Counterstrain

In addition to vastly increasing the specificity, scope, and number of Counterstrain techniques, Brian Tuckey, PT, OCS, JSCCI, developed Fascial Counterstrain along with a remarkably powerful diagnostic tool called the cranial scan. This cranial motion test, developed and refined over the last 15 years, allows practitioners to rapidly identify dysfunctional systems and regions of the body in under sixty seconds. For example, a motion test of the occipitomastoid suture will quickly allow a practitioner to identify any existing dysfunctions of the autonomic nervous system.

​Counterstrain embraces the concepts of holistic and osteopathic medicine. By normalizing blood flow, muscular tension, vascular drainage, and neural input, Counterstrain maximizes the body’s intrinsic healing capacity. Multi-system diagnosis and manipulation is the key to correcting chronic and acute conditions of all types. This treatment model allows practitioners to identify and correct the source of their patient’s pain and disability, not just their symptoms.

For more information on how Counterstrain works, see Strain Counterstrain from Rational Manual Therapies by Randall Kusunose, PT, OCS, JSCCI, or Osteopathic Manipulative Treatment: Counterstrain/FPR Procedure by Adithi Vemuri and Kiyomi K. Goto.

For a deeper dive into Counterstrain rationale, see Brian Tuckey’s hypothesis on idiopathic pain syndromes.

Dr. Jones’s motivation to experiment with the concept of positional release was born, in part, from his frustration with the rationale of his time—namely the osteopathic lesion (which has since been renamed “somatic dysfunction”). He was taught to believe that joints became locked or subluxed and that bursting them loose through high velocity thrusts was the only way to treat them. While he generally saw good results from that technique, Dr. Jones occasionally encountered cases that resisted all manipulative skills. “Only stubbornness kept me from admitting I was stumped,” he said. He recounted that he was treating one such case when he discovered positional release.

The patient was a young man with psoasitis (stooped posture) and was unable to stand completely upright without severe pain across the low lumbar area. For six weeks, Dr. Jones was unable to provide relief using HVLA techniques. In prior months, the patient had also been treated by two chiropractors with no relief. He complained of pain while sleeping along with an inability to find a comfortable position that he could stay in longer than fifteen minutes.

Dr. Jones decided to devote one treatment session to finding a reasonably comfortable position for the patient to sleep in. After twenty minutes of experimentation, they were able to find a comfortable position. Dr. Jones recounted, “The patient was nearly rolled into a ball with his pelvis rotated about forty-five degrees and laterally flexed about thirty degrees.” After four months of treatment, the patient had his first positive response. Dr. Jones propped him in position and went off to treat another patient. When he returned, he helped the patient upright and was astonished to find he could stand completely erect in total comfort. Examination revealed a full and nearly pain-free range of motion. Dr. Jones discovered how Counterstrain works by simply putting the patient in a position of comfort. The results were dramatic.

​Fascial Counterstrain Discovery

The development of Fascial Counterstrain began in 1998 by Brian Tuckey, PT, OCS, JSCCI. He recounted his experience as follows.

“I had just returned from a visceral manipulation course and began to apply the visceral stretching techniques I had learned to my chronic pain population. I was able to identify the deep visceral-fascial restrictions, but was frustrated by the fact that the restrictions were fighting back. In other words, I perceived active resistance to my direct manipulation efforts. Since this repeated observation could not be explained by the visceral adhesion rationale offered in the course, I decided to go in the wrong direction and attempt an indirect treatment or ‘Counterstrain’ of the visceral restriction.

The result was an immediate relaxation of the surrounding tissue and the perception of a faint therapeutic pulse or vascular release in the surrounding tissue. I maintained the position for ninety seconds and after reassessment, noted a complete correction of the visceral restriction. The patient also reported an instant improvement in pain and said, ‘I don’t know what you just did, but that really helped!’

Further experimentation verified the success of indirect manipulation in the viscera. From that point on I began a laborious, multi-year process of identifying visceral tender points and the specific organ manipulation that would correct each restriction.

This eventually turned into a comprehensive compilation of every anatomical structure in the body that has been worked on over the last twenty years and is still in the process of being completed.”