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Flashcards in Intro to Counterstrain Deck (26)
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What are the absolute contraindications to counterstrain


Severe illness with strict positional restrictions

Instability of treatment area - potential to produce neurological or vascular side effects

Vascular or neurological syndromes which might lead to compromise of these systems

Severe degenerative spondylosis with no motion at the level of treatment


What is the counterstrain position of optimal comfort?

The position at which 100% of tenderness is alleviated


What are the 7 steps of counterstrain treatment?

  1. Find a significant tenderpoint
  2. Establish tenderness scale
  3. Monitor the tender point throughout treatment
  4. Place patient in position of optimal comfort
  5. Maintain position for 90 seconds
  6. Slow return to neutral
  7. Recheck tenderpoint


What is the nociceptive model of counterstrain?

When a tissue is strained, it recruits nociceptors within that tissue => reflexive tissue contraction => contraction of affected tissue becomes neutral

Agonist tissue strained => agonist tissue shortening


How much pressure should be placed on a tenderpoint during a counterstrain treatment?

Light pressure

(firm pressure discourages relaxation)


In the relaxation phase of counterstrain, what are the 3 planes that the affected tissue is shortened?





The treatment position "fSaRA" indicates what?

Small amount of flexion

Small amount of sidebending

Large amount of rotation

(Magnitude of action indicated by upper and lowercase)


What are the direct OMT techniques?

Soft tissue/Articulation Muscle Energy HVLA MFR Cranial


What is the likelihood of achieving a therapeutic reaction with counterstrain?

20-30% of pts will have a therapeutic pulse


How is a counterstrain dysfunction treated?

Applying position of mild strain in the direction exactly opposite to that of the false strain reflex by the use of specific point tenderness followed by specific directed positioning


What are the similarities between a trigger point and a tender point?

Locally tender Elicits jump sign when pressed Located in muscle


What occurs during phase 3 of counterstrain?

Washout - metabolic waste products built up because increased muscular tone inhibits blood flow, will be washed out after 1 minute, may feel a therapeutic pulse


About how many tender points can you treat in one treatment?

No more than 6


What are the indirect OMT techniques?

Strain/Counterstrain MFR Cranial BLT


How long must you maintain counterstrain position for ribs?

120 seconds


Which phase of counterstrain causes a rapid decrease in nociceptive input?

Relaxation phase


What are the benefits of counterstrain?

Passive, indirect technique

Can be used in patients with severe osteoporosis, metastatic bone disease, and acute injuries

The only absolute requirement is that pt must be able and willing to relax muscles


What is a maverick tender point?

Tenderpoint that does not respond to typical positioning

Typically requires the opposite position from standard


What are the primary endings of muscle spindle stretch receptors responsible for in muscle contraction?

Sense rate of change in length of muscle (length)


What is the definition of the counterstrain dysfunction?

Continuing, inappropriate strain reflex


Why is phase 4 of counterstrain a slow return to neutral?

Rapid return can reactivate spindle cell activity


What are the 4 phases of counterstrain?

  1. Relaxation
  2. Reset of spindle fibers and nociceptors
  3. Washout
  4. Slow return to neutral


What is the counterstrain position of comfort?

THe point at which at least 70% of tenderness is alleviated


What is the proprioceptive model of counterstrain?

Abnormal muscle lengthening causes antagonist muscles to shorten => CNS causes contraction of the antagonist muscle to become the new neutral state

Agonist tissue strained => antagonist tissue shortening


What are the differences between a trigger point and a tender point?


What are the relative contraindications to counterstrain?

Pt cannot voluntarily relax

Pt cannot discern level of pain or change in pain with positioning

Pt cannot understand instructions

Pt with underlying conditions restricted by positioning (arthritis, connective tissue disease)