Counterstrain

Counterstrain is a technique used in osteopathic medicine to treat somatic dysfunction.

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Technique

In this technique, the physician identifies a point of maximum pain, called a tender point. Monitoring the tender point, the physician positions the patient to maximally relieve the discomfort. The physician holds the patient in the maximally relaxed position 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 loss of range of motion.

Physiological basis

Tender points are foci of hypertonicity resulting from reflexive muscular contracture. The physician breaks the reflex cycle by positioning the patient in such a way that the hypertonic tissue is maximally relaxed. This position eliminates or minimizes stimulation leading to reflex-mediated contraction. Relaxation results in restoration of range of motion and resolution of somatic dysfunction.

Sources

• Ward, Robert C. et al; Foundations for Osteopathic Medicine (2nd ed.). Philadelphia: Lippincot Williams and Wilkins. ISBN 0-7817-3497-5.