Counterstrain

Question 1

Basics of counterstrain

Answer 1

Indirect technique
90s
Establish pain scale, want 3/10 or less

Question 2

Proprioceptive technique

Answer 2

Rapid stretch of muscle spindles causes muscle to contract to avoid injury
Imbalance leads to altered motor neuron activity and creates tenderpoint

Question 3

Sustained abnormal metabolism theory

Answer 3

Tissue injury alters local body position and affects microcirculation and tissue metabolism
Localized ischemia causes reduced nutrient supply and metabolic waste removal
Cytokines produce local inflammation and will manifest as localized edema and tenderness

Question 4

Impaired ligamento-muscular reflex theory

Answer 4

Similar to proprioceptive
However dysfunction may result from protective reflex when ligaments and myofascial structures placed under strain
Localized strain can reflexively inhibit muscular contractions that increase ligamentous strain while stimulating muscular contractions that reduce strain

Question 5

Tenderpoint

Answer 5

Muscles, tendons, ligaments, fascia
Non radiating
No pain pattern
No dermographia 
Counterstrain

Question 6

Indications for counterstrain

Answer 6

Tender point
Acute or chronic MSK conditions
Cannot tolerate other forms of manipulation

Question 7

Contraindications for counterstrain

Answer 7

Patient refusal
Cannot tolerate position
Exacerbation of certain conditions
Fracture in area of treatment
Torn ligament in area
(Cannot relax or child)

Question 8

Anterior cervical points

Answer 8

F SARA
AC1: F RA
AC7: F STRA

Question 9

Posterior cervical

Answer 9

E SARA
PC1 midline: F
PC3 midline: F SARA

Question 10

Anterior thoracic

Answer 10

F STRA

AT1-6: F

Question 11

Posterior thoracic

Answer 11

Lateral: E SARA
Midline: E

Question 12

Anterior rib

Answer 12

F STRT

Question 13

Posterior ribs

Answer 13

E SARA
PR1: E SART
PR 2-6: F SARA

Question 14

Anterior lumbar

Answer 14

F SART
AL1: STRA
AL5: SARA

Question 15

Posterior lumbar

Answer 15

E STRA