Chapter 14 - Counterstrain and FPR Flashcards Preview

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Flashcards in Chapter 14 - Counterstrain and FPR Deck (26):

Counterstrain is (passive/active) and (direct/indirect)

Passive, Indirect


Tenderpoints are typically located where?

Near bony attachments of tendons, ligaments
OR in the belly of some muscles


Why is counterstrain held for 90 seconds?

The time required for the proprioceptive firing to decrease in frequency and amplitude


If a tenderpoint is associated with a V-S reflex, how long will the pain be reduced following a counterstrain treatment?

A few hours at most


Anterior cervical TPs - treatment position?

SB and Rotate AWAY


Tenderpoint 2-3 cm lateral to the SC joint on the clavicle

This point is considered a _____

Treatment position?

C7 (SCM lateral attachment)

Maverick point

Flex, SB toward, Rotate away


Posterior cervical TPs - treatment position?

Extend, SB and Rotate AWAY


PC1 inion - location?

Considered a ____

Treatment position?

Posterior occipital protuberance

Maverick point



T1 - T6 - locations

*AT2 tenderpoint specifically?

Midline on the sternum at the attachment of those ribs

AT2 is on the sternum at the Angle of Lewis


T7-T12 - locations

specifics for AT9-12
*what is special about AT12?

(MOST) In the rectus abdominus muscle, 1 inch lateral to midline on the R or L

AT9 - 1cm above umbilicus
AT10 - 1-2 cm below umbilicus
AT11 - 2 in below umbilicus
AT12- inner ala of ilium in midaxillary line bilaterally (*the only AT tender point with two locations - bilateral)


Anterior thoracic points - treatment position?

Flex thorax, little SB and Rotation AWAY


Posterior thoracic points - treatment position?

Extend thorax, little SB and Rotation AWAY


Anterior rib tenderpoints = ____

Posterior rib tenderpoints = ____

EXHALATION (depressed) ribs

INHALATION (elevated) ribs


AR1 - location

Treatment position?

Below the medial clavicle, where rib 1 attaches to the manubrium

Flex head, SB and Rotation TOWARDS (like rib 2)


AR2 - location

Treatment position?

6-8 cm lateral to sternum on rib 2

Flex head, SB and Rotation TOWARDS (like rib 1)


Ribs 3-6 - location

Treatment position?

Mid-axillary line on the corresponding rib

SB and Rotate thorax TOWARD, slight flexion


Posterior rib points - location

Treatment position?

Angle of the rib

SB and Rotate AWAY, minimal flexion


L1 - location
L2-4 - locations
**L5 - location

L1 = Medial to ASIS
L2-4 = Medial, Lateral, and Inferior to ASIS
L5 = 1cm lateral to pubic symphysis on superior ramus


Anterior lumbar points - treatment position

Supine, hips and knees flexed and ER (rot away)


Posterior lumbar points - locations

SP or TP of lumbar vertebrae
L3, L4 = maybe iliac crest
L5 = maybe PSIS


Posterior lumbar points - treatment position

Prone, extended, SB away (Rotation toward or away)


Lower pole L5 - location

Treatment position

Caudad to PSIS

Prone, Hip and knee flexed, leg IR and ADD


Iliacus - location

Treatment position

7 cm medial to ASIS

Supine, hip flexed and ER


Piriformis - location

Treatment position

7 cm medial and slightly cephalad to trochanter

Prone, Hip and Knee flexed, thigh abducted and ER


Describe FPR
- Direct or indirect?
- Patient position? Why?
- After positioning?
- How long to hold?

Indirect MFR where body part is placed into a NEUTRAL position to diminish tissue and joint tension in all planes, then adding an ACTIVATING force (compression or torsion). Hold force for 3-4 seconds.


FPR - steps (5)

1. Neutral position, straighten the AP curvature
2. Apply facilitating force (compression or torsion)
3. Shorten muscle
4. Hold for 3-4 seconds
5. Release and re-evaluate