Intro To Counterstrain Flashcards
___ states that when a muscle receives a nerve impulse to contract, its antagonists, receive, simultaneously, an impulse to relax
Sherringtons law
This pathway is reflex mediated through spindle-gamma motor neuron pathway
Strain-counterstrain
This pathway is direct injury to tissues results in nociceptive maintained TP’s
Trauma
What are the 5 models?
Resp/circulatory –> restore circulation
Metabolic –> improve physiology and exercise ability
Neurologic –> interrupt pathophysiologic reflexes and pain pathways
Posture/motion –> balance posture and function
Behavior –> optimize function
What are some indications for counterstrain?
Presence of a TP
Reluctant/afraid patients
Frail patients
Trial of OMT to assess pt tolerance
What are some absolute contraindications to counterstrain?
Fracture (not stabilized)
Torn ligament (not stabilized)
Patient refusal
What are relative contraindications to counterstrain?
Stress pts who cant relax
Uncooperative children
Severe osteoporosis
C-spine tx in pts with vertebral artery disease
Severely ill pts who may not tolerate a tx rxn (metastatic cancer, cervical in RA, medically not stabilized
What is the order of tx guidelines of counterstrain?
Relevant structural exam –> regional TP exam –> find worst TP –> establish pain scale –> position of ease –> hold 90 secs –> slow return to neutral –> retest TP/SD
Where are TPs usually located?
In muscle belly or the tendinous insertions
How long should TP’s be held? What about ribs?
90 secs
120 secs for ribs
If you have multiple TPs, which one do you tx?
The worst one
Anterior TPs typically require __
Flexion
Posterior TPs typically require ___
Extension
Midline TPs typically require pure ___ if anterior and pure ___ if posterior
Flexion
Extension
When is follow-up recommended after initial counterstrain tx?
3-7 days
1-2 weeks may be more practical
