Releasing Muscle Spasms Utilizing Indirect Techniques

History of Jones’ Strain/Counterstrain

Strain- Counterstrain has proven to be a necessary and very effective technique in any manual therapy practice. After over 40 yeas of clinical practice Lawrence Jones, D.O. published his first book on Strain-Counterstrain in 1981. In 1995, Dr. Jones published a newer book on this subject, which I suggest all interested in this approach read for themselves. I first learned Strain-Counterstrain techniques from Dr. Rex of the URSA foundation in the late 1980’s. I began teaching courses in protective muscle spasms utilizing Strain-Counterstrain in the early 1990’s. Dr. Jones himself began teaching in Hartford where I was working at the time and although I did not meet him, many of my clients were models during their courses and I was amazed at some of his insights on those clients. Dr. Jones died a few years ago but was teaching his approach up to that point. Dr. Jones was well over 6 feet tall so those of us who are closer to 5 feet may need to adapt some techniques to fit our own size. Please remember that no matter what technique you use to treat your clients that you yourself are comfortable.

Dr. Jones had many views on rheumatic pain. He felt this is a poorly understood malady encompassing 2/3 of all human pain. He felt it is not effectively treated by modern medicine and not a medical problem , but a physical one. One cause of pain is when there is a malfunctioning neuromuscular reflex reporting continuous strain where there is none. If a practitioner inhibits the malfunctioning reflex and its continuous irritation this will enable the body to heal that which it could not heal before.

Strain- Counterstrain is the treatment of choice for acute patients. It works well for back pain clients in the hospital or those who walk in your office in severe muscle spasms. In addition it works well with all other clients. It is gentle and atraumatic. The body is moved slowly in nonpainful positions that are nonthreatening and readily within their limited ROM.

Treating the neuromuscular component in the acute condition facilitates improved circulation and promotes the body’s ability to heal the damaged tissue. The gentleness of SCS makes it safe and effective for treating pain conditions related to elderly, pregnant, and pediatric population. SCS is valuable for chronic patients as it overcomes the aberrant flow of afferent impulses in involved muscles. It restores normal neuromuscular reflexes balancing the muscular forces that effect joint function.

SCS also produces increases in ROM, relief of pain, and improved joint function. This reduction of pain and guarding facilitates the effectiveness of direct mechanical mobilization and rehabilitation exercises.. For the neurologically involved patient, the practitioner is guided by tissue tension changes. SCS can make a significant contribution when integrated with other manual medicine procedures.

In 1975 Irvin Korr, Ph.D. wrote the article, “Proprioceptors and Somatic Dysfunction.” Dr. Korr found that different proprioceptors required different amount of time to be reset. The longest being 90 seconds. Therefore, you will find that all treatments are held for at least 90 seconds.

There are 4 types of mechanoreceptors:

Type 1 Within the joint capsules these receptors have tonic reflexogenic effects on the neck, limbs, jaws, and eye. They effect postural and kinesthetic sensation, and pain suppression. They are slow adapting.

Type 2 Within the joint capsules, rapid adapting, suppress pain, and phasic reflexogenic.

Type 3 Fusiform corpuscles in ligaments and tendons. They have high threshold, are slow adapting, and inhibit motor neurons.

Type 4 Nociceptors within capsules. They are high threshold and tonic reflexes. Stimulated by narrowing of the disc, Dislocation of joints, and chemical irritation with inflammatory processes.

Joint capsule innnervation is a balanced interaction between mechanoreceptors and nociceptors. Mechanoreptors provide a dampening effect on the nociceptive input through the interneurons. Muscle spindles are sensitive to changes in length and will induce reflex contraction of the same muscle and help reciprocal inhibition of antagonists. Muscles for fine and precise movement have higher concentration of spindles. The suboccipital area has 150-200 spindles per gram of muscle tissue. The rectus femoris has 50 spindles, and the paraspinals have 200-500 spindles per gram of muscle tissue.

Golgi tendon organs (Type 1B) are sensitive to stretch during contraction. They inhibit muscles and facilitates the antagonists- autogenic inhibition. Long term increase in muscle tone will overload tendons, impair circulation, lead to lack of oxygen at the cellular level, and end with progressive degenerative tendon changes.

SCS uses a system of Tender points. These are points of hypersensitivity beneath the skin and smaller than a finger tip. They are 4 times more tender than normal to finger probing. They are enough to make the client flinch from a pressure not at all painful to normal tissue. Each tender point is specific for 1 joint and nearly always for the position that will relieve it. The tender point is a manifestation of the facilitated segment. The skill required is learning to feel tissue tension of tender points and the changes in the response to positioning of the client’s body.

There are 3 simple rules:

1. Move the affected joint passively into its position of greatest comfort.

2. Return slowly enough the pain does not return.

3. Avoid any sudden return even if the position is painful. Back off a little, wait a few seconds and proceed slowly again.

Role of manipulation in correction of somatic dysfunction:

1. When the body is in the correct anatomical position this leads to normal pressures and tension in myofascial tissues.

2. Mechanoreceptors would have the proper dampening effect on nociceptor input.

3. Normal resting tone would be in the myofascial tissues.

4. Dynamic equilibrium present between antagonists, synergists, and agonists.

SCS brings maximal shortening to the proprioceptors reporting strain so well it cannot continue to report strain. It shortens the spindle of the agonist and strains the GTO of the antagonist. Counterstrain corrects the aberrant alpha-gamma loop misinformation and restores normal tone to the tissues. The severity, acuteness, chronicity, and emotional investment of the injury will all determine the length of treatment required for resolution of the lesion.