Counterstrain FAQ

What is Counterstrain?

  • Counterstrain is a type of physical therapy that was developed by a physical therapist named Brian Tuckey. It’s a therapeutic, manual, hands-on method, designed to release spasm in all tissues of the human body. By manual therapy technique, we mean that a physical therapist will find and fix any pain or dysfunction you’re experiencing by simply using the gentle touch of their hands and slight position changes of your body. It’s a very gentle, effective, and non-strenuous way to treat patients’ pain and to maintain patients’ relief after a treatment session. 
  • When patients come into ARC for physical therapy, they have 45-minutes of one-on-one Counterstrain treatment time with a Physical Therapist here. Rather than treating just the symptoms of a health issue you may be experiencing, our therapists who practice Counterstrain will treat the underlying reason and root causes of your pain and those surface-level symptoms so you can feel better!
  • Counterstrain treats the most fundamental aspects of almost every painful condition. It can be used to treat very acute traumas (like sports injuries, car accidents, or even an ankle sprain) and also can treat more chronic types of traumas (like TMJ, migraines, Parkinson’s, Cerebral Palsy, Arthritis, Hypermobility conditions, and so much more). The gentleness of Counterstrain makes it extremely safe and effective for treating almost everyone, even the most-fragile patients – like elderly patients, pregnant women, patients with extreme pain or joint hypermobility, and infants with torticollis, for example. The list goes on. 

How does it work?

  • To best explain how Counterstrain works, I’ll walk you through how a typical Counterstrain treatment session looks like here. First, an ARC Physical Therapist will quickly assess your entire body for areas of pain and dysfunction by looking at very specific “tender points” in your head. These “tender points” tell your physical therapist which fascial structure is involved and what specific treatment is needed to correct your dysfunction and alleviate your pain. The “tender points” on your body are similar to how a road map tells you which road will lead to the destination you want to get to. 
  • There are over 1,000 fascial “tender points” in your body, and the number of tender points that need to be treated varies from person to person, depending on the type and severity of your problem.
  • Next, your Physical Therapist will shorten any particular fascial structure they’ve identified through those tender points manually with their hands through gently positioning your body in specific ways until they feel a “pulsing” sensation at the “tender point” associated with that fascial structure. For example, they may have you slightly move your hand to the side or turn your neck to the left or the right, it all just depends on the point they are treating. This positioning your Physical Therapist will have you do is extremely slow, gentle, and non-traumatic — and our therapists are always guided by what feels good to you as the patient. 
  • The positioning you do as the patient and the manual shortening of the fascia that your therapist does with their hands facilitates your healing process for a faster and more complete recovery and allows the fascia to relax. Positions are typically held for about 30 seconds and, when your therapist releases that shortened tissue, the nerve endings and smooth muscle in your fascia are “reset” — which stops the inflammation and spasm that was happening and causing you to have pain or dysfunction in that specific area of your body. 
  • Although this seems complicated, our therapists will always explain what Counterstrain and Fascia is upon your first interaction with them – so don’t stress! 

What is fascia?

  • To give you a better understanding of fascia, we like to first tell patients to visualize themselves biting into an orange and that white webbing that holds each individually wrapped orange wedge is similar to our own body’s fascia!
  • But, from a scientific explanation, fascia is a thin casing of connective tissue that surrounds and holds every single organ, blood vessel, artery, vein, bone, nerve, and muscle in your body. Not only does fascia provide internal structure for your body, but it is also filled with millions of different nerve endings and smooth muscle cells so it can contract if we’re injured or traumatized. 
  • To explain, fascia tightens up and contracts when it’s stressed so our nerve endings can start producing inflammatory chemicals — and this stress that causes our fascia to contract could be from something like a quick, unexpected stretch, a strain, surgery, or even just prolonged bad posture.
  • In other words, fascia is everywhere in our bodies and has the ability to influence a lot of the pain and dysfunction we experience throughout our life. 

What’s it like getting the treatment?

  • When patients come into ARC for treatment, they have 45-minutes of private, one-on-one Counterstrain treatment time with one of our Physical Therapists here.
  • Treatment is very personalized for each patients’ needs and body, and Counterstrain treatment is extremely gentle, comfortable, and pain free. In fact, sometimes patients are so comfortable and relaxed during treatment that they may doze off into sleep or close their eyes!  Patients frequently describe the therapeutic sensation of release in their body as “fascinating” and “amazing”.
  • Many patients feel relief after only a couple of visits, sometimes even after just one appointment!
  • Depending on your needs and the treatment plan your therapist deems necessary, your therapist will spend most of their time doing Counterstrain on you, but spend some time providing you with a variety of exercises to complete in our clinic’s gym or at home to help you improve and maintain the relief you experience from Counterstrain.

Does insurance cover it?

  • Yes, insurance covers Counterstrain physical therapy appointments just like they would cover any other “typical” physical therapy appointment. Your coverage and benefits obviously depend on the type of insurance you have, but before you come in as a new patient, we will always verify your insurance benefits ahead of time to remain completely transparent and upfront with you regarding the price you will have to pay every visit.

How is it different from physical therapy?

  • With “typical” physical therapy, physical therapists mostly focus on your muscles, tendons, bones, and ligaments. Usually, with this approach, physical therapists will treat your symptoms and anything causing you pain at that moment. You may feel some or complete relief and improvement, but overtime, your pain and dysfunction might return because the true, root cause of your pain and symptoms were not addressed appropriately.
  • However, with Counterstrain, physical therapists will look at your entire body — so they will focus on your muscles, tendons, bones, and ligaments like a “standard” physical therapist would, but they will also focus equally on your lymphatic system, nerves, fascia, organs, and even your arteries and veins.
  • With this approach, patients tend to feel more effective and LONG-LASTING relief because the root cause of your pain and dysfunction was addressed! Counterstrain always looks at patients as a whole and looks beyond just the surface-level issues that were occurring as a result of an underlying, bigger issue within your body.
  • In the past, if you’ve gone to “typical” physical therapy, you might have gone for treatment, gotten rid of your problem, and then had it come back eventually. Or, your problem improved by 70%, but did not improve completely. This usually happens when your therapist fails to evaluate and treat your WHOLE body and only assesses your resulting symptoms and not the underlying causes of those symptoms or experiences.
  • Also, in the Chicagoland area, ARC Physical Therapy is the only physical therapy practice where all of the professional staff receives advanced training in Counterstrain! So, you can be sure that you will get an excellent, Counterstrain-certified physical therapist no matter who you see here for treatment!

Is it strenuous?

  • No, it is not strenuous at all. Counterstrain is a manual therapy technique – meaning our physical therapists use their hands to find and fix any pain or dysfunction you have by gently scanning your body and slightly positioning your body in certain movements to provide you relief and to relax your fascia. 
  • It’s an extremely gentle, very effective, and non-strenuous way to treat patients’ pain and to maintain patients’ relief after they undergo treatment. 
  • Any positioning that your Physical Therapist has you do is slow, gentle, at-your-own-pace, and   non-traumatic — and our Physical Therapists are always guided by what feels good to you as the patient! 
  • In fact, some patients even fall asleep during treatment because of how comfortable and gentle treatment sessions are — and patients frequently describe the therapeutic sensation of release in their body as “fascinating” and “amazing”.

I only want an appointment with ___PT name here__?

  • Although I understand your preference for ___PT name here__ . . . I just wanted to mention that all of our Physical Therapists have undergone the exact same training and certification, and they each have different strengths and capabilities that make them great with our patients. 
  • The good part about ARC is that, after you come in for a free consultation or your first Counterstrain session, the therapist you see will either continue seeing you (which is most cases), or direct you to another physical therapist who may be better-fit for you and your body’s needs.
  • Also, in the Chicagoland area, ARC Physical Therapy is the only physical therapy practice where all of our professional staff receive advanced training in Counterstrain. So, you can be sure when you come here that you will be getting excellent, Counterstrain-certified, well-trained physical therapy no matter who you see here for treatment.

Is Counterstrain a holistic treatment, like acupuncture, acupressure, or massage therapy?

  • Although Counterstrain embraces the concepts of holistic treatment and addresses the body as a whole, it is not considered a holistic treatment and is more so a medical practice and type of manual physical therapy. 
  • Counterstrain is a therapeutic, hands-on method designed to release spasm in all tissues of the human body. In order to practice Counterstrain, you have to be a physical therapy practitioner and certified by 
  • Following the completion of the Fascial Counterstrain introductory course, physical therapists will complete training that is structured around the major systems of the body, including the musculoskeletal, visceral, lymphatic and venous, arterial, and nervous systems. Fascial Counterstrain training starts with a combination of 3-Day Introductory Courses and is followed by a large number of 40-hour (typically 5-day) Mastery Level Courses.
  • This training and education allows our Physical Therapists to normalize patients’ blood flow, muscular tension, vascular drainage, and neural input, and maximize the body’s innate healing capacities — in addition to practicing other techniques therapists learn in standard physical therapy school. 
  • This treatment model also allows Physical Therapists to identify and correct the source of a patient’s pain and disability, not just their surface symptoms. So, it’s considered more of a medical practice that follows holistic treatment mentalities and values.

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Our Happy Patients

I have had physical therapy in the past but I have never had the Fascial Counterstrain techniques used until I went to ARC. My PT, Alison Brown Ferguson’s expertise with evaluating the exact problem areas and using the Counterstrain techniques has allowed me to regain physical function and greatly decreased my pain. I strongly recommend ARC and Alison to anyone in need of physical therapy treatment.

John Doe

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