OPP I_1-4 Counterstrain Principles

-Convenience
-Gentle, acceptable
-Symptom specific
-Rapid response in acute settings
-If muscle or tendon is involved

-Less articular specificity.
-Slow!
-Works for some dysfunctions, not all.
-If it hurts, don’t do it.
-If patient cannot be passive.

-Dx by tender-point; assess regionally; treat the worst first
-Tx by passive positioning, (to comfort)
-Emphasis on neuromuscular resetting
-Hypothetical basis, neurophysiology to be discussed further in the future.
-Time element essential

-Start w/ Hx
-Identify TP, sometimes by
palpable nodular edema or muscle tension
-Survey of adjacent TPs
for primary (front/back, origin/insertion, regionally related
-Label this “10“ (not to be confused with pain scale)

-position of ease, “2 or less” (less than 3)on pain scale ; often corresponds to a position of injury – try for “0”
-keep monitoring finger in place until retest
-hold position of ease in passive mode
for 90 seconds (ribs 120 seconds?)
-return patient to resting position without their active effort
-retest, retreat with fine tuning or progress to adjacent areas

-Identify and scale TP
-Passive positioning to “2” or less
-Monitor location, do not remove finger
-Hold for 90 seconds
-Passive return to neutral
-Retest, retreat

5-6

-Local tissue damage or inflammation.
-Reflexive tenderness or pain.
-Psychogenically amplified pain intolerance.
-May or may not correspond to location of structural diagnosis
-Treat the patient, not the tenderpoint

-Counterstrain tenderpoint
-(Travell) trigger point
-Cellulalgia point of Maigne’s system

The dominant current hypothesis to explain the cause of somatic dysfunction
in the counterstrain model is that trauma or sudden strain causes proprioceptive
dysregulation.

-Jones’ mapping, with modifications
-Anatomic correlations
-Pain or sensitivity reflects strain