Intro to Counterstrain Flashcards
Trigger or tender
characteristic pain pattern
trigger
trigger or tender
no characteristic pain pattern
tender
trigger or tender
located in muscle tissue only
trigger
trigger or tender
located in muscle, tendons, ligaments, and fascia
tender
trigger or tender
locally tender
both
trigger or tender
elicits a jump sign when pressed
both
trigger or tender
radiating pain pattern
trigger
trigger or tender
no radiating pain pattern
tender
trigger or tender
elicits twitch response with snapping palpation
trigger
trigger or tender
no twitch response
tender
trigger or tender
dermogrpahia of skin overp oint
trigger
trigger or tender
dermographia of skin not present
tender
a tissue is strained leading to recruitment of pain receptors within that tissue that respond by reflexive contraction. which pain model
nociceptive
MoA of counterstrain in which excessive stretch of primary spindle induces protective contraction of extrafusal fibers
proprioceptive
counterstrain theory in which agonist is shortened in response to strain
nociceptor
countesrtrain theory in which the antagonist muscle is shortened
proprioceptive
four phases of counterstrain
relaxation
reset fo spindle fibers and nociceptors
washout
slow return to neutral
phase of counterstrain in which the affected tissue is shortened in three plaines
relaxation
phase of counterstrain where the primary and secondary endings of muscle spindle stretch receptors (but not golgi tendon organs) are reset
spindle reset
when does metabolic washout begin to occur
10-15 seconds after optimal position is achieved
when does peak washout occur
approximately 1 minute
why do we slowly return to normal in counterstrain?
a rapid return could reactivate spindle cell activity
where can tender points be found
where motor nerve pierces investing fascia and enters the muscle
tendons, ligaments, fascia, muscle bellies
where do you document counterstrain
in objective
usually abbreviated
what is the limit to the amount of counterstrain points you should treat in one day
no more than 6 per day
absolute contraindications for counterstrain
trauma
severe illness with positional restrictions
instability of treatment area
vascular/ neurolgic syndromes that compromise these areas
severe degernative spondylosis
relative contraindications to counterstrain
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
benefits of counterstrain
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
