Title: Strain-counterstrain: Dipping a toe in the water
Dates: 2 February 2020
Course leader: Rod MacDonald
About the course
Strain-counterstrain (SCS) is one of a range of treatment methods officially claimed for osteopathy and yet despite its sixty years of existence it does not seem to occupy a significant place in most UK graduates’ toolboxes. Its major phenomenon – the positional release of specific tender points – is a game-changing discovery in understanding the neurophysiology of both musculoskeletal pain and the physiology of voluntary motor function. We would aim to enthuse you with its history and implications and equip you to start using it on some of the most common and significant conditions we see in practice. We will discuss Randomised Controlled Trial (RCT) findings on the management of Restless Leg Syndrome with SCS. Management of patients with lower back pain will also be explored.
Summary of osteopathic practice standards (updated) and other CPD elements covered
A) Communication and patient partnership- A3, A4
B) Knowledge, skills and performance - B1, B2, B3, B4
C) Safety and quality in practice - C1, C4, C5, C6
D) Professionalism - D9
Communication and consent - 1 hour
On explaining the treatment modality to patients and gaining consent for treatment involving intimate areas.
- Be able to re-iterate the process of discovery and development that has established the present practice of SCS and the possible progressions or obstacles to progress from this situation.
- Understand the essential features of a “Jones’ “ tender point, its “release” by positioning, and the neurophysiological implications leading to plausible working hypotheses; tools to investigate the disordered function that is a basic tenet of osteopathic practice.
- Be able to recognise and treat the tender points most commonly found in low back pain.
- Gain the knowledge to safely explore SCS to the point where, if successful, you will be able to plan further study.
- Know the essential features of Restless Legs Syndrome, its management and self-management by SCS.
09:00 - 09:30 Registration
09:30 - 10:15 Lecture - The discovery of positional release by Lawrence Jones. The methods he proposed and the atlas of points and suggested positions that he published. Overall principles of management.
10:15 - 11:15 Demonstration and practical working in small groups on plinths: Finding the most frequently used tender points associated with the most socially significant area of dysfunction, the lumbar spine. Exploring how to use multiple ranges of movement combined in an area to achieve reduction of tenderness and palpable recovery of their normal tissue pliability.
11:30 - 12:00 Lecture and discussion: Case description of treatment response after thirty years of disability. Personally significant events in the development of individual career choices. The multi-directional dysfunction.
12:00 - 12:30 Reflection: and discussion of the implications of the positional release phenomenon for pain neurophysiology and the mechanisms of dysfunction.
12:30 - 13:30 lunch
13:30 - 14:00 Practical: Repeat practice of mid-lumbar positioning on multiple subjects to reinforce learning and develop skills.
14:00 - 14:20 Lecture: Introduction of the sacroiliac joint as a multi-dimensional strain gauge sub-serving proprioception with tender point features reflecting different vectors of impairment, pain provocation and positional release.
14:20 - 15:00 Practical: Identifying two most common pelvis dysfunction points and their positional release.
15:00 - 15:30 Lecture: Restless Legs Syndrome. Its pathophysiology and natural history. Narrative of the discovery and investigation of its responsiveness to SCS.
15:30 - 16:15 Practical: Demonstration of techniques for SCS treatment of RLS as both a passive treatment performed on the subject and, more practically, as a self-treatment technique that sufferers can be taught.
16:30 – 17:30 Reflection and discussion of the ongoing measures that participants can take: (a) to gain experience of finding Jones’ tender points confidently; (b) to decide if they have any apparent value in diagnosing or excluding dysfunction; (c) to develop ability to achieve release in those points where this is possible; (d) to monitor responses in order to make a decision whether to pursue greater expertise in the technique. All these stages to be carried out within a strategy that gives full regard to patients’ safety and avoids putting personal experience above their benefit.
Soft loose clothing for lower half of body which could be shorts or tracksuit bottoms but not lycra gym leggings. Shorts would be preferable.
A phone with a second timer, kitchen timer or watch timer capable of audible signal after 90 secs.
The course is suitable for qualified osteopaths, physiotherapists or MSK doctor.
About the course tutor
Rod MacDonald qualified in Medicine and, whilst working as a GP, trained at the London College of Osteopathic Medicine. He went on to work as an osteopath and then a Musculoskeletal Physician in the NHS from 1992 and still works in a Community Musculoskeletal MSK service for West London NHS Trust dealing with complex spinal cases. In 1990, in Spine, he published perhaps the first RCT of osteopathic manipulation in back pain demonstrating a significant acceleration of recovery. Strain-counterstrain has been his main treatment method for 25 years. His other main interest in musculoskeletal care is in patient education to acquire skills in the optimal use of the spine using methods emerging from Alexander’s fundamental ideas.
The UCO regrets that no refunds can be made for cancelled places unless a substitute participant can be found. The UCO cannot guarantee that any course will run. In the event of your course being cancelled, all paid fees and deposits will be refunded in full.