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*OSII > Introduction to Counterstrain > Flashcards

Introduction to Counterstrain Flashcards

1
Q

What is counterstrain?

A

passive & indirect OMM technique for MSK pain

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2
Q

Steps for counterstrain

A

TART

tenderpoint

fold & hold

spontaneous release

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3
Q

What is a tenderpoint?

A

a non-radiating area of tenderness that is located w/ in a muscle, tendon, ligament or fascia

is reduced when placed into position of ease

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4
Q

Who developed counterstrain?

A

Dr. Lawrence Jones in 1955

for pt who couldn’t find good sleeping position

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5
Q

How did Dr. Jones develop CS?

A

placed pts & whole body into positions of comfort for long periods of time

noted posterior tenderpoints that assoc w/ TART findings

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6
Q

What was a problem Dr. Jones encountered w/ CS?

A

only found posterior tender points on 1/2 of pts

started to find ant tenderpoints

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7
Q

What are trigger points?

A

located ONLY in muscle

characteristic & radiating pain patterns

locally tender & radiates pain

present w/ taut band of tissue that WILL TWITCH

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8
Q

Indications for CS

A

fragile pts

sensitive pts

pt must be willing to be positioned & relaxed

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9
Q

Contraindications for CS

A

severe trauma/illness

pt can’t relax

unable to position pt w/o extreme pain or anatomic changes

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10
Q

How to name tenderpoint

A

laterality

anterior/posterior

vertebra/anatomic structure

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11
Q

L PC4

A

left posterior cervical 4 (has 4 possible tender points)

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12
Q

L Psoas

A

Belly of L psoas muscle

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13
Q

How do you treat R PC6 diagnosis?

A

extend, sidebend away & rotate away from tenderpoint

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14
Q

What is a maverick point?

A

tenderpoint w/ treatment position opposite of rest of region

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15
Q

What is a stoic point?

A

distinct palpable TTA w/o tenderness

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16
Q

Nociceptive perspective of tenderpoints

A

tell you when something is strained to prevent more strain

17
Q

Proprioceptive perspective of tenderpoints

A

muscle spindle fiber determines length & stretch of muscle thru LMN

change in muscle can shut down agonist or anatgonist m (rapid stretch causes protective contraction)

18
Q

What are the consequences of prolonged contraction/nociception?

A

sustained contracture

nociceptive produces cascade of neuropeptides

19
Q

What is sustained contracture assoc w/?

A

change in muscle perfusion

reduced metabolic recovery of muscles

buildup of lactic acid that sensitizes nerve endings

20
Q

What is the result of neuropeptide cascade from nociceptive firing?

A

produces local edema

sensitizes nerve endings

21
Q

What does pathologic neutral mean?

A

contracture of muscles that produces a new neutral (where muscles are most relaxed)

22
Q

In what direction does CS go?

A

in direction of pathologic neutral

23
Q

Phases of Counterstrain

A

Relaxation phase

Normalization of nocicpetive & neuro input phase

Washout phase

Slow return to neutral phase

24
Q

Relaxation phase of CS

A

tissues shortened into position of ease

get into pathologic neutral (localize all 3 planes)

25
Q

Normalization phase of CS

A

nociceptive input resolves in position of ease

spindle fiber length resets & gamma loop back to normal input

26
Q

Washout phase of CS

A

hold position (lasts for 1 min)

27
Q

Slow return to neutral phase of CS

A

tissues are moved back to normal neutral

needs to be a slow return (3 to 5 seconds)

28
Q

Steps of counterstrain

A

find most signif tenderpoint

establish tenderness scale

monitor tenderpoint

place into position of ease

hold 90 seconds

slowly return to neutral

recheck tenderness

29
Q

How to find a tenderpoiint

A

begin w/ TART screen of whole body

need to ask pt if feel tenderness

30
Q

Establish tenderness scale

A

talk w/ pt to describe level of pain & where want to get to

can determine how effective treatment will be

31
Q

What are steps 3 & 4 of CS assoc w?

A

relaxation & normalizing of nociceptive & neuro input phase

32
Q

What are steps 5-7 of CS assoc w?

A

washout & slow return to neutral phases

*OSII (39 decks)

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