Inside the Clinical Application of Counterstrain
Counterstrain in Practice · Volume 3
Applying new techniques in the clinic can feel overwhelming, not just for those new to Counterstrain, but also for experienced clinicians continuing to build on their skills.
The lab offers clarity: concepts feel organized, techniques come together, and confidence builds. But translating that experience into real-time patient care—recalling assessments, navigating treatment order, and adapting on the fly—can feel far less straightforward.
The clinical application of Counterstrain looks different for every clinician and often evolves over time. These early experiences show how that shift first took shape in practice.
Integration as a marathon, not a sprint
In a recent social media post, Andrew Adams shared how he began integrating Counterstrain into the muscle energy and joint mobility work he was already using in the clinic. Rather than abandoning those techniques, he found that even a brief application of Fascial Counterstrain beforehand made his existing work more effective, improving outcomes with less resistance.
For Izzy Sanchez, the clinical application of Counterstrain was a lightning strike: fast, powerful, and impossible to ignore.
His post-surgical client had been stuck in a slouched posture despite repeated direct treatment to the surrounding musculature. After a brief, three-minute application of newly learned SCS techniques, Izzy’s patient could fully straighten his spine and lie flat for the first time in years.
While that single result was a turning point in Izzy’s practice, he considered Counterstrain a tool among others in his toolkit. “I’d be lying if I said I planned a methodical transition to Counterstrain” he said. “I still relied heavily on my direct work.”
But as training progressed and clinical demands increased, so did his reliance on Counterstrain. “The more I trained, the less direct work I needed. It took me about eleven months since my first class to fully transition to Counterstrain.” Today, Izzy’s work is “99.9% Counterstrain based,” with only minimal direct visceral manipulation remaining, adapted through the same principles.
Key strategies for the clinical application of Counterstrain
Lymphatic-Venous instructor, Greg Zadow, emphasizes that integration is most successful when it’s intentional. Instead of trying to apply everything at once, he suggests starting with a patient with whom there is already a strong therapeutic relationship. “Being upfront with this type of patient seems to be received positively,” especially when introducing new techniques as a way to better address their specific complaints.
From there, it’s all about narrowing the scope. “I suggest initially focusing on one particular area of the body that perhaps many of your existing patients have in common.” By concentrating on a single region—reviewing tender points, scans, and treatments regularly—clinicians can build familiarity and confidence more quickly. “Pretty soon you will have the knee down pat and then you can add your next most common area.”
Across each of these experiences, a consistent theme emerges.
Integrating Counterstrain into practice doesn’t mean clinicians must abandon what came before. Rather, they can build on their existing approach, allowing the new paradigm to take hold as they start to see consistent results.
As the curricula continue to evolve, so does the pathway for integration, making the clinical application of Counterstrain more accessible and efficient than ever before.
And for many clinicians, it begins the same way: by trying something new and letting the results speak for themselves.
Counterstrain in Practice is a monthly series exploring real-world experiences across the Counterstrain learning journey. Find previous volumes here: