Intro to Counterstrain

Question 1

Trigger or tender

characteristic pain pattern

Answer 1

trigger

Question 2

trigger or tender

no characteristic pain pattern

Answer 2

tender

Question 3

trigger or tender

located in muscle tissue only

Answer 3

trigger

Question 4

trigger or tender

located in muscle, tendons, ligaments, and fascia

Answer 4

tender

Question 5

trigger or tender

locally tender

Answer 5

both

Question 6

trigger or tender

elicits a jump sign when pressed

Answer 6

both

Question 7

trigger or tender

radiating pain pattern

Answer 7

trigger

Question 8

trigger or tender

no radiating pain pattern

Answer 8

tender

Question 9

trigger or tender

elicits twitch response with snapping palpation

Answer 9

trigger

Question 10

trigger or tender

no twitch response

Answer 10

tender

Question 11

trigger or tender

dermogrpahia of skin overp oint

Answer 11

trigger

Question 12

trigger or tender

dermographia of skin not present

Answer 12

tender

Question 13

a tissue is strained leading to recruitment of pain receptors within that tissue that respond by reflexive contraction. which pain model

Answer 13

nociceptive

Question 14

MoA of counterstrain in which excessive stretch of primary spindle induces protective contraction of extrafusal fibers

Answer 14

proprioceptive

Question 15

counterstrain theory in which agonist is shortened in response to strain

Answer 15

nociceptor

Question 16

countesrtrain theory in which the antagonist muscle is shortened

Answer 16

proprioceptive

Question 17

four phases of counterstrain

Answer 17

relaxation
reset fo spindle fibers and nociceptors
washout
slow return to neutral

Question 18

phase of counterstrain in which the affected tissue is shortened in three plaines

Answer 18

relaxation

Question 19

phase of counterstrain where the primary and secondary endings of muscle spindle stretch receptors (but not golgi tendon organs) are reset

Answer 19

spindle reset

Question 20

when does metabolic washout begin to occur

Answer 20

10-15 seconds after optimal position is achieved

Question 21

when does peak washout occur

Answer 21

approximately 1 minute

Question 22

why do we slowly return to normal in counterstrain?

Answer 22

a rapid return could reactivate spindle cell activity

Question 23

where can tender points be found

Answer 23

where motor nerve pierces investing fascia and enters the muscle
tendons, ligaments, fascia, muscle bellies

Question 24

where do you document counterstrain

Answer 24

in objective

usually abbreviated

Question 25

what is the limit to the amount of counterstrain points you should treat in one day

Answer 25

no more than 6 per day

Question 26

absolute contraindications for counterstrain

Answer 26

trauma
severe illness with positional restrictions
instability of treatment area
vascular/ neurolgic syndromes that compromise these areas
severe degernative spondylosis

Question 27

relative contraindications to counterstrain

Answer 27

patient cannot voluntarily relax
pt cannot discern level of pain or its change in secondary positioning
pt who cannot understand the instructions
pt with underlying conditions in whom positioning exacerbates the underlying conditions

Question 28

benefits of counterstrain

Answer 28

passive, indirect technique
can be used in patients with severe osteoporosis, metastatic bone disease and acute injuries
only abosulte requirement is pt must be able and willign to relax