Counterstrain Lecture and Lab Flashcards
Is counterstrain active or passive?
passive
Counterstain is all about ROM or tenderness?
tenderness
Who cam up with counterstrain?
Dr. Lawrence Jones in 1955
How long do you hold counterstrain?
90 sec.
What is a tender point
Located in muscle, tendon, ligaments, fascia
No characteristic pain pattern
Only locally tender
No taut band or twitch response
what is a trigger point
Trigger is only muscle. Characteristic pain pattern. Locally tender and radiates pains. Present with taut band of tissue that will twitch when palpated
Indications for counterstrain
CS is a passive indirect OMM technique for musculoskeletal pain
Useable with
Very fragile
Sensitive
Recent trauma/surgery
Only requirement: patient must be able/willing to be positioned and relax
Contraindications of counterstrain
Severe trauma/illness/instability where management beside OMM is indicated Patient cannot voluntarily relax Unable to position patient without extreme pain due to anatomic changes
What is a maverick?
Tenderpoint with treatment position opposite of rest of region
What is a Stoic
Distinct palpable TTA without tenderness
What is the MOA of counterstrain?
Initiated by nociceptors in strained tissue
muscle, tendon, ligaments, fascia
Produces reflexive contraction to protect tissue
Stuck in reflex loop
This contracture maintained by gamma motor system
Nociceptive input resolves in position of ease
Spindle fiber length resets and gamma loop is restored to normal input
Metabolic washout begins at 10-15 seconds after optimal position achieved
Peak washout occurs at approximately 1 minute
What are lateral verse midline points?
Lateral is on the Tp and the midline points are just inferior to the SP.
How much improvement to look for in tenderness?
70%
Treatment for all PTSP is?
e-E (shortening the interspinales muscles)
How to extend Upper PTSP (T1-4)
Extend head off table
