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OPP Exam 2 > Counterstrain > Flashcards

Counterstrain Flashcards

1
Q

When and who made Counterstrain?

A

1955 and Lawrence Jones, DO (spontaneous release by positioning)

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2
Q

What did counterstrain used to be called?

A

Strain-counterstrain

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3
Q

Define Counterstrain

A

An Osteopathic system of diagnosis and indirect treatment in which the patient’s somatic dysfunction, diagnosed by an associated myofascial tender point, is treated by using a position of spontaneous tissue release while simultaneously monitoring the tenderpoint

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4
Q

Why was strain-counterstrain once a name for it?

A

Considered to be related to a continuing inappropriate strain reflex

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5
Q

Describe the counterstrain tenderpoints

A

Counterstrain tender points are discrete, NON RADIATING, hyperalgesic areas in the myofascial (muscle and fascia) tissues. The named points are found at consistent anatomical locations.

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6
Q

What initial position did Lawrence Jones put the patient in?

A

One of comfort

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7
Q

Initially only what was identified?

A

Posterior points, but later determined anterior points as well

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8
Q

What year did Dr. Jones publish his first paper?

A

1964

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9
Q

When was Dr. Jones thesis published?

A

1980

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10
Q

What 3 theories provide the clinical efficacy of counterstrain?

A
  1. Proprioceptive theory
  2. Sustained abnormal metabolism theory
  3. Impaired ligamento-muscular reflex theory
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11
Q

Proprioceptive Theory

A

Tender points develop when local muscle fibers are maintained in a hypertonic state due to an inappropriate proprioceptive reflex during the initiation of somatic dysfunction

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12
Q

What are the 2 phases to proprioceptive theory?

A
  1. Sudden lengthening of a shortened muscle, or overstretching or overloading of a muscle
  2. Defensively initiated contraction of that muscle in an effort to prevent injury.
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13
Q

Sustained Abnormal Metabolism Theory

A

Tissue injury alters local body position which affects local microcirculation and tissue metabolism.

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14
Q

What does localized ischemia do?

A

Reduces nutrient supply and removal of metabolic waste products to affected area

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15
Q

What is increased in SAMT?

A

Proinflammatory cytokine production

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16
Q

Does SAMT cause lowering of the firing threshold of sensory neurons causing localized neuronal sensitization?

A

Yes; manifest as localized edema and tenderness

17
Q

What does the precise body positioning in counterstrain do?

A

Improves local vascular circulation and reduces localized production of inflammatory mediators

18
Q

What must the physician ascertain?

A

The somatic dysfunction, its severity, its tissue location and type, and whether any of these precautions or contraindications are present.

19
Q

What happens to treatment effectiveness as pain rises?

A

For every ascending numeric level of pain that remains, an associated 10% of treatment effectiveness is lost

20
Q

What is the goal?

A

100% reduction if possible

21
Q

What do anterior points require?

A

Flexion

22
Q

What do posterior points require?

A

Extension

23
Q

What happens as tender points move further from the midline?

A

Greater is the possibility for necessity of more side bending

24
Q

How long do we maintain the position?

A

90 seconds

25
Q

Is the fingerpad putting any therapeutic pressure on the tissues?

A

No

26
Q

Do we ever remove the fingerpad point?

A

No

27
Q

How do return the patient after 90 seconds?

A

PASSIVELY through the path of least resistance to original neutral position in which the tender point was illicited

28
Q

Can the patient help in returning to neutral after the 90 seconds?

A

NO!!!!!!!

29
Q

What do we always do at the end?

A

Recheck!!!

30
Q

Give the percentage of an improvement example

A

If the pain is reduced to a 3 after it being a 10, it was 70% treated

31
Q

What are the 6 shorthand rules?

A
  1. Find the tender point associated with the dysfunction.
  2. Tell the patient the tender point is a 10 or 100 or a dollar’s worth of pain.
  3. Place the patient in the position that reduces the pain of the tender point 100%, or as close to 100% as possible, but at least 70%.
  4. Hold this position for 90 seconds.
  5. Slowly, through a path of least resistance, return the relaxed patient to neutral.
  6. Recheck the tender point and the other diagnostic components of the dysfunction (TART).
32
Q

What correlates with soreness?

A

Treating more than 6 tender points in 1 visit

33
Q

What do we instruct to do to treat soreness?

A

Instruct the patient to increase fluids and use ice packs over the sore areas for 15 to 20 minutes every 3 hours as needed

34
Q

What normal intervals for treatment are normal and how do we determine that?

A

3-day intervals are appropriate. The patient’s response will determine how often the patient needs treatment

OPP Exam 2 (9 decks)

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