Counterstrain Points

Question 1

Name the TP:

___: 1.5 inches below xiphoid

___: midline about 1-2 cm below umbilicus

___: midline below xiphoid, 1-2 cm above umbilicus

___: Midline about 3-4 cm below umbilicus

___: mid-axillary line on superior-medial surface of iliac crest

Answer 1

AT8

AT10

AT9

AT11

AT12

Question 2

Name the TP:

___: On the costal cartilages of T5 and T6

___: On inferior medial surface of costal cartilages, 1 and 2 in from xiphoid

Answer 2

AL 5-6

AL 7-8

Question 3

List the TP:

___: below clavicle on rib 1 lateral to manubrium

___: 1.5 in lateral to manubriumon rib, on midclavicular line, also found deep to axilla

___: anterior axillary line on ribs 3-6

Answer 3

AR1

AR2

AR 3-6

Question 4

Name the TP:

____: superior surface of angles of ribs, at medial border of scapula about 2.5 in lateral to midline

___: posterior margin of rib head beneath the margin of trapezius

Answer 4

PR2-6

PR1

Question 5

List the TP:

___: lateral to AIIS

___: inferior to AIIS

___: medial to ASIS

___: medial to AIIS

___: inferior to pubic tubercle

Answer 5

AL3

AL4

AL1

AL2

AL5

Question 6

List the TP:

___: midline lumbar spinous process

___: transverse processes of L1-3

___: superior aspect of PSIS

___: inferior aspect of PSIS

___: 1/3 distance from PSIS to greater trochanter

___: 2/3 distance from PSIS to greater trochanter

Answer 6

PL1-5 midline

PL1-3 TP

UPL5

LPL5

PL3Lat

PL4Lat

Question 7

Name the TP:

___ lower quadrant in the iliac fossa

Answer 7

Iliacus TP

Question 8

Name the TP:

___: superior aspect of lateral ramus of pubic bone where psoas crosses pelvic rim

Answer 8

Low ilium

Question 9

Name the TP:

Medial surface of descending ramus of pubic bone. May be related to iliococcygeus muscle

Answer 9

Low ilium flare out

Question 10

Name the TP:

___: lateral surface of pubic bone, near attachment of inguinal ligament

Answer 10

Inguinal ligament TP

Question 11

Name the TP:

___: near its muscle attachment on the ASIS. Palpate from about 2-3 cm caudad to ASIS by pushing toward inferior aspect of ASIS

Answer 11

Sartorius

Question 12

Name the TP:

___: press against lateral aspect of PSIS. Depndening on depth of palpation, may be related to gluteus maximus or medius

Answer 12

High ilium

Question 13

Name the TP:

___: inferolateral aspect of ILA. Probably sacrospinous or sacrotuberous ligament

Answer 13

High ilium flare out (HIFO)

Question 14

Name the TP:

___: along sacroiliac joint, inferior to LPL5 and cephalon to ILA

Answer 14

Flare-in sacroiliac (FISI)

Question 15

Name the TP:

___ : about 1/2 to 2/3 of the way form the ILA to the greater trochanter pushing toward its musculotendinous junction

Answer 15

Piriformis

Question 16

Name the TP:

___: midline on sacrum between or below spines

___: 1/4 medial and superior to ILA b/l

___: 1/2 inch medial to inferior aspect f PSIS b/l

Answer 16

PS2-4

PS5

PS1

Question 17

Name the TP:

___: superolateral aspect of posterior surface of greater trochanter. Probably the lateral aspect of piriformis m.

Answer 17

Posterior lateral trochanter

Question 18

Name the TP:

___: inferior to greater trochanter and in mid-coronal line

Answer 18

Lateral trochanter

Question 19

Name the TP:

___: close to middle of popliteral space (1 point)

___: at widest part of popliteal space (2 points)

Answer 19

PCL

ACL

Question 20

name the TP:

__: located at the level of the lower edge of patella, at medial meniscus. Push medial to lateral

Answer 20

Medial meniscus

Question 21

Name the TP:

__: attachment of medial hamstring tendon, lateral to medial meniscus of TP. Push medial to lateral, posterior to superior

Answer 21

Medial hamstring

Question 22

Name the group for these 3 TPs:

• On patellar ligament/tendon
• In front on medial meniscus
• on front of medial surface of tibia

Push anterior to posterior

Answer 22

Knee extenders

Question 23

Name the TP:

___: posterior joint of acromion and clavicle

Answer 23

Posterior acromioclavicular

Question 24

Name the TP:

___: slightly medial to the tip of the clavicle

Answer 24

Anterior acromioclavicular

Question 25

Name the TP: ___: in belly of this rotator cuff in the fossa above the spine of the scapula

Answer 25

Supraspinatus

Question 26

Name the TP: ___: 1 cm from medial margin and 5 cm inferior to spine of scapula ___: 2 or 3 cm below spine and 3 cm more lateral than the lower one

Answer 26

Low infraspinatus Upper infraspinatus

Question 27

Name the TP: ___: lateral border of scapula under the arm, back of head of humerus

Answer 27

Teres minor

Question 28

Name the TP ___: lateral and posterior surface of scapula, at inferior angle.

Answer 28

Teres major

Question 29

Name the TP: ___: superior medial surface of front of coracoid process. Pec minor muscle

Answer 29

Medial coracoid

Question 30

Name the TP: ___: on anterior surface of scapula, DEEP in belly of the muscle

Answer 30

Subscapularis

Question 31

Name the TP: ___: slightly medial of center on the anterior humerus, on the tendon of the muscle

Answer 31

Latissimus dorsi

Question 32

Name the TP: ___: inferolateral aspect of coracoid process at insertion of this part of biceps muscle

Answer 32

Short head

Question 33

Name the TP: ___: tendon of this part of biceps muscle in the bicipital groove

Answer 33

Long head

Question 34

Name the TP: ___: Coronoid process of ulna

Answer 34

Flexion elbow

Question 35

Name the TP: ___: at side of olecranon process of ulna near triceps tendon

Answer 35

Extension elbow

Question 36

Name the TP: ___: lateral part of radial head. Push anterior to posterior on flexor surface

Answer 36

Radial head

Question 37

What are the big 3 muscles to evaluate in Tension headaches?

Answer 37

Trapezius Levator scapulae SCM

Question 38

What are common offender muscles in Anterior Shoulder Pain?

Answer 38

``` Biceps (LH and SH) Pec major and minor Infra & supraspinatus Deltoid Scalenes ```

Question 39

What are common muscle offenders in Posterior Shoulder Pain?

Answer 39

``` Levator scapulae Teres major and minor Supraspinatus Trapezius Subscapularis Serratus posterior superior (referral pattern is to the shoulder) ```

Question 40

What are common tender points for Anterior Thoracic?

Answer 40

Pec major Serratus anterior T2-6 points

Question 41

What are common TPs for forearm/wrist/hand?

Answer 41

Triceps (LH most common) Medial elbow-Pronator teres, flexor carpi radialis and ulnaris, palmaris longus Lateral elbow-supinator (radial head), extensor carpi radialis/anconeus/common extensor tendon involved

Question 42

In regards to anterior lumbar/pelvis/hips TP's: Myofascially the ___ TP is in the internal oblique, ___ TP is in the lower external oblique, ___ TP's in the iliopsoas, and ___ in the Rectus abdominal and pyramidalis These muscles are often related to GI conditions (e.g., IBS)

Answer 42

AL1 AL2 AL3-4 AL5 Ext oblique, lower rectus, iliacus

Question 43

What muscles should be considered for deep pelvis pain

Answer 43

Obturator internus and external Adductor magnus Lower ext abdominal oblique

Question 44

What muscles should be considered for anterior hip pain?

Answer 44

Pectineus (inguinal l.) | Lower ext abdominal oblique

Question 45

For posterior lumbar/pelvis/sacrum, list the common muscles that refer to the pelvis:

Answer 45

Quadratus lumborum Longissimus thoracis Iliocostalis

Question 46

What are common anterior knee offenders?

Answer 46

Rectus femoris Vastus medialis Adductor longus/brevis

Question 47

What are common lateral knee offenders?

Answer 47

Vastus lateralis, IT band

Question 48

What are common posterior knee offenders?

Answer 48

``` Gastrocs Biceps femoris (athletes) Soleus Semimembranosus Semitendinosus Popliteal Plantaris ```

Question 49

What are common ankle offenders?

Answer 49

``` Fibularis longus and brevis Tibialis anterior (medial), soleus/posterior tibialis/gastrocnemius (posterior) ```

Question 50

What are common plantar heel pain offenders?

Answer 50

Quadratus plantae

Question 51

Name the common offenders for foot (bunion region):

Answer 51

Flexor digitorum brevis Adductor hallicis Flexor hallicis brevis

Question 52

Name common offenders for dorsum of foot:

Answer 52

Extensor digitorum brevis | Extensor hallicis brevis

Question 53

Name the TP: ___: midline in Supra sternal notch ___: level of costal cartilage related to named vertebra ___: midline manubrium ___: inch above xiphoid ___: tip of xiphoid ___: xiphoid-sternal junction

Answer 53

AT1 AT3-4 AT2 AT5 AT7 AT6