Strain and CounterStrain - American Academy of Osteopathy

110 Pages·2012·8.01 MB·English

by  Edward K. Goering

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Osteopathic Medical Associates
Edward K Goering DO

Special Thank you to
Brian Tuckey PT, OCS,JSCSC
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Manual therapy is the therapeutic application of manually
guided forces by a practitioner to improve physiologic
function and/or support homeostasis that has been altered by
somatic dysfunction.(1)

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Osteopathic
Manipulative Treatment
Or Manual Therapy -
Definition
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Direct vs. Indirect Manipulative
Techniques


Direct Techniques: The operator manipulates
the joint or tissue into the direction of motion
restriction. Operator generated force then
allows movement beyond the perceived
(3)
restrictive barrier.


Indirect Techniques: The operator positions the
joint or tissue away from the perceived motion
barrier toward ease or freedom. Indirect
techniques alter neural mechanisms in order to
alleviate restrictive barriers. (3)
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Effects of Manipulation
Alternative Medicine and Rehabilitation: A Guide for Practitioners. Wainapel SF, Fast A, editors,
Chapter 1
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Joint mobilization or Functional Indirect Technique
Articulatory Technique(4) (6)
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HVLA (5) Jones Strain/CounterStrain
* Technique (10)
Muscle Energy Technique (6)
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* Cranial Sacral
Myofascial Release Technique (7)
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Manual Lymphatic Drainage (8)
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Visceral Manipulation (9)
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Cranial Sacral
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Examples of Direct and
Indirect Manipulation
Techniques

Definition: A passive positional
procedure that places the body in
a position of greatest comfort,
thereby relieving pain and
dysfunction by reduction and
arrest of inappropriate
proprioceptive activity that
maintains somatic dysfunction. (11)

CounterStrain is targeted to both
muscular and non-muscular
(fascial) tissues, e.g. - ACL, PCL,
ITB, Piriformis, Teres Major/ Minor
etc. (11)

The technique involves positioning
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for comfort, followed by a 90
Strain and
second hold and finally a slow
return to neutral. (11)
CounterStrain
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Somatic dysfunction is defined as impaired or
altered function of related components of the
somatic (body framework) system: skeletal,
arthrodial and fascial structures and their related
vascular, lymphatic and neural elements(2)
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Somatic dysfunction is characterized in early stages
by vasodilation, edema, tenderness, pain and
tissue contraction. It is diagnosed by history and
palpatory assessment of tenderness, asymmetry or
relative position, restriction of motion and tissue
texture change. (2)

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What Are We
Treating?
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Before we can answer that question we need
to discuss 5 topics:
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Fascia and it relationships
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Proprioceptors
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Nociceptors
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Muscles
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Inflammation

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What is The Current
Theoretical Basis for
CounterStrain