How to Explain Counterstrain
Counterstrain in Practice · Volume 2
When a new patient asks, “So what exactly is Counterstrain?” they’re not always looking for a technical definition.
They want to know if they can trust you.
Most people have never heard of interstitial inflammatory stasis. They don’t need a lecture on cytokines. They need to understand what you’re doing and why it might finally move the needle.
We asked our instructors and TAs how they explain Counterstrain to someone who’s never heard of it—whether that’s a brand-new patient or someone they’ve been treating who could benefit from a different approach. The answers were different, but they all came back to the same thing. Meet your patient where they are with language they can actually hear.
Simplicity is key
For many clinicians, the best explanation is straightforward.
MSK-C instructor Kyle Kusunose explains it like this: “Counterstrain identifies areas where inflammation has become trapped in the body’s tissues and systems. Through a specific diagnostic process, we find those restrictions and use a gentle, indirect technique to help that stagnation drain out of the tissue and recirculate.”
He also gives a simple analogy that patients can easily understand.
“When a suitcase zipper gets stuck, you can keep yanking on it. Or you can back up, adjust what’s caught, move some clothes out of the way, then zip it up smoothly.”
Translating the research on Fascial Counterstrain
Underneath that simple explanation is real research. In 2021, Brian Tuckey and colleagues explored impaired lymphatic drainage and interstitial inflammatory stasis in chronic musculoskeletal and idiopathic pain syndromes.
It gives context to what we’re seeing in practice—like pain that lingers beyond expected recovery timelines, or symptoms that don’t line up neatly with imaging.
But patients don’t need to hear the terminology.
They need something like, “There’s an area where fluid isn’t draining well. When that clears, your system can calm down.”
It’s clear and concrete. And if a patient wants to go deeper, the research is there to support it.
On reframing inexperience (and owning it)
There’s another layer to this.
If Counterstrain is new to you, say that. You don’t have to present it as something you’ve done for twenty years.
“I’ve been studying a different way of looking at inflammation and pain. I’ve seen the results firsthand, and I really think it could help.”
That kind of honesty builds trust faster than pretending you’ve always done it this way. It also helps ease the pressure of needing to get it perfect while you’re still learning.
Patients respect clinicians who keep learning. Bringing new tools to the table—even when you’re still refining them—can often reinforce your credibility.
Earning your patients’ buy-in
Some patients want research. Some want a simple analogy. Most just want reassurance that treatment will actually work. Your job is to recognize what they need to hear.
Getting patients on board with something new starts with how you communicate it. Even if Counterstrain is new to you, speak clearly and confidently. Invite them into the process. Instead of prescribing, propose. “Here’s what I’m seeing. Here’s why I think this could help. Let’s try it and see how your body responds.”
That subtle shift changes the dynamic. When patients feel involved in the decision-making process, they’re steadier and more trusting, and that carries into the treatment itself.
Counterstrain in Practice is a monthly series exploring real-world experiences across the Counterstrain learning journey.
From the archives:
1 Comment
This is great!
I like the formal and informal explanations that I can pass on to my clients. They already feel at ease because Counterstrain is about listening to the body and what it wants instead of “No pain, no gain”, but this is something they can pass on to their circle when asked “what are they doing there that is different from other therapy places”.
Thanks for this and everything.