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By Dr Sarah Varmalis, Senior Osteopath Counterstrain is a gentle, hands-on therapy that helps the body release tension, restore mobility, and calm an overactive nervous system. It works by identifying very specific points of irritation — often where fascia (connective tissue), nerves, blood vessels, or organs have become irritated or inflamed — and then positioning the body in a way that allows those tissues to “let go” of their protective reflexes. This isn’t a technique that forces anything to change — it invites the body to reset itself. Counterstrain is based on the idea that pain and restriction often come from the body trying to protect itself. When something gets overstretched or irritated, the body can clamp down around it. That’s helpful in the short term — it stops you from injuring yourself further — but over time, it can create layers of compensation and dysfunction. Counterstrain gently unwinds that.  A Short, Winding History of Counterstrain Like many good stories in osteopathy, this one starts with curiosity. Back in the 1950s, Dr. Lawrence Jones, an osteopathic physician in Oregon, was treating a man with chronic back pain. The patient couldn’t stand upright, and nothing seemed to help — not adjustments, not stretches, not rest. So Dr. Jones tried something different: he propped the man up with pillows in a way that felt totally comfortable — no pulling, no pain. He let the patient rest like that, and when the man stood up… he was about 80% better. Not just temporarily, either — the results lasted. Jones was fascinated. He started experimenting with this approach and noticed that if he held the body in these pain-free positions for about 30 to 90 seconds (sometimes shorter, sometimes longer), the body would often relax, reset, and the pain would diminish. He called the sensitive areas he worked on “tender points,” and over time, he mapped out over 200 of them. This method became known as Strain-Counterstrain (SCS). Fast forward a few decades, and one of the few physical therapists trained directly by Dr. Jones — Brian Tuckey — took the work even deeper. He noticed that a lot of dysfunction didn’t seem to be coming from muscles alone. Instead, it was showing up in the fascia around nerves, blood vessels, even organs. These deeper systems had their own reflexes and protective patterns. Tuckey refined the technique to target these more complex areas, and Fascial Counterstrain (FCS) was born. Today, there are thousands of known tender points — and we’re still finding more. How Does It Work? Your body is wired to protect itself. When something hurts — whether it's a twist, strain, inflammation, or infection — your nervous system often responds by tightening up around it. That’s a smart move at first, but if it sticks around too long, it can become part of the problem. Counterstrain works by gently placing the body into positions that turn off these protective reflexes. When we find the right tender point, we guide the body into a posture that’s as comfortable as possible — which might mean curling around it, twisting slightly, or supporting the area. We hold that position for 30 to 90 seconds (or a little longer, if needed), allowing the tissue to reset. This process can reduce pain, improve movement, and calm the nervous system — all without needing to stretch, crack, or force anything. Using the Cranial Scan to Guide Treatment One of the key tools I use in Counterstrain is the cranial scan — a gentle, hands-on assessment that helps pinpoint exactly where the body’s restrictions and tender points lie. By lightly palpating specific points along the skull with minimal force, I can feel for subtle restrictions or tension patterns in the tissues. For example, if I detect a restriction along the superior temporal line, that clue helps me identify which system or region in the body needs attention. This scan guides me in locating the precise tender points to treat, whether they’re related to muscles, fascia, nerves, or other connective tissues. It’s a bit like tuning in to the body’s signals, allowing the treatment to be targeted, effective, and incredibly gentle. What Does It Feel Like? Most people describe it as relaxing, relieving, or strangely satisfying. You’ll be guided into a very specific, comfortable position — often using soft bolsters or the practitioner’s hands for support. You don’t need to stay fully clothed during the session — wearing appropriate undergarments or soft clothing that allows direct skin access is usually recommended, depending on the area being treated. While the position is being held, you might feel warmth, pulsing, or even a wave of tiredness. That’s a good sign — your nervous system is shifting gears. After the release, the practitioner will slowly bring you out of the position and recheck the area. Often, people notice improved range of motion, less tenderness, or an immediate lightness in the body. What Kinds of Issues Does Counterstrain Help With? Because it works with the body’s reflexes and connective tissues, Counterstrain can help with a surprisingly wide range of issues — even some that don’t seem “muscular” at all. Here are just a few things it may help with:
Multiple Sclerosis is a many, many layered condition that has a long list of symptoms, including pain, fatigue, and weakness. There is currently no cure for MS. But just because there is no cure, does that mean there is nothing that can be done to help reduce these symptoms and maintain muscle health? From clinical experience, I've found massage and a variety of myotherapy techniques to be incredibly useful for patients living with MS. You can read more about my clinical experience with treating MS in this blog. I've been running for The May 50K during COVID19 isolation to raise funds and awareness for MS, so I thought its only fitting that I write up a bit of a literature review on the research! You can read the article here for the full study details, as published in the International Journal of Therapeutic Massage and Bodywork in December 2016.  What does the research say specifically about massage therapy and MS?
There are a few things to keep in mind when we read this study. Firstly, manual therapies are hard to study, because the techniques used are almost always different every single treatment. As experienced therapists, we select techniques that are the most relevant to the patient each time they come for an appointment, and our selections are based off what we assess in the consultation, as well as what the patient agrees to on the day - for example, some days a deep pressure trigger point treatment can be tolerable and helpful, and other days it may feel too much. Secondly, Multiple Sclerosis affects people in widely different ways. There is no one "best" treatment technique for MS, and the symptom types, areas and intensity are vastly different from person to person. Keeping that in mind, lets have a look at how these researchers completed their study, and what they found. How did they design a study for massage therapy for Multiple Sclerosis? A specific massage sequence was designed for the study. This sequence was to be followed to the letter for every patient at every session, regardless of the symptoms on the day. This isn't an ideal way of providing a treatment in a clinical setting, however in a research setting its important to be able to make the tested treatment or therapy able to be reliably the same for every subject in the study. The sequence involved a full body massage therapy routine which included gliding strokes, kneading, cross fibre friction, and trigger point treatment. The 24 participants were scheduled for a weekly one hour treatment using the specific massage routine for 6 weeks. If a participant missed a scheduled treatment, they aimed to reschedule it within a week, so that each participant received 6 identical treatments over the course of no longer than 8 weeks. How did they measure and assess it? Five measurement scales were used to assess the outcomes in a variety of symptoms. The participants recorded scores for
What did they find out? The results overall suggested that massage therapy was a safe and useful tool in providing relief from fatigue and pain, and improving mental health and general quality of life. Fatigue - The MFIS indicated that 22 out of 24 participants reported decreased fatigue scores. There was a significant correlation between fatigue decreasing and pain decreasing. Spasticity - 19 out of 24 participants completed the MAS spasticity evaluation, and of these, 16 reported experiencing spasticity symptoms ranging from slight to considerable increase in muscle tone. There were no significant changes in spasticity after the end of the 6 week treatment period. Pain - On average, participants reported a significant 18% reduction in pain on the MOS Pain Effect Scale. The reduced pain scores correlated with improved mental health scores. Mental Health - A significant increase in the total scores on the MHI indicates overall mental health improvement. A small number of participants did not improve on some subscales, such as anxiety (3 participants) and depression (1 participant) Quality of Life - Overall, the quality of life scores on the HSQ showed improvement. Emotional and Social subscales showed more improvement than Health and Physical. The results indicated that as fatigue and pain decreased, measures of quality of life increased. Can we help you? Do you have MS and want to discuss treatment options? Our clinic is temporarily closed due to COVID19, but we expect to reopen by June. Check our availability on our online bookings page for updates. Are you receiving assistance from MS Employment Services? You may be eligible for funded Myotherapy treatment through your Occupational Therapist. Contact your OT to see if you can apply, and they will forward us the documents to begin the process for you. Do you have MS, you're currently working or seeking work, and you're not receiving assistance? Check the MS Employment Services website to see if you're able to receive support. |
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