Counterstrain is a technique used in osteopathic medicine and osteopathy to treat somatic dysfunction. It is a system of diagnosis and treatment that considers the dysfunction to be a continuing, inappropriate strain reflex, which is inhibited by applying a position of mild strain in the direction exactly opposite to that of the reflex; this is accomplished by specific directed positioning about the point of tenderness to achieve the desired therapeutic response. [1] The Australian and French osteopathic practitioners use the terms: Jones technique, (correction spontaneous by position), spontaneous release by position. It was developed by Lawrence Jones, DO in 1955. Originally, it was called “Spontaneous Release by Positioning,” and later termed “strain-counterstrain.” [2]
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In this technique, the clinician identifies a point of maximum pain, called a tender point. Monitoring the tender point, the physician positions the patient to maximally relieve the discomfort. The physician holds the patient in the maximally relaxed position and then slowly returns the passive patient to a neutral body position. Success of treatment is evaluated by reassessing both the tender point and any accompanying loss of range of motion.
Tender points are foci of hypertonicity resulting from inappropriate reflexive muscular contracture. The physician breaks the reflex cycle by positioning the patient in such a way that the hypertonic tissue is maximally relaxed. This position eliminates or minimizes stimulation leading to reflex-mediated contraction. Relaxation results in restoration of range of motion and resolution of somatic dysfunction.