Overview
Strain-Counterstrain (SCS) is a gentle passive osteopathic technique developed in the 1950s by Dr. Lawrence Jones. The method involves identifying and tender points in localised areas of hypersensitivity caused by muscle or ligament strain, often due to injury, poor posture, or overuse. The technique relieves pain and dysfunction by positioning the body to "counteract" the strain that has caused the tender point to form.
Technique:
Locate Tender Points: The practitioner palpates muscles or ligaments to find tender points, which are small, discrete areas of hypersensitivity typically found in muscles or ligaments.
Positioning: Once a tender point is identified, the practitioner positions the patient in a position that shortens the muscle or tissue involved, thus relieving the strain in that area. The position of comfort is the key component in counteracting the strain. The degree of movement to achieve this position is minimal, often requiring only slight adjustments.
Hold and Duration: The patient is held in the position of comfort for 90 seconds to 2 minutes. This allows the body to release the abnormal tension in the tissue, after which the tender point often diminishes or resolves.
Reevaluation: The tender point is re-assessed to confirm reduced sensitivity. If necessary, the technique may be repeated or adapted to address additional tender points.
Mechanism of Action: The theory behind Strain-Counterstrain is that by positioning the body in a way that decreases strain on the tissues, the body's natural healing processes are facilitated. This leads to reduced pain, a normalization of muscle tone, and improved function and range of motion.
Clinical Indications: Strain-Counterstrain can be used to treat a variety of musculoskeletal issues, including:
• Acute or chronic muscle strains
• Postural dysfunctions
• Ligamentous strain
• Tender points in conditions like
fibromyalgia or myofascial pain
syndrome
• Somatic dysfunction related to joint or tissue restriction
Case Study: A 45-year-old male presents with chronic lower back pain. The patient reports a history of poor posture at work, prolonged sitting, and occasional heavy lifting. On examination, tender points are palpated in the lumbar and paraspinal muscles, specifically around the L3 and L4 vertebrae. The patient also demonstrates a limited range of motion in lumbar flexion.
Treatment: The practitioner identifies a tender point in the right lumbar paraspinal region. To address this, the practitioner gently positions the patient in a way that shortens the muscles around the lumbar region, bringing the patient into slight flexion with a slight rotation. The practitioner holds this position for approximately 90 seconds, during which the muscle tension gradually decreases. After the release, the practitioner reassesses the tender point, noting a significant reduction in tenderness and an improvement in the patient’s ability to flex the lumbar spine without pain.
Outcome: Following a series of treatments utilising Strain-Counterstrain, the patient reports a marked reduction in pain and an improved range of motion in the lumbar spine. The patient is advised on posture correction and ergonomic adjustments at work to prevent future episodes.
This detailed approach to Strain-Counterstrain demonstrates its value in treating musculoskeletal disorders while emphasising the clinical method and patient benefits.
References:
Jones, L. H., & Duvall, L. (1995). Strain-Counterstrain. Journal of the American Osteopathic Association, 95(11), 673-678.
Kaptchuk, T. J. (2002). The Web That Has No Weaver: Understanding Chinese Medicine. McGraw-Hill.
Chila, A. G. (2005). Osteopathic Medicine: Principles and Practice. Lippincott Williams & Wilkins.
Leach, R. A. (2004). Osteopathic Medicine: A Family Practitioner’s Guide. Springer.
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