COUNTERSTRAIN PRINICPLES PRINCIPLES: TREATMENT

• Position the patient to a point of maximum comfort while continuously monitoring the tender point
• Examine all of affected region(s) to find most significant tender point:
• The patient can assist you in getting into the treatment position
• The most tender one • Check for 70% resolution of tenderness

• If more than 1 of similar tenderness, the most central one • Make at least three attempts to get to a 0/10

• Keep your finger on the tenderpoint during the entire treatment, monitoring tissue changes
• Treat the tenderpoint you think is most significant first
• Light touch to monitor, not pressure!

• If there are several tenderpoints and you are sorting for the worst, establish a tenderness scale, (0-10) • Periodically recheck the tender point (at least at 30 seconds)

• Hold the position for 90 seconds

• Tell that patient that a 0/10 is no tenderness, and a 10/10 is bad enough that you’d want to be put under sedation (or something similar)
• Position the patient to a point of maximum comfort while continuously monitoring the tender point
• When you pick the one to treat, probe the tenderpoint and tell the patient you are now assigning a value of “10” to that level of tenderness. • The patient can assist you in getting into the treatment position

• “This is now a 10/10” • Recheck for continued 70% resolution of tenderness at lease at every 30 seconds

• Slowly and passively, bring the patient back to neutral (while still maintaining finger on the tender point whenever possible)
• Place the patient in the classic position of ease (first gross level, then fine tuning)
• Retest the tender point on the tenderness scale chosen, ensuring sufficient resolution

Tenderness is the diagnostic criterion for counterstrain, but also notice any tissue texture abnormalities or asymmetries as you palpate • As the somatic dysfunction resolves, there is a palpatory sensation of tissue tension decreasing

RIBS & STERNUM

4 Functions

• Protection of vital organs

• Respiration

• Pump for venous and

lymphatic return

• Platform for upper

extremities