Lumbar Counterstrain Flashcards

AL1: F STRT
Location: medial ASIS
Treatment position: Pt supine.
Doc on ipsilateral side.
Flex hips/knees to 90
supporting with doc’s leg on table.
Pull ankles (SB) & knees (Rot) towards doc.

AL 2: F SARAH
Location: medial AIIS
Treatment position: Pt supine.
Doc contralateral side.
Hips/knees flexed.
Ankles (SB)
knees (Rot) toward Doc, away from TP.
Rot >>> SB
Location: medial AIIS
AL2
Location: medial to ASIS
AL1
Location: lateral and inferior AIIS
A3(L), A4(Inf)

AL 5
Location: lateral to pubic symphysis
Treatment position: Pt supine.
Doc ipsilateral w/ ft on table.
Flex hip to 135
ankles (SB) away from doc & TP.
Knees (rot.) slightly toward doc & TP.
▫ F SART

PL 1-5 Spinous Process
Location: Midline on respective SP
Treatment position: Pt prone
Doc ipsilateral to TP.
Extend hip, fine tune with SB as necessary
AL3 and AL4 counterstrain
Treatment position: Pt supine.
Doc ipsilateral w/ ft on table.
Flex knees/hips to 90.
Ankles (SB) away from doc & TP
knees (Rot) toward doc & TP
▫ F SART

Upper Pole L5 (UPL5)
Location: superomedial PSIS
Treatment position: Pt prone.
Doc contralateral to TP.
Extend hip ipsilateral to TP, externally rotates hip towards TP
*Same motion as PL 1-3 TP. Monitoring at diff. location with different amounts of extension/rotation to address specific tenderpoint*
U-PLP-EE-5

Lower Pole L5 (LPL5)
Location: inferior PSIS
Treatment position: Pt prone with dysfunctional side over side of table.
Doc flexes hip & knee to 90.
Add IR/Adduction of hip to fine tune.

- PL3 Lateral/Gluteus
- Location: between PSIS/TFL
- Treatment position: Pt prone. Doc ipsilateral. Extend hip, fine tune with Abduction.
- Actions of glutes
(same picture, different spot)

PL4 Lateral/Gluteus
Location: posterior margin of TFL
Treatment position: Pt prone. Doc ipsilateral. Extend hip, fine tune with Abduction. (Less ext. than PL3)
▫ Actions of glutes
- F SART
- F SARAH
- F STRT
- F SART - A3/A4/A5
- F SARAH - A2
- F STRT - A 1
PL 1-3 Transverse Process
PL 1-3 Transverse Process
Location: on respective TP, can be b/l
Treatment position: Pt prone.
Doc contralateral side.
Extend ipsilateral hip to TP, externally rotate hip towards TP.
TPEE

Location: RLQ, medial to ASIS, deep in iliac fossa
Treatment position: Pt supine.
Doc ipsilateral w/ foot on table.
Flex hips/knees to 90, crossing ankles over doc’s knee, inducing marked ER
▫ “Frog leg”

Low Ilium
Location: superior pubic ramus, where psoas m. crosses pelvic rim
Treatment position: Pt supine.
Doc ipsilateral. Flex hip & knee to >90. Fine tune if nec.

Inguinal Ligament
Location: lateral pubic tubercle
Treatment position: Pt supine.
Doc ipsilateral w/ foot on table.
Flex hips/knees to 90, rest on doc’s knee. Cross c/l ankle over i/l leg, pull ankles towards doc (IR of dysfnl. hip)
▫Assoc.: inguinal lig. and/or pectineus m.

High Ilium Sacroiliac (HISI)
Location: lateral PSIS
Treatment position: Pt prone.
Doc ipsilateral.
Extend hip and fine tune with ab/adduction.
Assoc. with Glut. max., Q. lumborum, or iliolumbar lig.

High Ilium Flairout (HIFO)
Location: 2” inferior, just medial to PSIS
Treatment position: Pt prone. Doc contralateral. Extend dysfnl leg enough to clear opp. leg. Induce marked adduction/ER pulling leg towards doc.
▫ Assoc. w/ coccygeus m.

Piriformis
Location: half-way from ILA to greater trochanter in belly of m.
Treatment position: Pt prone, dysfnl side off table. Flex pt’s hip to 135. Abduct and externally rotate by lifting knee superolaterally
Which PLs require the doctor to stand on the contralateral side?
PL1-3 and UPL5
Which PLs require the doctor to be standing ipsilaterl to the TP?
PL 1-5 SP, LPPL5, PL 3 Lat Glut, PL 4 Lat Glut
which PLs require external rotation?
UPL5
PL1-3 TPs
U-PEE-L5
PL1,2,ThrEE




