Draft:Positional Release Therapy
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Positional Release Therapy (PRT), also called strain‑counterstrain, is a passive, indirect manual therapy used by physical therapists, osteopathic physicians, athletic trainers, and massage therapists to treat somatic dysfunction and pain."Introduction". Physiology, Counterstrain and Facilitated Positional Release. StatPearls Publishing. 2025. The technique positions the body, or a body segment, in a position of maximal comfort—usually a shortening of the involved muscle—so that abnormal proprioceptive activity is reduced and local tenderness diminishes.
History
[edit]The approach was first described by American osteopathic physician Lawrence Jones in 1955 and was further systematised in the 1980s.Jones, L.H. (1981). "Strain and Counterstrain". Journal of the American Osteopathic Association. 80 (1): 55–62.
Proposed mechanism
[edit]Maintaining the slackened position for approximately 90 seconds is thought to decrease the firing rate of muscle spindles and Golgi tendon organs, interrupting the pain–spasm–pain cycle and allowing tissues to return to their normal resting length.Chandran, A; Gopinathan, M (2016). "Effectiveness of strain‑counterstrain technique in the treatment of patients with mechanical neck pain". Journal of Bodywork and Movement Therapies. 20 (4): 816–821. doi:10.1016/j.jbmt.2016.07.010.
Clinical evidence
[edit]Systematic reviews report low‑to‑moderate quality evidence that PRT can reduce myofascial tender‑point pain compared with sham or no treatment. Randomised trials have found short‑term improvements in pain, pressure pain threshold, and cervical range of motion in mechanical neck painMasaracchio, Michael (2022). "Influence of adding strain‑counterstrain to standard therapy on pain and disability in patients with mechanical neck pain". Musculoskeletal Science and Practice. 58: 102531. doi:10.1016/j.msksp.2022.102531. and reduced pain in latent upper‑trapezius trigger points.Oladele, A (2021). "Positional release therapy versus therapeutic massage in the management of myofascial trigger points". Manual Therapy. 55: 105005. doi:10.1016/j.math.2021.105005. Evidence for long‑term benefit or superiority over other manual therapies remains limited.Snodgrass, S.J. (2016). "Trigger point dry‑needling versus strain‑counterstrain for upper trapezius pain: a randomised trial". Journal of Manual and Manipulative Therapy. 24 (4): 177‑185. doi:10.1080/10669817.2015.1106315.
Positional Release Therapy Institute
[edit]The Positional Release Therapy Institute (PRT‑I) is a private organisation founded in the United States in 2009 to provide continuing‑education courses and certification in PRT. Its president, Timothy E. Speicher, PhD, ATC, received first‑place awards for outstanding manuscripts from the Athletic Training Education Journal in 2013 and 2014."Author page: Timothy Speicher". Human Kinetics. Retrieved 25 June 2025. PRT‑I courses have been approved for continuing‑education credits by the National Athletic Trainers' Association Board of Certification."PRT‑I Education". Positional Release Therapy Institute. Retrieved 25 June 2025.
See also
[edit]Myofascial release
Osteopathic manipulative medicine
Manual therapy
References
[edit]StatPearls Publishing. (2025). Physiology, Counterstrain and Facilitated Positional Release. Retrieved from StatPearls.
Jones, L.H. (1981). Strain and Counterstrain. Journal of the American Osteopathic Association, 80(1), 55–62.
Chandran, A., & Gopinathan, M. (2016). Effectiveness of strain‑counterstrain technique in the treatment of patients with mechanical neck pain. Journal of Bodywork and Movement Therapies, 20(4), 816–821. https://doi.org/10.1016/j.jbmt.2016.07.010
Masaracchio, M. (2022). Influence of adding strain‑counterstrain to standard therapy on pain and disability in patients with mechanical neck pain. Musculoskeletal Science and Practice, 58, 102531. https://doi.org/10.1016/j.msksp.2022.102531
Oladele, A. (2021). Positional release therapy versus therapeutic massage in the management of myofascial trigger points. Manual Therapy, 55, 105005. https://doi.org/10.1016/j.math.2021.105005
Snodgrass, S.J. (2016). Trigger point dry‑needling versus strain‑counterstrain for upper trapezius pain: a randomised trial. Journal of Manual and Manipulative Therapy, 24(4), 177–185. https://doi.org/10.1080/10669817.2015.1106315
Human Kinetics. Author page: Timothy Speicher. Retrieved from https://www.human-kinetics.co.uk/author/timothy-speicher/
Positional Release Therapy Institute. PRT‑I Education. Retrieved from https://prt-i.com
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