Principles of Counterstrain Flashcards
Who developed counterstrain?
Lawrence Jones. He identified tender points “counterstrain points”. Discovered optimal time to keep patient in was 90 seconds
Counterstrain Technique
method of diagnosis and indirect (in the ease) treatment in which the patient’s somatic dysfunction, diagnosed by an associated myofascial tender point (Counterstrain Point), is treated by using a position of spontaneous tissue relaxation while simultaneously monitoring the tender point
What are neurophysiological basics behind counterstrain?
the gamma efferent activity of mechanoreceptors of muscle spindle are necessary. Made up of two parts: afferent: pathways with input to the CNS like sensory, and efferent: motor pathway that carry signals to muscles and glands
What is function of gamma motor efferent?
innervate contractile muscle fibers located on periphery of spindle. Increased firing of gamma motor efferent to intrafusal contractile muscles leads to more tension which activate the afferent alpha motor neuron
What are 3 theoretical basis of counterstrain?
- Proprioceptive
- Sustained Abnormal Metabolism Theory
- Impaired Ligament muscular reflex
Proprioceptive Theory
Gamma system causes reflex, caused by rapid change in muscle causing afferent feedback to indicate muscle strain. This causes rapid contraction of muscle A, and stretch of muscle B. Muscle B ends up becoming hypertonic with dysfunctional rest
Sustained Abnormal Metabolism Theory
Trauma produces change in myofascial tissue, leading to reduction of transport of nutrients throughout the body. Nociceptive reflex occurs causing tissue damage such as release bradykinin, PGE2, vasodilation. Damage leads to increased sensitivity or “counterstrain point”
Impaired Ligament Muscular Reflex Theory
When a ligament is sprained, muscles that would increase the sprain are inhibited while other muscles that would reduce the sprain are stimulated which can lead to contraction/inhibition that’s symptomatic
Relative Contradictions where you can’t use counterstrain
A patient who can’t relax ex. with Parkinson’s, cervical ligamentous instability ex. downs syndrome, Severe osteoporosis, thoracic Extension, Acute rheumatological flare, Apprehensive patient, Can’t communicate
Counterstrain mechanism of action
By placing the injured tissue at rest, neural excitation keeping the muscle hypertonic is dampened, and the gamma motor neurons & spindle afferent neurons reset
What are 5 steps to counterstrain?
1) Find a significant counterstrain point, use pad of finger tip, quantify initial tenderness as a 10
2) Position the patient for maximum comfort
3) Maintain the position for 90 seconds
4) Slowly return the patient to a neutral position
5) Recheck the tenderpoint
What happens in viscerosomatic tender points
a lot of times they respond to treatment, but then the tenderness returns; these need to be medically evaluated
Therapeutic Pulse
Synchronous with the radial pulse that slows then stops and the tissues undergo a softening and warming sensation indicating the end-point for the technique
