Thoracic spine counterstrain
Notes
Thoracic spine
Thoracic spine counterstrain
ANTERIOR THORACIC (AT) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| AT1 | Midline at jugular notch | Flex | ||
| AT2 | Midline at junction of manubrium and sternum | Flex | ||
| AT3 | On sternum at level of costal cartilage related to named vertebra | Flex | ||
| AT4 | On sternum at level of costal cartilage related to named vertebra | Flex | ||
| AT5 | About 2–3 cm above xiphisternal junction | Flex | ||
| AT6 | At xiphisternal junction | Flex | ||
| AT7 | Tip of xiphoid and inferolateral on either side (3 points) | Seated Flex, side bend toward, rotate away (F STRA) | ||
| AT8 | About 4–5 cm inferior to xiphoid process (halfway between AT7 and AT9) | Seated Flex, side bend toward, rotate away (F STRA) | ||
| AT9 | About 1–2 cm superolateral to umbilicus | Seated Flex, side bend toward, rotate away (F STRA) | ||
| AT10 | About 1–2 cm inferolateral to umbilicus | Supine Flex, side bend toward, rotate away (F STRA) | ||
| AT11 | About 4 cm inferolateral to umbilicus | Supine Flex, side bend toward, rotate away (F STRA) | ||
| AT12 | Superomedial surface of iliac crest on mid-axillary line | Supine Flex, side bend toward, rotate away (F STRA) | ||
Figure 1. Locations of the anterior thoracic (AT) counterstrain points.
POSTERIOR & LATERAL POSTERIOR THORACIC (PT & LPT) | ||||
| TENDER POINT | ANATOMICAL POSITION | TREATMENT POSITION | ||
| PT1–PT12 | Lateral edge of inferior aspect of respective spinous process | Extend, side bend away, rotate away (E SARA) | ||
| LPT1–LPT12 | Lateral aspect of respective transverse process | Extend, side bend away, rotate toward (E SART) | ||
Figure 2. Locations of the posterior (green) and lateral posterior (purple) thoracic counterstrain tender points.
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Aileen Lin, MScBMC
Editor: Robyn Hughes, MScBMC
Key Takeaways
Thoracic spine counterstrain is a manual therapy technique used to relieve pain and restore mobility to the thoracic spine. It is a gentle and non-invasive technique that involves finding tender points in the muscles and applying a precise amount of pressure to those points to release tension and improve range of motion. Thoracic spine counterstrain is a safe and effective technique that can be used to treat a variety of conditions, including back pain, postural problems, and musculoskeletal disorders. It is often used in conjunction with other manual therapy techniques, such as myofascial release, trigger point therapy, and stretching, to provide a comprehensive treatment approach.