Editing Osteopathy (section)

=== Counterstrain ===
{{Main|Counterstrain}}
Counterstrain is a system of diagnosis and treatment that considers the physical dysfunction to be a continuing, inappropriate strain [[reflex]], which is inhibited during treatment by applying a position of mild strain in the direction exactly opposite to that of the reflex.<ref name=DiGiovanna_86>{{Harvnb|DiGiovanna|Schiowitz|Dowling|2005|pp=86–8}}</ref> After a counterstrain point tender to palpation has been diagnosed,<ref name="Wong2014"/> the identified tender point is treated by the osteopathic physician who, while monitoring the tender point, positions the patient such that the point is no longer tender to palpation.<ref name="counterstrain">{{cite journal |author=Wong CK |title=Strain counterstrain: Current concepts and clinical evidence |date=February 2012 |journal=Manual Therapy |volume=17 |issue=1 |pages=2–8 |pmid=22030379 |doi=10.1016/j.math.2011.10.001}}</ref> This position is held for ninety seconds and the patient is subsequently returned to their normal posture.<ref name="Wong2014">{{cite journal |vauthors=Wong CK, Abraham T, Karimi P, Ow-Wing C |title=Strain counterstrain technique to decrease tender point palpation pain compared to control conditions: A systematic review with meta-analysis |date=April 2014 |journal=Journal of Bodywork and Movement Therapies |volume=18 |issue=2 |pages=165–73 |pmid=24725782 |doi=10.1016/j.jbmt.2013.09.010 |type=Systematic review and meta-analysis}}</ref> Most often this position of ease is usually achieved by shortening the muscle of interest.<ref name="counterstrain"/> Improvement or resolution of the tenderness at the identified counterstrain point is the desired outcome.<ref name="Wong2014"/> The use of counterstrain technique is contraindicated in patients with severe osteoporosis, pathology of the [[Vertebral artery|vertebral arteries]], and in patients who are very ill or cannot voluntarily relax during the procedure.