Strain-Counterstrain
Harmon Myers, DO
Origin of Counterstrain
Lawrence Jones, DO
Original Patient: 4 Months of
lower back pain, sleep
deprivation and high velocity
therapy
Jones’ Discovery
STRAIN-COUNTERSTRAIN
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Strain counterstrain theory Harmon Myers, Slides of Occupational therapy
Strain counterstrain theory describes in origin counterstrain, lawrence jones, travell's discovery, pathology, treatment positions, case headache.
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Strain-Counterstrain
Harmon Myers, DO
Origin of Counterstrain
Lawrence Jones, DO
Original Patient: 4 Months of lower back pain, sleep deprivation and high velocity therapy
Jones’ Discovery
STRAIN-COUNTERSTRAIN
“Passive, positional procedure that places the body in a position of greatest comfort, thereby relieving pain by reduction and arrest of inappropriate proprioceptor activity that maintains somatic dysfunction” -Lawrence Jones, DO, FAAO
Travell’s Discovery
MYOFASCIAL PATTERNS OF PAIN
Travell’s Trigger Points
“hyperirritable spot in skeletal muscle... hypersensitive palpable nodule in a taut band... tender when pressed and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena." Simons DG, Travell JG, Simons LS. Travell and Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol1. Upper Half of Body. 2nd ed. Baltimore, Md: Williams & Wilkins; 1999
Myers’ Insight
Jones’ Tender Points ⟺ Travell’s Trigger Points Counterstrain shortens the muscle identified by Travell’s Trigger Point
Theory Application
--RESET INAPPROPRIATE FIRING
Application
-Put antagonist muscle into passively shortened position -“reset” inappropriate “gain” in proprioceptor
Application
1-Find the pathology 2-Passively shorten muscle 3-Return to neutral slowly 4-Re-evaluate
Find the Pathology
--What myofascial pattern refers pain to the area? --What muscle hurts to stretch? --Is TP on opposite side of pain? --Which is most tender TP?
Treatment Position-
--Slowly position to shorten muscle --Monitor subjective pain and objective texture of TP --Hold position for !90 seconds --Treat most tender or middle TP first
Treatment Position-
--Anterior TP’s: flexion --Posterior TP’s: extension --Lateral TP’s: ඹsidebending, rotation --Midline TP’s: රsidebending, rotation
Treatment Position-
--Patient should be comfortable; if not, position is wrong --Treat most tender TP first --Treat midline TP’s first
Trapezius Levator Scapula
Case--Abdominal Pain
--Rectus Abdominis --External Abdominal Oblique --Iliacus --Longissimus Thoracis
Rectus Abdominis
External Abdominal Oblique Iliacus
“Clinical Applications of Counterstrain” by Harmon Myers, DO
Longissimus Thoracis Case--Back pain
--Quadratus Lumborum --Longissimus Thoracis --Multifidis --Rectus Abdominis --Soleus
Soleus Case--Knee pain
--Rectus Femoris --Vastus Medialis --Vastus Lateralis
Rectus Femoris Vastus Medialis
Vastus Lateralis Caveat
Position of Comfort!