The idea that one can relieve chronic muscle pain in less then two minutes seems almost too good to be true. The technique known as “strain/counterstrain” (SCS) was originally developed by an osteopath by the name of Lawrence H. Jones, DO. Often referred to as “spontaneous release by positioning,” “positional release therapy,” or “fold and hold,” its effectiveness is based on a surprisingly simple idea… move in the direction of ease.

The story goes, a client of Dr. Jones had come to him with a case of acute back pain. The pain was so severe that it prevented him from standing up straight and made sleeping nearly impossible. After having gone through two chiropractors, various remedies and still no success, Dr. Jones decided to work with him. Eight weeks worth of treatments later, there had been very little progress and the client was still in pain! One day, frustrated and tired from a lack of sleep, the client merely asked the doctor to help him find a comfortable resting position so he could lie there and sleep for a few minutes. For twenty minutes Dr. Jones moved him into various positions, checking and re-checking, until they found an optimal position that provided the most relief. He stepped out for the remainder of the session and upon his return, found his client standing fully erect and pain free! Somehow his patient had been miraculously cured. But how exactly? What Dr. Jones hadn’t fully realized yet was that he had inadvertently stumbled upon the secret behind the neuromuscular technique he came to call “strain/counterstrain.”

The technique works with the body’s own self-correcting reflexes to help relieve pain and discomfort. Sometimes a reflex, for all intents and purposes, can get caught in a loop. When this happens the body mistakenly perceives a stimulus as a threat and continuously engages the self-correcting reflex, which in turn perpetuates the problem. The body is trying to right itself, but unsuccessfully. We probably never give this any thought but whenever we contract a muscle, its opposing muscle must relax and lengthen in order for movement to happen. This is what’s known as “reciprocal inhibition,” and it happens all the time.

Whenever we flex our biceps, the triceps must relax so that our elbow can move. If the triceps were to lock up and spasm, movement would not be possible. Protective muscle spasms can occur when an opposing muscle is quickly and suddenly over-lengthened. As a result, a reflexive contraction occurs due to tiny propioceptive neurons located in the belly of a muscle known as “muscle spindle organs.” These MSOs are designed to detect changes in muscle length and contract as a means of protection. Once the threat has passed, the reflex should reset itself. On occasion however a reflexive contraction can be misperceived by the sympathetic nervous system as a continuous threat. The nervous system gets thrown off and maintains an elevated level of tone in the muscle. This maladaptive spasm is often very painful and only adds to the perceived threat. If the contraction becomes chronic, the muscle may be duped into thinking this new shortened state is its actual neutral position. And the cycle continues.

SCS can break this reflexive cycle and help reset MSO activity. How? By moving in the direction of ease. SCS does not involve any forceful movements, cracking or popping of joints, or painful stretches. These techniques only provide temporary relief at best and do not address the underlying cause of the problem. When you slacken a spastic muscle and allow it to relax for approximately 90seconds, you minimize the stimulation, which is actually triggering the reflexive contraction. The sympathetic nervous system in turn will perceive this new, comfortable position as non-threatening and allow the muscle to soften. Then when the muscle is moved back into its original resting length, a re-education of the MSOs takes place and the reflexive contraction is broken.

SCS is safe, gentle and always about moving into greater comfort. Although there are self-care techniques we can do on ourselves, the technique is most effective when done passively by a practitioner. There are several reasons for this. First, whenever we move our bodies into different positions we are contracting muscles in order to do this. It’s this constant contraction of muscle however that often perpetuates the protective spasm. Allowing someone to move us passively makes it that much easier for us to relax into these slackened positions. Being touched also has the added benefit of releasing endorphins, which act as powerful pain blockers.

There are four essential steps in performing SCS:

1) Find a tender/painful spot: Often times it’s these overly sensitive and hypertonic spots where the reflexive contraction is occurring. It’s important to locate these painful points and monitor their sensitivity as you perform SCS.

2) Fold the body over the tender spot: The next step is to maximally slacken the muscle involved. If you already know how to stretch key muscle groups, then moving in the opposite direction will essentially slacken the muscle.

Let’s consider the biceps again. To effectively stretch the biceps, you must a) rotate your forearm so your palm is face down, b) extend your elbow fully, and c) extend the shoulder back by extending the whole arm behind you. This creates a maximum stretch for the biceps. So to slacken the biceps, you take everything in the opposite direction. And this is where the importance of having someone perform these movements for you becomes obvious. For to do it ourselves, requires muscle contraction – the opposite of what we want. Consider these next steps for slackening the biceps as though you were performing them on someone else a) rotate the forearm so the palm is face up, b) flex the biceps by folding the elbow, and c) flex the shoulder by moving the upper arm to the head. This will maximally slacken the biceps.

So what do we do if we’re not sure what precise movements will maximally slacken a muscle (this will probably be the case in most instances)? From here we need to think of creating a cave around the tender spot. If you bring the two ends of a taut piece of rope together, the rope will slacken. The same holds true for muscles. Move the ends of the surrounding tender spot as close together as possible.

3) Hold the position for at least 90 seconds: Once you’ve maximally slackened the muscle with the tender spot, the next step it to hold this position for at least 90 seconds or until you feel the muscle soften. Having a finger or two on the tender spot will allow you to feel when the tension has decreased. This can take as little as 90 seconds or in some cases, a few minutes. The position being held should be relaxing and comfortable in order for this to happen. Doing this allows those propioceptive neurons (MSOs) to recalibrate themselves to this new, non-threatening position. One should also start to notice the decreased sensitivity of the tender spot.

4) Release slowly, back to a neutral position: This next step is critical and often overlooked. This is where the re-education in the sympathetic nervous system takes place. The once shortened and painful muscle has now softened and slipped back into place. The stimulus perpetuating the maladaptive reflex has ceased and the cycle is broken. Some gentle rocking or jostling by the practitioner will help to “remind” the body of its true resting position.

There is a whole school of thought dedicated to this unique form of neuromuscular bodywork. Position Release Therapy uses the concepts behind SCS and works with the body’s inherent self-correcting reflexes to help relieve muscle pain. If you’re interested in experiencing the effects of this relaxing yet effective technique in your next massage, ask for it by name.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.