What is the manifestation of Counterstrain (Counterstrain technique)?

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Last updated: March 12, 2025View editorial policy

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From the Research

Counterstrain manifesting is a gentle manual therapy technique that treats pain and dysfunction by identifying tender points in the body and placing them in positions of comfort to reset muscle tone and function. The practitioner locates specific tender points associated with somatic dysfunction, then positions the patient in a way that reduces tenderness by at least 70%, holding this position for 90 seconds. This allows the nervous system to reset abnormal muscle tone and restore proper function. The technique works by interrupting the neurological feedback loop causing muscle spasm and pain, essentially "retraining" the proprioceptors (position sensors) in muscles and joints. Counterstrain is particularly effective for treating acute muscle spasms, post-injury pain, and chronic musculoskeletal conditions, as supported by a recent study 1 that compared the effects of physical therapy with the Active Release Technique and Strain-Counterstrain Manipulation with massage alone on pain and disability in patients with chronic neck pain. The treatment is painless and non-traumatic, making it suitable for patients who cannot tolerate more aggressive manual therapies. For optimal results, patients typically require multiple sessions, often starting with 2-3 treatments per week, then gradually decreasing frequency as symptoms improve. Some key points to consider when using Counterstrain include:

  • Identifying tender points associated with somatic dysfunction
  • Positioning the patient to reduce tenderness by at least 70%
  • Holding the position for 90 seconds to allow the nervous system to reset abnormal muscle tone
  • Using the technique to interrupt the neurological feedback loop causing muscle spasm and pain
  • Considering the use of Counterstrain in conjunction with other therapies, such as massage or Active Release Technique, as shown in the study 1. It's also important to note that the effectiveness of Counterstrain can vary depending on the individual patient and the specific condition being treated, as highlighted in studies 2 and 3. However, overall, Counterstrain is a valuable technique for treating a range of musculoskeletal conditions, and its gentle and non-invasive nature makes it a suitable option for patients who cannot tolerate more aggressive therapies. As supported by the most recent and highest quality study 1, Counterstrain is a effective technique for reducing pain and disability in patients with chronic neck pain, and its use should be considered in the treatment of this and other musculoskeletal conditions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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