In Physical Therapy, what is Strain-Counterstrain?

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  • Written By: Angela Crout-Mitchell
  • Edited By: Allegra J. Lingo
  • Last Modified Date: 08 October 2019
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Strain-counterstrain techniques are used in physical therapy fields, such as massage therapy, to improve muscle flexibility, relieve pain, and allow for a patient's greater range of motion. It is used to reduce muscle and joint pain. Most commonly referred to as positional release techniques, strain-counterstrain techniques are used to bring relief to patients affected by muscle strain or small knots of tissue known as trigger points. The manual therapy consists of assisting the patient into and exaggerated form of incorrect posture or positioning, allowing a 60 to 90 second rest time, and then helping the patient into a correct posture. The strain-counterstrain therapy often results in a greater range of motion motion and more comfort for the patient.

This massage technique has very specific applications and is not designed to help with every muscle or joint disorder. The physical or massage therapist will use positional release on only a select client base. People who suffer from fibromyalgia may benefit from this type of therapy. Cases of whiplash, back and neck pain, as well as some forms of post injury pain can benefit from these therapies. Overall, strain-counterstrain techniques are gentle enough to be used on both young children and elderly patients in the correct circumstances.


Strain-counterstrain therapy is designed to reduce the symptoms of musculoskeletal disorders and spasms, along with reliving accompanying pain. Trigger points and tight muscles often result in a limited range of motion and soreness in the shortened muscle areas. With positional release, the patient is encouraged to hold and even deepen the most comfortable position for them in their present state, and then are gently guided back to a more natural and healthy position by the therapist. In many cases this technique allows the patient to return to a position closer to normal while experiencing with very little or no discomfort.

These techniques are designed to assist damaged muscles in releasing dysfunctional muscle patterns. During the treatment it isn't uncommon for the massage therapist to palpate the strained area and seek out trigger points. Often, other techniques like trigger point pressure and friction are used to break apart muscle fiber knots, which offers the patient greater pain relief and motion along with the positional release therapy. It is not unusual for several physical therapy sessions to be needed in order to provide normal or near normal range of motion for the muscle group. Range of motion improvement, along with pain relief, are the primary benefits of strain-counterstrain physical therapy techniques.


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Post 3

What about muscular leg pain?

Post 1

I am looking at this for my wife. She has major neck pain and migraines. I understand that this technique can really help this and cure the migraine problem. Please let me know what you have on this.

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