Lumbar spine counterstrain
Page created: March 04, 2021
Notes
Lumbar Spine
Lumbar spine counterstrain
ANTERIOR LUMBAR (AL) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| AL1 | Medial aspect of ASIS | Flex, side bend toward, rotate away (F STRA) | ||
| AL2 | Medial aspect of AIIS | Flex, side bend away, rotate toward (F SART) | ||
| AL3 | Lateral aspect of ASIS | Flex, side bend away, rotate toward (F SART) | ||
| AL4 | Inferior aspect of ASIS | Flex, side bend away, rotate toward (F SART) | ||
| AL5 | Superior aspect of pubic ramus just lateral to pubic symphysis | Flex, side bend away, rotate away (F SARA) | ||
Figure 1. Locations of the anterior lumbar counterstrain tender points.
POSTERIOR LUMBAR (PL) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| PL1–PL5 spinous process (SP) | Inferolateral aspect of spinous process of L1–L5 | Extend ipsilateral thigh to level of tender point, side bend and rotate away by adducting ipsilateral lower extremity (E SARA) | ||
| PL1–PL5 transverse process (TP) | Lateral aspect of transverse process of L1–L5 | Extend ipsilateral thigh to level of tender point, side bend and rotate away by adducting ipsilateral lower extremity (E SARA) | ||
| Quadratus lumborum | Inferior aspect of 12th rib and superior aspect of iliac crest | Extend hip and thigh, abduct and externally rotate (E ABD ER) | ||
Figure 2. Locations of the posterior lumbar counterstrain tender points. Midline points (green) are at spinous processes and lateral points (purple) are at transverse processes.
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Aileen Lin, MScBMC
Editor: Robyn Hughes, MScBMC
Key Takeaways
Counterstrain is a type of manual therapy that uses gentle, sustained pressure to manipulate the musculoskeletal system and relieve pain. This type of therapy is based on the premise that pain is caused by muscle tension and inflammation in the body. By relieving this tension and inflammation, counterstrain aims to reduce or eliminate pain.
The lumbar spine counterstrain technique specifically targets the muscles and ligaments in the lower back. It involves applying pressure to specific points on the body in a particular order. This pressure is then held for a period of time while the patient relaxes into it. The therapist will then move on to another point and repeat the process.