Counterstrain Therapy in Fargo, ND
Dr. Kristine Martens, DO is a board-certified family physician trained in osteopathic manipulation at Nova Southeastern University College of Osteopathic Medicine, practicing in Fargo, ND since 2013.
Table of Contents
How Counterstrain Therapy Calms Painful Muscle Tension
From guarded muscle to quiet tissue
When a muscle is injured, overloaded, or protecting an irritated joint, it can lock into a shortened, guarded state. That guarding produces small, exquisitely tender spots in the tissue called tender points. Every attempt to stretch, press, or work the area harder can actually reinforce the spasm, which is why acute low-back muscle spasm, a stiff post-operative shoulder, or an elderly patient's fragile back often gets worse with aggressive manual care. The nervous system is protecting the area, and it needs a way to stand down.
Counterstrain therapy solves this by doing the opposite of what most therapy asks. Instead of stretching the tight tissue, Dr. Martens carefully positions the body into the exact posture of maximum comfort, the position that shortens the muscle and unloads the tender point. The nervous system releases its guard, the tissue re-sets to normal tone, and the tender point dissolves under her fingertip. It is entirely passive, no pushing back is required from the patient, and it makes very acute or fragile presentations treatable when nothing else feels safe.
What Is Counterstrain Therapy And How It Works
Counterstrain therapy is a gentle, hands-on osteopathic manipulative treatment (OMT) that resolves muscle spasm and tender points by positioning the body away from pain rather than stretching into it. Developed by Lawrence Jones, DO, it is now a core OMT approach taught in every U.S. college of osteopathic medicine and recognized by the American Osteopathic Association.
The mechanism is neuromuscular. When Dr. Martens finds the exact position that most shortens a guarded muscle, the stretch reflex quiets and the tender point releases. She holds that position of comfort for about 90 seconds, then slowly returns you to neutral so the nervous system does not re-engage the pattern. Most patients feel warmth, softening, and full-body relaxation, and it pairs naturally with myofascial release and muscle energy technique.
Treatment Timeline:
Session Length:
30 - 45 minutes (gentle positioning, no forceful thrusts)
First Relief:
Same day (tender points often ease immediately)
Full Response:
1 - 6 sessions (typical for lasting release)
Downtime:
None (return to activity right away)
Pain Patterns Counterstrain Therapy Addresses
Benefits of Counterstrain Therapy
Discover a gentle, non-invasive approach that relieves pain, improves mobility, and supports your body's natural healing process
Gentle
No thrusting, cracking, or forced stretching
Safe
When tissue is too irritated for direct techniques
Fragile Tissue
An option for elderly or osteoporotic patients
Zero Downtime
Return to work, driving, and family life the same day
Drug-Free
No muscle relaxers, NSAIDs, and opioids
Counterstrain Therapy vs Alternatives
Compare Your Options
| Treatment | Mechanism | Time | Comfort Level | Results | Downtime | Best For |
|---|---|---|---|---|---|---|
| Counterstrain Therapy (DO) | Passive positioning to shorten muscle and reset tender point | 30-45 min | Very gentle, often relaxing | Same-day relief, cumulative gains | None | Acute spasm, elderly, post-op, fragile tissue |
| Trigger Point Injections | Needle-delivered anesthetic into tender muscle | 15-20 min | Brief injection discomfort | Immediate localized relief | Minor soreness 1-2 days | Discrete trigger points, medication-tolerant patients |
| Massage Therapy | Muscle kneading and pressure for relaxation | 60 min | Comfortable to firm | Immediate relaxation | None | General stress and muscle tightness |
| Chiropractic HVLA Adjustment | High-velocity spinal thrust | 10-20 min | Firm, quick manipulation | Immediate joint mobilization | None to mild soreness | Vertebral joint restriction |
| Self-Stretching | Patient-applied lengthening of tight muscle | 5-10 min | Can aggravate acute spasm | Short-term relief | None | Mild tightness, prevention and maintenance |
Who Is a Good Candidate for Counterstrain Therapy?
Counterstrain therapy is one of the most broadly tolerated osteopathic techniques because it never forces tissue and never asks the patient to work against pain. It is especially useful when the body is too irritated, too fragile, or too guarded for more direct hands-on care. Dr. Martens begins every visit with a full osteopathic evaluation to confirm counterstrain is the right technique for the day, or to combine it with myofascial release or muscle energy technique if a broader response is needed.
Ideal Candidates for Counterstrain Therapy
- Adults with acute muscle spasm too painful to stretch or press
- Older or post-op patients with fragile tissue or protective guarding
- Well-defined tender points in the neck, back, ribs, hips, or pelvis
Who Should Wait or Avoid Counterstrain Therapy
- Active DVT, clotting disorder, or local infection at the site
- Acute or unstable fracture in the region being positioned
- New neurologic deficit or malignancy needing workup first
Honest Expectations About Results
- Calms muscle spasm and tender points, but does not fix structural issues
- Many feel relief after one session; layered patterns need a series
- Relief builds as the nervous system unlearns its guarding pattern
Absolute contraindications are rare, but safety comes first. If counterstrain is not appropriate that day, Dr. Martens will say so and coordinate the right next step. Guidance from the American Osteopathic Association and the National Center for Complementary and Integrative Health (NIH) informs our safety protocols.
Treatment Overview
What a session looks like
Evaluation
Find Tender Points
Position to Comfort
Hold About 90 Seconds
Reassess and Repeat
Side Effects and Safety
Counterstrain therapy has one of the strongest safety profiles in osteopathic manipulative treatment. Because the technique is entirely passive and never involves high-velocity thrusts, direct compression of an inflamed area, or forced stretching, the risk of serious adverse events is very low. Most patients report only mild, short-lived effects.
Common and expected
temporary tissue soreness for 24 to 48 hours (often described as feeling like a mild workout), a wave of drowsiness or full-body relaxation after the session, transient warmth in the treated area, and occasional light-headedness when first standing up. These are signs the nervous system responded and typically fade with light movement and water.
Less common
a short flare of the original symptom in the first 24 hours before improvement sets in, mild bruising over sensitive skin, or brief emotional release as chronic guarding patterns unwind.
Rare but reported for hands-on musculoskeletal care
aggravation of an underlying condition that was not obvious on exam. This is why Dr. Martens performs a full osteopathic evaluation before every session and screens carefully for contraindications. For general safety guidance on manual therapies, the National Center for Complementary and Integrative Health (NIH) is a helpful public resource. Any new severe or worsening pain, numbness, weakness, or fever after a session should be reported to Dr. Martens promptly.
Counterstrain Therapy Costs in Fargo
Transparent, cash-pay pricing
Resurgent Health is a Direct Primary Care clinic, which means our pricing is transparent, cash-pay, and free of insurance billing overhead. Counterstrain therapy is available to both DPC members and non-members in the Fargo community.
Session Pricing
- DPC Members: Included as part of your monthly membership when clinically appropriate. Ask at your Meet and Greet for current member terms.
- Non-Members (per visit): $95 to $150 per 30 to 45 minute session, depending on complexity and body regions treated.
- Package Discount: Multi-session packages available for patients working through a chronic tender-point pattern.
What Is Included
- Full osteopathic musculoskeletal evaluation
- Hands-on counterstrain therapy performed by Dr. Kristine Martens, DO
- Related OMT techniques such as myofascial release or muscle energy when indicated
- Personalized activity guidance and simple home movement suggestions
- Direct message follow-up between visits for DPC members
Because insurance is not involved, there are no surprise bills. You know the fee before you book. Interested in whether a DPC membership makes sense for your family? Ask about it at your Meet and Greet.
Why Choose Resurgent Health for Counterstrain Therapy in Fargo, ND
Dr. Kristine Martens, DO trained in osteopathic manipulation at Nova Southeastern College of Osteopathic Medicine and has practiced in Fargo since 2013. As a Direct Primary Care physician, she gives your tender-point evaluation the unhurried 30 to 45 minutes it needs, rather than the short slots typical of insurance visits.
Board-Certified DO
Every session performed by a licensed osteopathic physician, not a technician.
Unhurried DPC Time
Dedicated 30-45 minute appointments so multiple tender points can be released properly.
Gentle, Never Forceful
No thrusting or cracking, only positioning and 90-second holds.
Members and Non-Members
Available to DPC members and to community patients on cash-pay per visit.
Informed Technique
Peer-reviewed research shows reductions in tender-point pain.
Coordinated
Combined with myofascial release or muscle energy technique.
Related Services in Fargo
Osteopathic and whole-person care that pairs well with counterstrain therapy.
Myofascial Release
Gentle Hands-On Fascial Care
- Adults with chronic muscle tension or myofascial pain
- Recovery from strains, sprains, or repetitive-use injuries
- Low-back pain, hip stiffness, or neck and upper-back tension
Muscle Energy Technique
Active, Gentle Stretching for Joint Motion
- Adults with joint restriction in the neck, back, or pelvis
- Muscle guarding after a strain, or recovery needing low-force care
- Older adults wanting gentle mobility without high-velocity thrusts
Core Strengthening with Emsculpt Neo
Non-invasive HIFEM training for the deep core, pelvic floor, and glutes.
- Adults with chronic low back pain who cannot tolerate loaded core work
- Post-partum patients rebuilding deep core and pelvic floor (OB-cleared)
- Older adults or desk workers seeking non-invasive stability support
Counterstrain Therapy FAQ
Does counterstrain therapy hurt?
No. Counterstrain is one of the gentlest osteopathic techniques, and patients often fall asleep during a session. The whole point is to move the body into the position that feels best, then hold it there while the nervous system quiets. If a position ever feels uncomfortable, Dr. Martens adjusts until it does not.
How is this different from chiropractic care?
Chiropractic care typically uses high-velocity spinal adjustments (thrusts). Counterstrain therapy uses no thrusting, no cracking, and no forced movement. It is a passive positional release performed by a Doctor of Osteopathic Medicine, and it is especially helpful when a patient's tissue is too acute or too fragile for direct manipulation.
Do you offer Fascial Counterstrain (FCS)?
No. Resurgent Health offers general osteopathic counterstrain as taught in DO training. Fascial Counterstrain (FCS) is a separately certified system, and we do not claim that certification. If you are seeking FCS specifically, we can help you find a certified practitioner.
How many sessions will I need?
Acute muscle spasm often resolves in 1 to 2 visits. Chronic tender-point patterns typically respond over 3 to 6 sessions, spaced 1 to 2 weeks apart. Dr. Martens reassesses at each visit and stops care when your body no longer needs it.
Is counterstrain safe for older adults?
Yes. Counterstrain is one of the safest options for older adults, patients with osteoporosis, and anyone with fragile tissue, because no thrusting, cracking, or forceful stretching is involved. It is a common choice when other manual techniques feel too aggressive.
Is it safe during pregnancy?
Yes, with careful positioning. Counterstrain is a gentle option for pregnancy-related low back and pelvic pain. Dr. Martens screens for contraindications and adjusts positions for comfort at every stage of pregnancy.
Do I need to be a DPC member?
No. Counterstrain therapy is available to Fargo community patients on a per-visit cash-pay basis, and it is included in DPC membership when clinically indicated.
Contact Us Today
Send us a message for more information - DPC membership, a discovery call, or any other service you'd like to ask about.
References
- Wong CK. Strain counterstrain technique to decrease tender point palpation pain compared to control conditions: a systematic review with meta-analysis. J Bodyw Mov Ther. 2014. PubMed (PMID: 24725782). Systematic review with meta-analysis showing strain counterstrain reduces tender point palpation pain versus control conditions.
- Klein R, Bareis A, Schneider A, Linde K. Strain-counterstrain to treat restrictions of the mobility of the cervical spine in patients with neck pain: a sham-controlled randomized trial. Complement Ther Med. 2013. PubMed (PMID: 23374199). Sham-controlled trial supporting strain-counterstrain for cervical mobility and neck pain.
- Collins CK, Masaracchio M, Cleland JA. The effectiveness of strain counterstrain in the treatment of patients with chronic ankle instability: A randomized clinical trial. J Man Manip Ther. 2014. PubMed (PMID: 25125933). Randomized clinical trial showing strain counterstrain reduces pain and improves function in chronic ankle instability.
- Bethers AH, Swanson DC, Sponbeck JK, et al. Positional release therapy and therapeutic massage reduce muscle trigger and tender points. J Bodyw Mov Ther. 2021. PubMed (PMID: 34776151). Positional release therapy and therapeutic massage significantly reduced trigger and tender point counts.
- Danazumi MS, Bello B, Yakasai AM, Kaka B. Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome. J Osteopath Med. 2021. PubMed (PMID: 34049428). Positional release technique improved pain, function, and hip range of motion in patients with piriformis syndrome.