Another soft technique that people like
is called counterstrain technique.
And what that is, is finding the points
that relates to decrease in motion
or decrease in the ability to
use the musculoskeletal system.
There are counterstrain points
posteriorly and anteriorly.
And they're treated a
little bit differently.
Let's talk about the posterior
counterstrain points first.
The posterior counterstrain points are gonna
relate to the vertebral level, for T1, for T12.
It could be on the spinous process
or just lateral to the spinous process
on the transverse process.
A counterstrain point is in the area of softness,
boggyness and the indentation in the muscle
that generally elicits a sense of
discomfort or dis-ease in a patient.
So you find an area and you ask,
"Is that tender?"
And if it's tender they'll let you know
and that's an area you want to treat.
When you find a tender point
to treat, you monitor it.
You push in until you cause pain
and I'm gonna move your neck a little bit now
to try and ease some of the tenderness and pain.
And you monitor it with your finger,
feeling for the tenderness,
feeling for blood flow, pulsations
and you side bend, you rotate,
you twist until you have a decrease in the pain.
"Does that feel better?
Yes, that feels better."
At this point I'm gonna have to hold
this for 90 seconds.
After about 45 to 60 seconds,
you'll start feeling some easing up,
maybe some pulsations on that area.
And then at the end of the 90 seconds,
you return them and say,
"How much better is that?"
Typically you want 70 percent relief.
You wanna be able to push in it
and no longer have them wince,
no longer have them feel the discomfort.
And that's how you treat a tender point.
Again, posterior tender points T1 through
T12, either on the spinous processes
or just lateral the spinous processes.
Now maybe flip over?
Anterior counterstrain points usually
start anteriorly in the midline,
in the center of the chest.
T1 is where the first rib attaches
with the sternum.
T2, T3 and I'm just walking down the ribs.
T4, T5, T6 and T7.
T7 actually has 3 points.
One is midline, one lateral on each side.
So there are three T7 points.
T8 is lower, T9 is just above the umbilicus,
T10 below the umbilicus,
T11 even lower and T12 is by the ASIS,
just superior to the anterio-superior iliac spine.
Now I'm gonna talk about treatment
of the counterstrain points.
So we've identified all
12 counterstrain points anteriorly.
When you're treating T1 through T4,
it's generally easy with little bits of motion.
And the motion is gonna be from up
top from the head, finding the area of ease.
And once we find the tender point,
find an area where the pain goes away
and the tenderness goes away.
That's T1 through T4.
If you get to T5, 6, 7 and 8,
then the patient is gonna have
to move a little bit more.
And you may want to get your knee behind
it and move them up a little bit.
You may wanna induce
some side-bending and rotation.
In order to make sure that you
get the pain to be relieved
and the tenderness to go away
in that point.
So I often use my knee under the back,
in order to support him while I'm doing this.
And make sure that you get
a position of comfort.
So if I feel a tender point in the
abdominal area, like a T9 or T10,
I'll find the tender point.
Make sure that's the area that feels
a little bit uncomfortable, correct?
Can we have you bend your knees?
and then I'll take the knees and bend
it to relax the rectus abdominis,
twist it or find the area of comfort
where it tends to go away
and it tends to feel more
comfortable as this?
Feels like the place that's
gonna be the most comfortable.
and then you'll hold it for 90 seconds
or until you feel the pulsation
and you feel the relaxation.
And at the end of the 90 seconds, you reset
and re-monitor and say,
"Does it feel better?"
So that area has been treated.