Rib counterstrain
Notes
Ribs
Rib counterstrain
ANTERIOR RIBS (AR) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| AR1 | Inferior to clavicle on 1st chondrosternal articulation | Supine Flex, side bend toward, rotate toward (F STRT) | ||
| AR2 | Superior aspect of 2nd rib in mid-clavicular line | Supine Flex, side bend toward, rotate toward (F STRT) | ||
| AR3–AR10 | Anterior axillary line on corresponding rib | Seated Flex, side bend toward, rotate toward (F STRT) | ||
Figure 1. Locations of the anterior ribs' counterstrain tender points.
POSTERIOR RIBS (PR) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| PR1 | Superior aspect of 1st rib lateral to costotransverse articulation | Seated Extend, side bend away, rotate toward (E SART) | ||
| PR2–PR10 | Superior aspect of corresponding rib angle | Seated Flex, side bend away, rotate away (F SARA) | ||
Figure 2. Locations of the posterior ribs' counterstrain tender points.
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Aileen Lin, MScBMC
Editor: Robyn Hughes, MScBMC
Key Takeaways
Rib counterstrain is a technique used in osteopathic medicine to relieve pain and discomfort in the rib cage area. It is based on the principle of positional release therapy, which involves finding a position that relieves pain by releasing muscle tension or strain. It is considered a safe and effective treatment for rib-related pain, but it should be performed by a trained practitioner.