OMM Review — Counterstrain and Facilitated Positional Release
Original OMM review notes for counterstrain tenderpoints and facilitated positional release.
Counterstrain Principles
Counterstrain is an indirect technique that shortens the muscle harboring a tenderpoint. The point is monitored while the body part is positioned to reduce tenderness, held for approximately 90 seconds, then slowly returned to neutral.
The tenderpoint is not forced; the position is the one that reduces tenderness by 70% or more.
Common Tenderpoints
| Location | Muscle / region |
|---|---|
| Occiput | Suboccipital muscles |
| Anterior C7 | Scalene / prevertebral |
| Medial scapula | Rhomboids / middle trapezius |
| Posterior ASIS | Iliacus / psoas |
| Medial knee | Medial hamstrings / adductors |
Facilitated Positional Release
FPR combines positioning in ease with a facilitating force (compression, traction, or rotation). The added force is maintained while the tissues release, then the position is slowly unwound.
Indications
- Acute and chronic somatic dysfunction with tenderpoints.
- Patients who cannot tolerate high-velocity or direct stretching.
- Post-traumatic muscle spasm and guarding.
Q: How long is a counterstrain position typically held?
A: Approximately 90 seconds, followed by a slow return to neutral.
Q: Is counterstrain direct or indirect?
A: Indirect, because the muscle is placed in a shortened or eased position.