Lecture: Intro to Counterstrain

Question 1

What kind of technique is counterstrain?

Answer 1

passive, indirect

Question 2

What is a tender point?

Answer 2

• non-radiating area of tenderness that is located within muscle, tendon, ligaments, or fascia that reduces when placed in a position of ease

Question 3

Founder of counterstain method?

Answer 3

• Dr. Lawrence H Jones
• 1955
• anterior and posterior tender points

Question 4

Does a tender point hace a characteristic pain point or twitch?

Answer 4

no, neither

Question 5

What are some key features of counterstain?

Answer 5

• palpation of tenderloins during treatment = curcial
• only need to do regional positions
• 90 seconds is best

Question 6

What is the only requirement of counterstain besides consent?

Answer 6

-patient must be able/willing to be positioned and relax

Question 7

Contraindications to counterstain?

Answer 7

• severe trauma/illness/instability
• palsy (can’t relax)
• severe scoliosis (cannot position patient w/o pain)

Question 8

What does R PC6 treatment e-E SaRa mean?

Answer 8

• right posterior cervical 6

- extend (little then a lot) , side bend away, rotate away

Question 9

What does maverick mean?

Answer 9

tenderloins with treatment position opposite of rest of region

Question 10

What does stoic mean?

Answer 10

distinct palpable TTA w/o tenderness

Question 11

How does the nociceptive perspective play into counterstain?

Answer 11

-initiated by nociceptors in strained tissue
-produces reflexive contraction to protect tissue
-stuck in reflex loop
ex : ligament muscular reflex during ankle sprain

Question 12

How does the proprioceptive perspective play into counterstain?

Answer 12

• muscle spindle fiber determine length/stretch of muscle
• work with gamma motor neurons
• determine length of agonist and antagonist muscles through alpha motor neurons to prevent sudden changes

Question 13

Protective contraction in proprioceptive perspective?

Answer 13

• rapid stretch w/o recovery (injury/trauma) of spindle fiber will cause protective contraction
• contraction maintain by gamma motor system

Question 14

What are the consequences of prolonged contraction/ nociception?

Answer 14

• sustained contracture

- nociceptive produces cascade oof neuropeptides

Question 15

What does sustained contracture cause?

Answer 15

• overwhelm symptoms/parasym regulation of muscle perfusion
• reduced muscle perfusion
• lactic acid > sensitization of nerve endings

Question 16

What does the nociceptive neuropeptide cascade cause?

Answer 16

• local edema

- sensitizes nerve endings

Question 17

Where do we position our indirect techniques?

Answer 17

-pathological (shifted) neutral

Question 18

What are the phases of counterstain?

Answer 18

1. Relaxation phase
2. normalization of nociceptive and neuro input phase
3. Washout phase
4. slow return to neutral

Question 19

What characterizes the relaxation phase?

Answer 19

• tiussues shortened into position of ease
• –palpate TTA at tenderpoint
• –localize through 3 planes of motion to normalize tissue

Question 20

What characterizes the normalization of nociceptive input phase?

Answer 20

-nociceptive input revolves in position of ease

0spindle fiber length reset and gamma loop is restored to normal input

Question 21

What characterizes the washout phase?

Answer 21

• metabolic washout begins 10-15 seconds after optimal position achieved (90 s)
• peak wash out at ~ 1 min

Question 22

What characterizes the slow return to neutral phase?

Answer 22

• rapid return could reactivate spindle cells activity

- muscle spindles remain somewhat facilitated for up to 24 hrs after treatment (remind patients to take it easy)

Question 23

What are the 7 steps to counterstain?

Answer 23

1. Find most significant tenderloins
2. Physician establishes a tender scale
3. Monitor tenderpoint throughout
4. Place patient in “position of ease: of attest 70% improvement
5. hold for 90 seconds
6. Slowly return to neutral
7. Recheck tenderness
   DO NOT SKIP STEPS