Counterstrain

Last updated

Counterstrain is a technique used in osteopathic medicine, osteopathy, physical therapy, massage therapy, and chiropractic to treat somatic dysfunction. [1] It is a system of diagnosis and treatment that uses tender points, which are produced by trauma, inflammation, postural strain, or disease, to identify structures to manipulate. [2] The manipulation uses light pressure to decompress the local nociceptors and mechanoreceptors responsible for the sensation of pain, returning central sensitization to its normal state. This technique extends Strain-counterstrain, a technique inhibits the reflexes by putting the tissues in a position of ease directly opposite to that of the reflex. [3] [4] Strain-counterstrain is also known as the Jones technique, (correction spontaneous by position), and spontaneous release by position. Counterstrain was developed by Lawrence Jones in 1955 and was originally called “Spontaneous Release by Positioning,” before being termed “strain-counterstrain.” [5]

Contents

Strain-Counterstrain

In this technique, the practitioner identifies a point of musculoskeletal pain, called a tender point. Tender points are small, discrete, edematous areas on the body that elicit pain when palpated. Monitoring the tender point, the practitioner positions the patient such that the tenderness at the counterstrain point is minimized when pressed. [6] The practitioner holds the patient in a maximally relaxed position for 90 seconds and then slowly returns the passive patient to a neutral body position. Success of treatment is evaluated by reassessing both the tender point and any accompanying change in range of motion.

Over 200 tender point locations have been identified to correspond to strain in different muscles and joints. [7] The technique has developed to include variations of manipulations and methods to identify tender points. [4]

Conceptual basis

The idea behind counterstrain states that tender points result from reflexive muscular spasm that correspond to dysfunctional motor segments, due to the compensation of an antagonist muscle responding to agonist muscle over-lengthening. [7]

Related Research Articles

<span class="mw-page-title-main">Chiropractic</span> Form of pseudoscientific alternative medicine

Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.

<span class="mw-page-title-main">Temporomandibular joint dysfunction</span> Medical condition

Temporomandibular joint dysfunction is an umbrella term covering pain and dysfunction of the muscles of mastication and the temporomandibular joints. The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life; this is because the symptoms can become chronic and difficult to manage.

<span class="mw-page-title-main">Osteopathy</span> Alternative medicine emphasizing muscle and bone manipulation

Osteopathy, unlike osteopathic medicine, which is a branch of the medical profession in the United States, is a pseudoscientific system of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. In most countries, practitioners of osteopathy are not medically trained and are referred to as osteopaths.

<span class="mw-page-title-main">Craniosacral therapy</span> Pseudoscientific alternative medicine technique

Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull's bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery. It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.

Manual therapy, or manipulative therapy, is a part of Physiotherapy, it is a physical treatment primarily used by physical therapists, occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians.

<span class="mw-page-title-main">Myofascial trigger point</span> Medical condition

Myofascial trigger points (MTrPs), also known as trigger points, are described as hyperirritable spots in the skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibers. They are a topic of ongoing controversy, as there is limited data to inform a scientific understanding of the phenomenon. Accordingly, a formal acceptance of myofascial "knots" as an identifiable source of pain is more common among bodyworkers, physical therapists, chiropractors, and osteopathic practitioners. Nonetheless, the concept of trigger points provides a framework which may be used to help address certain musculoskeletal pain.

<span class="mw-page-title-main">Spinal adjustment</span> Chiropractic technique

Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.

Myofascial release is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles.

Myofascial pain syndrome (MPS), also known as chronic myofascial pain (CMP), is a syndrome characterized by chronic pain in multiple myofascial trigger points ("knots") and fascial constrictions. It can appear in any body part. Symptoms of a myofascial trigger point include: focal point tenderness, reproduction of pain upon trigger point palpation, hardening of the muscle upon trigger point palpation, pseudo-weakness of the involved muscle, referred pain, and limited range of motion following approximately 5 seconds of sustained trigger point pressure.

Muscle Energy Techniques (METs) describes a broad class of manual therapy techniques directed at improving musculoskeletal function or joint function, and improving pain. METs are commonly used by manual therapists, physical therapists, occupational therapist, chiropractors, athletic trainers, osteopathic physicians, and massage therapists. Muscle energy requires the patient to actively use his or her muscles on request to aid in treatment. Muscle energy techniques are used to treat somatic dysfunction, especially decreased range of motion, muscular hypertonicity, and pain.

Dry needling, also known as trigger point dry needling and intramuscular stimulation, is a treatment technique used by various healthcare practitioners, including physical therapists, physicians, and chiropractors, among others. Acupuncturists usually maintain that dry needling is adapted from acupuncture, but others consider dry needling as a variation of trigger point injections. It involves the use of either solid filiform needles or hollow-core hypodermic needles for therapy of muscle pain, including pain related to myofascial pain syndrome. Dry needling is mainly used to treat myofascial trigger points, but it is also used to target connective tissue, neural ailments, and muscular ailments. The American Physical Therapy Association defines dry needling as a technique used to treat dysfunction of skeletal muscle and connective tissue, minimize pain, and improve or regulate structural or functional damage.

Joint manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect.

Balanced ligamentous tension is both an indirect and direct technique used in osteopathic manipulative medicine.

Chiropractors use their version of spinal manipulation as their primary treatment method, with non-chiropractic use of spinal manipulation gaining more study and attention in mainstream medicine in the 1980s. There is no evidence that chiropractic spinal adjustments are effective for any medical condition, with the possible exception of treatment for lower back pain. The safety of manipulation, particularly on the cervical spine has been debated. Adverse results, including strokes and deaths, are rare.

Myotherapy is a form of muscle therapy which focuses on the assessment, treatment and rehabilitation of musculoskeletal pain and associated pathologies. The term myotherapy was coined by Bonnie Prudden to describe a specific type of trigger point therapy which she developed in the 1970s based on the earlier work of Travell and Simons who researched the cause and treatment of pain arising from myofascial trigger points. While based on rational principles, there is little scientific research regarding the efficacy of this therapy, so it remains controversial within the medical and academic disciplines.

Osteomyology is a multi-disciplined form of alternative medicine found almost exclusively in the United Kingdom and is loosely based on aggregated ideas from other manipulation therapies, principally chiropractic and osteopathy. It is a results-based physical therapy tailored specifically to the needs of the individual patient. Osteomyologists have been trained in osteopathy and chiropractic, but do not require to be regulated by the General Osteopathic Council (GOsC) or the General Chiropractic Council (GCC).

Articulatory technique is a type of Osteopathic Manipulative Treatment (OMT) performed by osteopathic practitioners and U.S. trained osteopathic physicians. The physician uses low velocity and moderate to high amplitude forces to carry a dysfunctional joint through its full range of motion, with the therapeutic goal of increasing range of motion. It is a technique that involves repeatedly taking a restricted joint into and out of its barrier to reduce a restriction.

Dentomandibular sensorimotor dysfunction (DMSD) is a medical condition involving the mandible, upper three cervical (neck) vertebrae, and the surrounding muscle and nerve areas.

Passive accessory intervertebral movements (PAIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland. The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness of the cervical and lumbar spine.

Fascial Manipulation is a manual therapy technique developed by Italian physiotherapist Luigi Stecco in the 1980s, aimed at evaluating and treating global fascial dysfunction by restoring normal motion/gliding to the system.

References

  1. ↑ Wong, CK; Abraham, T; Karimi, P; Ow-Wing, C (Apr 2014). "Strain counterstrain technique to decrease tender point palpation pain compared to control conditions: a systematic review with meta-analysis". Journal of Bodywork and Movement Therapies. 18 (2): 165. doi:10.1016/j.jbmt.2013.09.010. PMID   24725782.
  2. ↑ Tuckey, Brian; Shah, Jay; Tandon, Hannah (2017). "A New Rationale and Treatment Model for Neuromuscular Tender Points" (Document). Tuckey Continuing Education Services.
  3. ↑ DiGiovanna, Eileen; Stanley Schiowitz; Dennis J. Dowling (2005) [1991]. "Counterstrain (Chapter 14)". An Osteopathic Approach to Diagnosis and Treatment (Third ed.). Philadelphia, PA: Lippincott Williams & Wilkins. pp. 86–88.
  4. 1 2 Chaitow, Leon (2014). Fascial Dysfunction: Manual Therapy Approaches, Chapter 16 - Positional Release Techniques. Pencaitland, East Lothian: Handspring Publishing. pp. 205–213. ISBN   978-1-909141-10-0.
  5. ↑ "Glossary of Osteopathic Terminology" (PDF). American Association of Colleges of Osteopathic Medicine. April 2009. p. 28. Archived from the original (PDF) on 2 October 2013. Retrieved 25 August 2012.
  6. ↑ Wong, CK (2012). "Strain counterstrain: current concepts and clinical evidence". Manual Therapy. 17 (1): 2–8. doi:10.1016/j.math.2011.10.001. PMID   22030379.
  7. 1 2 Kusunose, Randall (1992). Rational Manual Therapies. Williams & Wilkins. pp. 324–325. ISBN   978-0683004205.

Sources

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.