What is Counterstrain?

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:

• Chronic or mysterious pain
• Headaches and migraines
• Neck and back pain
• Post-surgical or post-injury recovery
• Sciatica or nerve irritation
• Digestive discomfort
• Lymphatic congestion or puffiness
• Tinnitus and jaw tension
• Dizziness or brain fog
• Fatigue or burnout
• Old injuries that “never quite healed right”

It’s especially helpful when nothing else seems to work — or when the pain keeps coming back.