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  • David Wadsworth

Fascial Counterstrain – Treating Persistent Pain in the Entire Body

There are many manual therapy treatment approaches available for practitioners to help manage musculoskeletal pain. But none are as comprehensive in their scope as Fascial Counterstrain (FCS). So, what is FCS and how does it help?


Monitoring & treating a stomach tender point using Fascial Counterstrain (note that tender points are not always on the actual structure being treated!)

If you have read my recent post, you will now understand that a fibrous structure called “fascia” connects and binds the entire body together. It surrounds every tissue and structure you can think of from muscles to vessels, nerves to brain and spinal cord, even your organs. It is richly supplied with nerve endings, creates lubrication to allow motion without friction, creates stability when we are upright and contains cells which are capable of sensing and adapting to the loads placed upon them. These cells are myofibroblasts and under certain conditions their contraction may become sustained (often termed ”dysfunction”), leading to a range of tissue changes such as tension / tightness, reduced circulation and lymphatic drainage, and inflammation or dysfunction of whatever tissue the fascia surrounds.


Fascial Counterstrain is, as the name implies, a clinical approach that diagnoses these common neuro-lymphatic dysfunctions and treats them using gentle painless manual techniques. In general, FCS uses a diagnostic workflow to identify where restrictions are in the body, tests which restrictions are primary and which are secondary, and then tests which system of the body is dysfunctional, for example, is it the fascia surrounding the artery or the nerve or the muscle that is causing problems. Treatment involves locating diagnostic tender points in the relevant anatomical region and system which identifies the specific painful, tense and reflexively protected tissue. In chronic or complex cases, there is typically multiple dysfunctions in multiple systems of the body present simultaneously, which is one reason why simplistic treatments like stretching or exercise do not work in the longer term (read my latest post on the complex topic of persistent pain here).


Fascial Counterstrain treatment is gentle involving a hands-on process of slackening the affected tissue and decompressing involved structures. It is the opposite of “forcing things”. Successful treatment involves completely alleviating the pain in a tender point, and holding this comfortable, relaxed state for a short period to not only alleviate the reflexive dysfunction but give time for the inflamed tissues to drain. This gives FCS treatment a tremendous carry-over affect meaning that dysfunction tends not to recur providing that the diagnostic workflow correctly identifies the primary causes of your pain.

Fascial Counterstrain is gentle, alleviates pain during the technique, is lasting & effective. It includes diagnosis & treatment for all body systems such as musculoskeletal, vascular, neural, gastrointestinal, cardiopulmonary & genitourinary systems.
Fascial Counterstrain treatment for the superior gluteal vein, a common cause of buttock muscle tightness.

Not only does this treatment model help identify and correct the underlying primary problem(s), it normalises tissue drainage, local blood flow, nerve function and in so doing removes any impediments to the body’s innate healing capabilities. It is a true multi-system holistic approach currently unparalleled in musculoskeletal pain management and is consistent with current theories of persistent or chronic pain generation (Tuckey et al 2021).

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