Fascial Counterstrain Part 1

Hello, my name is Dmitry Shestakovsky, doctor of physical therapy and co-owner of Midtown East Physical Therapy (www.midtowneastphysicaltherapy.com), and I would like to introduce you to my 3-part blog series on Fascial Counterstrain, where the field of Physical Therapy is moving forward.

Think about the last time you experienced a significant musculoskeletal problem. Remember all the foam rolling you did? All the massages you had? Did all the stretching and strengthening prescriptions you followed – never mind all the medications prescribed – make any significant dent to heal your body? More importantly, how effectively did your quality of life improve right away?

The truth is, the majority of your neck, back, shoulder and knee pain are not just muscular problems. Your body is so smart that it produces a muscular contraction for the purposes of protecting the injured tissue.

Our bodies are devised in a framework of connective tissue called the fascia. The fascia is like a layer of “skin” covering your body’s insides, which include your muscles, tendons, ligaments, organs, nerves, even our blood vessels (i.e. arteries and veins). If we miss a step on a staircase, fall and injure ourselves, many structures will become strained, from muscles to the connective tissue surrounding organs, to veins and arteries in or near the injured tissue. These strained structures sensitize our central nervous system (CNS) “hijacking” our muscles into creating a protective muscular spasm. This reflex result is not just in skeletal muscle contraction, but also a smooth muscle contraction of the vessels involved, impeding the tissue’s ability to heal and eliminate the physical waste which results in that chronic swelling, limited joint mobility, limited blood flow, which may also contribute to degenerative changes and even organ dysfunction. Left uncorrected and if the reflexes are not “reset”, your body experiences this trauma over and over again unable to heal properly nor fully.

Fascial Counterstrain provides the unique ability to diagnose the tissue and system responsible for maintaining that “tight” neck or hamstring being tricked into doing its job protecting you, the patient. Fascial Counterstrain is an exponentially more effectively powerful technique employing a specific glide to unload the involved structure. This manipulation is performed on the specific clinically identified tissue by “liberating” diagnostic tender points which disappear when the proper release to the proper structure occurs. This technique may be repeated to other tender points the clinician may find, allowing the body to rid itself of these protective muscular reflexes I’ve been discussing. When your reflexes are normalized tissue texture abnormalities disappear. Pain free mobility returns to the involved structure. Most importantly, permanent healing begins.

Next up, I will outline Fascial Counterstrain treatments of chronic neck and back pain, all driven by the same Fascial connective Tissue.

If you’d like more information on Sciatica and how we can help relieve your symptoms, please contact our office or book an appointment!  


Dr. Dmitry


Author Dr. Dmitry Shestakovsky Director of Rehabilitation at MTE Physical Therapy with a focus on manual therapy with an emphasis on osteopathic and spinal manipulation in evaluating and treating musculoskeletal and neuromuscular dysfunction.

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