Strain/Counterstrain Technique

The Strain/Counterstrain Technique is a therapy practiced by osteopaths and chiropractors in whom the practitioner manually makes body adjustments to relieve muscle spasms and subluxations of the joints. This technique is not a treatment for damaged or injured tissues. Rather, it is a treatment to resolve aberrant neuromuscular reflexes and positioning that are causing muscle spasms. Unlike chiropractic adjustments, which involve sudden, forceful movements, this technique is more slow and deliberate.

This treatment is commonly performed to treat musculoskeletal conditions such as low back pain caused by back spasms, myofascial pain syndrome, and restless leg syndrome.

In many cases of injury, the muscles spasms originally in response to a tear in its structure of some other condition which affects the nerve supplied by that muscle. The nerve may be affected by an injury to itself, as in the case of nerve root compression, or by an injury to the soft tissues associated with that nerve. In most cases, the injury heals itself, the nerve stops firing as a result of this healing, and the muscle stops spasming as a result. In other cases, the nerves in the muscle continue to fire and send signals to the brain, causing a continued state of muscle spasms. The counterstrain technique is designed to inhibit this misfiring of these nerves.



Counterstrain techniques involve gently moving patients into positions that will inhibit the body's reflex action that causes the muscle to contract continuously. To do this, the therapist moves the affected body part into a position of strain in a direction that is opposite to the reflex causing the muscle contraction. The therapists experiments with positioning the patient in different positions until he or she finds one that allows the muscle to relax. Once the muscles begin to relax, they will begin to reset to their natural positions.

One of the leaders in this field of manipulative therapy is the expert Randall S. Kusunose, who is the author of Rational Manual Therapies. In this instructional book, he says that the cause of the continued contraction of the affected muscles is aberrant (neuron) flow from the muscle spindle. The counterstrain technique involves the movement of the muscle into a position where this neuronal response in inhibited, allowing the muscle to begin to reset into its natural position. He believes that for a variety of reasons, an injury causes the muscle or nerve supplying that muscle to be injured or strained, causing the reflexive action of the body that is a muscle contraction. This reflexive response may be reversed by moving the affected body parts into a position which involves applying a counterstrain. The therapist mimics the original strain position and then moves the joint in a direction that eases the strain. This movement shortens the affected muscle. Once the therapist has reached a position that eases the strain and shortens the muscle, this position will be held for a period of 90 seconds. This period allows the firing rate of the muscle spindle to slow down. Then the therapist will then slowly move the body back into a neutral position. By easing the body back into a neutral position slowly; it avoids re-exciting the previously spasmed muscles.

Once the natural position has been achieved, the doctor or massage therapist will then begin to stretch or manipulate the muscle to resolve any remaining points of tension or trigger points in the muscle tissue or muscle fascia. Once the trigger points in the muscle and fascia have been resolved, there should be a reduced likelihood of muscle spasms in the future. At the conclusion of the treatment program, the patient should experience lasting muscle positioning and function. The Strain/Counterstrain technique is common for conditions involving muscle spasms, trigger points, and muscular imbalances. Muscular imbalances often occur in the hip and shoulder - often following an injury to one of these areas. By correcting the positioning of the muscle, and eliminating areas of tightness, the patient will have an improved posture and comfort levels, and lasting pain relief.