Counterstrain and FPR Flashcards
AC2-6
slight anterior to or on lateral aspect of lateral masses
Tx: slightly flex, SB and rotate away from side of tenderpoint
AC1 mandible
rotate away
Anterior C7
2-3 CM lateral to medial end of clavicle at lateral attachment of SCM
Tx: flex, STRA
Counterstrain
passive indirect technique, tissue positioned at point of balance or ease, away from restrictive barrier
Tenderpoint
small tense edematous areas of tenderness about size of a fingertip
near bony attachments of tendons, ligaments or in belly of some muscles
Do not radiate pain to other locations
Steps to counterstrain tx
- locate significant tenderpoint
- palpate the tenderpoints
- place pt in position of optimal comfort - shorten muscle, fine to to 70 percent reduction of pain
- hold for 90 sec (120 for ribs)
- slow passive return to neutral
- recheck
Posterior cervical tenderpoints
tip of spinous process or lateral sides of spinous process
tx: extend, SB slightly, rotate away
PC1-Inion
at inion (posterior occipital protuberance) or just below
Tx: marked flexion
Anterior thoracic tenderpoints
T1-6 midline of the sternum at the attachment of the corresponding ribs
T7-T12 - in the rectus abdominus about 1 inch lateral to midline on the right of left
Tx:
flex thorax and add small amount of sidebending and rotation away
Posterior thoracic tender points
either side of the spinous process or on the TP
Tx:
extend, rotate away, side bend slightly away
AR 1 and AR 2 (anterior ribs)
Rib 1: tender point just below medial end of clavicle
Rib 2: tenderpoint is 6-8 cm lateral to the sternum on rib 2
Tx: flex head, sidebend and rotate towards
AR 3-6 (anterior ribs)
tenderpoints along mid-axillary line on corresponding rib
Tx: sidebend and rotate the thorax toward, encourage slight flexion
Posterior rib tenderpoints
on angle of corresponding rib
Tx: minimal flexion, sidebend away, rotation away
AL 1
medial to ASIS
Tx: hip flexed, sidebend towards, rotate away
AL2-AL4
AL2 - medial to AIIS
AL3 - Lateral to AIIS
AL4 - inferior to AIIS
Tx: hip flexed, sidebend away, rotate towards
AL5
one cm lateral to pubic symphysis on superior ramus
Tx: hip flexed, sidebend towards, rotate away
Iliacus tenderpoint
1/3 distance from ASIS to midline (approx 7 cm), laterally
tx: supine, hip flexed and externally rotated - figure 4
Psoas tenderpoint
1/2 distance between ASIS and umbilicus - deep
tx: supine, hip flexed and externally rotated - figure 4
Piriformis tenderpoint
1/2 distance between the greater trochanter and the midpoint between PSIS and ILA
Tx: prone, hip and knee flexed, thigh abducted and externally rotated
FPR procedure
neutralize spine apply facilitating force shorten muscle or place vertebrae into indirect position (where it likes to live) hold for 3-5 seconds move to neutral and recheck
