The Little-Known Physical Therapy Method That Can Stop Injuries In Their Tracks, Fix Fascia & Amplify Your Recovery & Performance: Counterstrain

My name is Ben Greenfield, and on this episode of the Ben Greenfield Life podcast.

So we're looking at removing the source of the inflammatory buildup in the body by physically decompressing it. And then what happens is the tender point just goes away because you've evacuated enough of the garbage that that central area of convergence in the cord is no longer inflamed.

Faith, family, fitness, health, performance, nutrition, longevity, ancestral living, biohacking, and a whole lot more. Welcome to the show. All right, folks, so you may have heard me interview the authors of a book called Lifeforce, which was all about longevity and anti aging and regenerative medicine. Their names were Tony Robbins and Peter Diamandis, and they're pretty well known guys and they've got their fingers pretty deep in this whole world of what works and what doesn't when it comes to keeping your body put together, fighting injuries and strains and sprains, everything from stem cells to more fringe anti aging tactics. And when I interviewed them, Tony in particular kept talking about this manual therapy technique that had provided him specifically a great deal of relief from pain and dysfunction. I had already read about it in the book and then when he brought up on the podcast, I kept talking about it. I'm like, geez, I got to look into this stuff. So it's called Counterstrain, counter strain. It's almost like a kind of like physical therapy or manual therapy. And I reached out to counter strain because I was interested in it and I wanted to see what it actually felt like, what the experience was like. And one of the leaders in the counter strain movement actually flew out to my house and did a treatment on me. We actually video recorded it by the way, if you want to see it. I'm going to put the video video where the shownotes are for this show@BenGreenfieldLife.com counterstrain so anyways, it was like nothing I'd ever experienced. Tim was basically just mapping my body through points in my head and I didn't know what was going on half the time. He was doing a pretty good job explaining it, but the whole time I was thinking, geez, I want to take a deep dive in this on a podcast. So that's what we are about to do. And if you deal with pain, dysfunction, movement limitations, et cetera, then this is definitely something you're going to want to stay tuned into. And as a matter of fact, I have another counter strain practitioner scheduled too to come to my house and treat me in a couple of weeks based on that initial work with Tim. So, anyways, who's Tim? His last name is Hodges. He's worked in physical rehab since 1996. He helps to develop this whole counter strain technique as well as train practitioners in it. He started his private practice called Counter Strained Portland back in 2003. So he's been doing this for quite some time and is based out of the Portland, Oregon area. So, Tim, thanks for coming on, man.

Hey, my pleasure, Ben. Thank you for having me.

Yeah. And there's obviously a ton of places we could start, including all the weird things you were doing to my head and the rest of my body when you came up and visited my home a couple of months ago. But I think I would love to step back and hear a little bit more about how you would actually describe what counterstrain is and how it came to be developed.

Yeah, that's probably the most commonly asked question that we get, because most people have not heard of it. It is a relatively new technique, I guess, in the grand scheme of things, all medical conditions or medical treatments. If you looked at the history of that field, counterstrain is basically an infant. It's been around roughly about 75 years. And the original form of counter strain, known as strain and counterstrain, or sometimes referred to as the Jones technique, that dates back to, like, 1955. And that was really the kind of frustration of a practitioner trying to figure out what to do with a client who had resisted all of his best efforts. And Jones, on this one momentous occasion, just offered to position this guy in a way that allowed him to sleep because the guy wasn't able to sleep. And so he spent about 20 minutes doing so. And the guy actually had the most relief that he had had in, like, six or eight months just from lying in this position for about 20 minutes. And Jones was stunned. Yeah, he was like, I don't understand what happened. I thought we were just trying to figure out a place to put you so that you could get a night's sleep, because the guy was basically waking up every 10, 15 minutes and not having restful sleep. And the guy stood up at the end of the session and looked at Jones eye to eye. Previously, he had been bent over, pulled off to one side, not able to fully stand upright, and was completely altered. And so Jones now had the sleepless nights and was pacing back and forth trying to figure out what in the world had happened. And that was the beginning. So he began to search for just comfortable positions for patients that were in really bad kind of acute states that led to the realization that very specific Tender point locations on the body would actually indicate what position needed to be performed. So I think you remember in our session, like I'd poke around on your head and I'd look for various tender points in the body. Then I'd immediately, yeah, immediately go into a treatment that was specifically designed for that location. So that's the origin of it. And I think he probably continued on that path for the better part of his career figuring things out. And he passed in 1996 after doing counter strain for almost 40 years or so. But that's where it came from. He was an osteopath. Those of you who have not heard of osteopaths, they're physicians, but they are a little bit different. They're more like a functional medicine doc. That's a very popular thing these days.

And very good at manipulation too, by the way. My physician growing up, my family physician for some of my life was an osteopath. And I remember he'd always take care of me in the same way that an allopath did. But then he'd do a lot of hands on manipulation type of stuff. Almost like a blend between. And I'll probably bastardize the whole profession by saying this, a blend between a chiropractic doc and a traditionally trained physician.

No, that's exactly. I think they actually share origins. A lot of chiropractors can trace their origins back to the osteopathic community. So they started in a very similar time in history, 1890s. And so they do share a lot of their manipulative techniques with each other.

Yeah, yeah. Okay, so first of all, first question for you, there's these tender points, right? So you were going around my head, you're going around my body, and you were actually touching on each of these different points. How would you define what a tender point actually is?

Tender points, a lot of us are probably familiar with trigger points. That's a more commonly associated painful entity. When it comes to body work, or if you're an athlete, you're constantly getting these really tender or taut bands of tissue worked out by massage therapists or athletic trainers. And the research into what actually goes on in the body in those locations indicates that there is a stuck inflammatory particulate and it doesn't really get out of the area due to like physical entrapment or tension. A tender point, it's a little bit different in that it doesn't always have to be related to a myofascial structure. Most myofascial trigger points are related to the myofascial system. A tender point, on the other hand, can come from literally anything. It could be from a visceral structure like your colon or the pleura within your lungs.

Okay.

It could be peritoneum of the. Of the intestines. It could be vascular, could come from a vein or an artery. It could come from the outer sheath of a nerve bone. The bone actually is covered With a pretty tough connective tissue called periosteum, Cartilaginous tissues, et cetera. All of these things have within them nerves that can sense when there's a problem. Then when you follow that nerve back into the spinal cord, these will converge on a sensory tract. You get multiple sources of input to a singular location, and then you get what's called retrograde inflammation. So if this thing is being bombarded with inflammatory information due to pain, that pain signal will begin to saturate the spinal cord such that you get this kind of trickling out or referred sensation due to central sensitization. I don't know if you follow that, but.

Yeah, yeah, that makes sense.

That actually creates a location very specifically in the body that becomes very, very tender. It just manifests because of the neurological convergence in the cord. So it's not the problem. And I think that's kind of the difference between what you're experiencing is like, I'm finding those locations, but then once we go down to the tender point, I don't do anything to it. I position the body such that it just goes away. So we're looking at removing the source of the inflammatory buildup in the body by physically decompressing it. And then what happens is the tender point just goes away because you've evacuated enough of the garbage that that central area of convergence in the cord is no longer inflamed. And that's kind of how the process works.

Okay. It kind of reminds me a little bit, but it is different. Perhaps you can explain the difference of this form of therapy that I used to receive a lot when I do Ironman active release therapy, or active release technique. I forget what the T stands for, But I would go down and raise Ironman Hawaii. There'd be a giant tent full of art practitioners. They'd kind of find a tender spot, and they'd pin it and then move the joint through a range of motion While that spot was kind of pinched or had pressure applied to it by the art therapist. And my understanding was that part of that did involve deep fascial pain, Like a lot of these nociceptors that, if triggered, will Keep the tissue that surrounds the area like an overprotected or a very guarded state, thus limiting range of motion and increasing pain or increasing stiffness. Now, what's the difference between something like fascial catalyst counter strain, where you're working with these tender points, and something like art, where they're working on tender points or what I think they might call trigger points.

So I think, again, it's concept. And how do you look at the problem in the body? I would look at the tender point as evidence of a thing, but I would not blame the tender point for the problem. So I look at it as a messenger from the central nervous system that said, hey, the blood supply in my spinal cord is stuck at T8. Can you help me out? And so I say, oh, yeah, no problem. Go ahead and position you so that the vascular tissues at the TA level and the spinal cord will relax. Whereas maybe an art practitioner may look at the focal area of pain as the problem. And so they will do some direct method to it. So they're going to contact. And by the way, there's the tender point. But then there's also this secondary effect which is the myofascial element. And I think this is probably where people get a little more kind of drawn into the conversation about, like, how exactly is this manifesting? Because every one of these structures that has a sensory neuron on it, which is literally everything in the body. So whether it's a vessel or nerve or muscle, it doesn't really matter. They have these sensory mechanisms that can feel when this thing is potentially at the point of being stressed to a failure point. And so they will produce not only this inflammatory response, but a second order reflex will cause the myofascial structures in that area to go into a protective tone. So it elevates beyond what you're consciously able to control the myofascial system to go into this protective mode. So that second level problem would restrict range of motion, would perhaps show up as a weak spot. It could change your posture, it could cause nerve compression and be a pain generator. So the difference between a direct method attacking some structure in the body and an indirect method is again, concept. I look at the myofascial element, again, as a protective second order. So I don't look at it as the primary driver. Now, in some cases it can be, but we can differentiate between them. Basically, when you're looking at individual systems, they can all produce a very similar effect in the body. So it wouldn't matter if it was a lung or a rib or cartilage or sympathetic nerves in the lung. You might get a depressed shoulder or forward protracted position in the body. And so I need to know which system is primary. And when I get the primary one, I get a very quick restoration in position, posture, freedom of movement, strength, blood flow, whatever, it all will kind of synergistically release. If I get the primary thing, if I'm constantly on the surface of it, looking at the myofascial presentation, I am getting to something, see that the carryover is quite as good as I want it to be, because I'm looking again at the second order, not the primary, but the second order presentation into the myofascial system. Do you follow that? Does that make sense to you?

Yeah, that makes sense. And the thing in terms of identifying the areas that need to be treated just absolutely intrigued me because you did, and you already alluded to it a couple times when you were explaining what counterstrain is. You did what's called a cranial scan and you had this whole guidebook with hundreds and hundreds of different points that you're supposed to touch on the body or different tender spots. But you started with this cranial scan. Can you tell me about that, how that originate and what exactly it does and what it's looking for.

The easiest way to just out of the gate address the concept that literally everything is connected in the body and there's no, there's no separate parts to the body. So, you know, if I pull on someone's foot, they will likely be able to full line of tension all the way up into their head or neck. Like they can feel something being pulled upon. So having everything connected and having a nerve to literally every structure within the body, it's not difficult to understand how various regions might, you know, based upon the type of tissue that we find there be somewhat of a homunculus or a map where various tissues or regions of the body might manifest as tension if they were to become tight. So if you had a hamstring that tightened up and it was related to the nervous system, there might be something in the brain or in the nervous system, in the central nervous system, like the spinal cord brainstem or in the cerebral cortex that would manifest that as well, like a physical tension. We look at the cranial scan as a very quick way to ascertain what systems in the body potentially are problematic. Now why exactly they line up the way they do. I think that's one of those. It's a God question. We're made that way. And so that's Just how it is. I don't know that we're going to know exactly what the underlying mechanisms are, but the mechanical one makes the most sense. Then perhaps the cerebral cortex of the dura being a second level of connection where you see, like, okay, there's a dural tension, and maybe that dural tension is connected to some part of the cortex as well. We feel a physical rigidity in the cranial skull. A lot of people think of the cranium as being a pretty solid structure, and it is. Of course, there are many joints within it, but it is fairly stable. But there are tissue texture changes that we identify as dysfunction, and these can be anywhere in the body. They just happen to also manifest in the head, Just a very high concentration. Again, thinking central nervous system, the dura. There's a concept of neural crest, which is basically something that can become centrally sensitized and create a large pattern in the body. There are many embryological connections to why this region can't function as a diagnostic process for us, again, goes back to what part of the head is stuck. And we have mapped this out based on bone and ligamentous and spinal cord lymphatics, visceral tissue, myofascia nerves, whether they're sympathetic nerves, or there's somatic nerves, or the dural membranes of the brain, including the vascular tissues of the brain, et cetera. So it is fast for us to be able to figure out where your problem is. And then I can very quickly connect this, as you might remember, to a motion restriction in the body, which we picked up something in your neck, I think, in the first few minutes and had you move. And then we did various contact locations on the head, which would cause a momentary cancellation of the way the body protects itself. So it just relaxes it momentarily. It's not a treatment, but it is to show.

Okay, that makes sense. That makes sense. So the tender points that you're finding in the head that you're then treating are basically causing this reflex reaction somewhere else, like in my case, in my neck, that then would cause that area to relax, get out of that persistently guarded or overprotected state, and potentially return to normal function, which actually makes perfect sense. But the other thing I think that you had mentioned to me was that if there's localized tissue inflammation, localized tissue edema, that there's some type of a metabolite drainage or kind of this resetting of inflammation that occurs from counter strain, which to me seemed really interesting. You could be working on my head in one spot and draining inflammation Almost in a lymphatic drainage type of way in another spot. And then I went to look at some of the research on it, and it turns out, I guess, that Brian Tuckey, who helped to develop Counter Strain, he actually had an article that was about impaired lymphatic drainage and what was called interstitial inflammatory stasis in musculoskeletal and pain syndromes. So can you get into what's going on from an edema, inflammation, in terms of how some type of drainage would actually be occurring? Because I don't even understand the mechanism of action.

I think we've had multiple theories over the last 50 years, but this is the newest one, and I actually think it makes the most sense, because ultimately, what we do, if you go back, I don't know, at least 20 years, we thought it was reflexive. It was purely a neurological response. If that were the case, why did we have to hold it for a period of time? That never made sense? I'm like, if it's a reflex and I calm it, why am I now holding this for a period of time? So we now hold these treatments, depending on where they are, what system, on average, I'd say 30, maybe 45 seconds. Back in the day, Dr. Jones would hold them 90 seconds. And what you're really waiting there for that period of time is for physical decompression of the area that has been stuck in this protective state, so that when it does relax, the internal. We call them intrinsic lymphatics. They're very tiny, very small vessels. Now, because of the newest research indicating that the interstitium is actually its own system within the body, it's actually been recognized as a separate anatomical system from other tissues. It is filled with tiny little vessels called interstitial vessels. These two things become physically compressed during a protective state such that they don't drain. They contribute somewhat to this stasis of fluid.

Oh, so it's like they're compressed when they're in that guarded state. And then when you remove them from the guarded state, you almost get, like, an expansion that causes lymphatic drainage.

That is precisely what happens. So there's a little more that happens in addition to that. But that's the mechanics of it. Because if you look at all of the tissues in the body, it doesn't really matter what they are. They have this layer of drainage. Everything has to. And the action of lymphatics being not really a passive system, it's an active system. If you impair its ability to remove fluid you will automatically become swollen or inflamed. That's a pain generator. And it doesn't matter where it is. It's going to lock up that area. And until you can get the fluid out, and I would say reduce the pro inflammatory state in the tissue, it will stay like that. It kind of digs itself a bit of a hole in that the inflammatory cytokines that are released by cells that are feeling strain or stress Are the same ones that shut off the active lymphatic pump. So unless you can mechanically open these things to get some fluid to move out. Right. This thing just stays chronic.

Yeah. Yeah. That's really interesting. So do you think that you would still want to do something like lymphatic drainage massage. Or some type of massage therapy that would more directly target that area in conjunction with counter strain if you were really trying to decrease some type of systemic inflammatory condition?

Most manual therapies work based upon the concept that fluid movement is beneficial. And I think massage therapy certainly helps. Certain chiropractic techniques obviously would target that as well, from maybe a slightly different mechanism. But there's a synergistic effect to multiple types of manual therapies. And I think that the underlying mechanism as to why something stays persistent, to the best of our knowledge, it is how Brian has presented this. So I think that, yes, there's this decompression first has to happen, and then sustained decompression such that the area drains. The only way that we know that it really clears out, at least from our standpoint and can verify it, Is by checking to see if the tender point has been extinguished. Because, remember, that is not a local manifestation as much as it is a central nervous system manifestation.

And that's where you go back up to the head and check, right?

Well, no, you can check the local tender point. Right. The scan that we use in the diagnostic state, you know, when we're up at the head, we're looking to see is that region clear? But it still tells me to go down and look to see if I've gotten all of the really bad tender points in the area. So I might do one or two things. Go back up, and the head says, you still haven't gotten it. So I got to go back down and recheck. When I get it gone, then our main diagnostic at the head no longer shows that that area is sensitive, and that would be an extinguished area. So then we move on to the next thing.

Okay, got it. Now, it seems to me that it's not that surprising that this seems to do a good job alleviating some musculoskeletal conditions, like aches and strains and little joint pains and things like that. But there's some other things that seem to be affected by musculoskeletal conditions like that. Perhaps even some surprising things like, say, headaches or cardiovascular issues or emotional struggles like depression, things like that. I'm curious if you've come across some surprising applications of counters strain that actually really leapt out to you as conditions that you wouldn't expect to respond to something like this that actually did.

Well, I would say that during the development of counterstrain for the nervous system, we ran into things that. I would say that we thought it was possible conceptually prior to actually coming across the actual treatments that were the most effective. But treating in the sympathetic and the parasympathetic nervous system can have a profound impact on ptsd, anxiety, depression. In addition to things like you mentioned, like cardiovascular problems. What you're looking at there is the central nervous system's effect through these peripheral neurons that are specific to the autonomic nervous system. What do they do? They function to regulate, typically, blood flow into organs, drainage out of organs. Some of the sympathetics can ramp up the activity of the cardiovascular system. Some of the sympathetics, the lower down ones, into the GI can slow down the GI process. Parasympathetics obviously would speed up the GI process. You look at things like digestive disorders, constipation, irritable bowel disease, and in the heart and lung region, tachycardia, difficulty breathing, Maybe issues with O2 saturation levels. You're looking now at the functioning processes of the organs being regulated by the nervous system and being able to release specific nerve pathways that are sympathetic in origin means you can calm this aberrant tone in the nervous system. And then you get a calmer organ system or you get a calmer state within the body. A lot of these things obviously project back up into the brain. And so if you have a persistent level of irritation coming from peripheral neurons that are sympathetic, then you constantly drive various parts of the brain, the cortex, into a state of anxiety. So the person can experience an emotional state that they have no reason why they're feeling like that. They don't feel like it's coming from their brain. And in this case it's not. It's coming from their body. So, yeah, we do see application to things.

That's fascinating, by the way. That kind of makes me think about this upcoming treatment I have with, I think, Andrea from Spokane has come up to treat me in a couple of evenings and I was thinking about wearing a real time HRV monitor to see what was happening to the nervous system in terms of sympathetic and parasympathetic strain during a treatment like this. And it sounds like there is a pretty big impact on the nervous system. Have you ever actually had anyone quantify that? And when I say quantification, I guess I'm just kind of curious if you guys have ever quantified anything from what happens to HRV during a treatment or if you've looked into, from a lymphatic drainage standpoint, presence of cytokines, like measuring blood and biomarkers pre or post treatment or anything like that from a quantification standpoint.

I think there's some ongoing studies happening right now. One by my friend, Dr. Holly Christie. She's a naturopath in Washington state and she took it upon herself to form a nonprofit called, I think it's called the bridgeback organization or bridgeback.org and they target specifically PTSD. So they're reaching out to a lot of the first responders, military, and they've been doing some research now, I think for the last three years, three or four years. And they have found at this point, I don't know that it's published yet. And so hopefully I'm not stating this in a pre published state, but they have found that the counterstrain method to treating PTSD so far has outpaced all other current methods. And this is early preliminary findings in their research that is being done. As far as heart rate variability, I have purely anecdotal from the athletes that I treat because they all wear some type of device, whether it's a whoop. And the oura ring is another one, I think that can pick up on all these little variations within the cardiovascular system. They all report the same thing, that their heart rate variability improved. It would make sense if you're removing a strain from a system that's pretty tightly controlled. The cardiovascular system is arguably extremely important. Fine tuning how this thing runs and keeping a tab on every aspect of it, that's the job of the sympathetic nervous system and the intrinsic neural system within the heart itself. So, yes, we've had reports and I can't say that this has been researched because this is something that has been happening over the last several years in our clinics. But it's certainly something that I would say is ripe for research. And a lot of idiopathic conditions in this region often turn out to be dysfunction. I think it's very difficult to image. Take a CT or MRI and figure out what's going on from this world because you're looking at such small amounts of inflammation, you know, inflammation along a very tiny autonomic nerve pathway. Not general inflammation like, you know, you got a disc in the cord that's, you know, upsetting the central nervous system.

Yeah.

So it's probably very difficult at this point to image.

Okay, that makes sense. What about like, like taking measurements on cytokines or inflammatory markers or anything like that? Have you guys looked into that?

So that the article that you quoted before. Impaired lymphatic drainage, interstitial inflammatory stasis. I think one of the co authors, Jay Shaw, did do a study where they took a very small fluid sampling from a tender point and they assessed it, and it was basically full of pro inflammatory inflammatory cytokines. So we know that the tissues that become hypoxic and irritated, any tissue really, if it becomes irritated to a point of releasing an inflammatory cytokine, the ones that they typically release the Most are your interleukin 6, interleukin 1B, and tumor necrosis factor alpha. So those three show up over and over and over again. They're the ones that shut down the lymphatic pump. They're the ones that are released during tissue trauma. Hypoxia can cause the body to release these. And then depending on where it is, like, let's say this is all occurring in the gut, you might see that the entire GI becomes inflamed. And now you have systemic levels of inflammation due to lymphatic drainage of the gut back into venous circulation. So then you see levels of CRP going up. So when we see those kind of things that we're thinking, oh, there's a mesentery problem, there's a GI problem that is creating this almost like an autoimmune state of inflammation, and it's being propagated throughout the body.

Yeah, yeah. It's interesting too, because when you think about a lot of idiopathic conditions or unexplainable illnesses and think about how many of them can be rooted to inflammation, it seems to me that even something for people listening in, if you could find a practitioner and just at least start off with something like a cranial scan to see what's going on, because for me, this is not necessarily trying to fix a disease or a serious issue, but I'm just curious about how the body would respond to a few episodes of this as far as just little aches and pains. Or just small things in terms of overall energy levels or sleep or anything like that. So I'm actually in very curiosity driven mode right now when it comes to receiving my own series of treatments here coming up. And that's actually what I wanted to talk to you a little bit about was the whole logistics of this, like what it's like to receive a treatment. So let's say someone schedules with a counter strain practitioner. I'll link to a bunch of directories if you go to BenGreenfieldLife.com counterstrain let's say someone goes in or as is in my case, actually convinces the practitioner and pays a little extra travel time for it to have someone come to their house. What's that first treatment actually look like? And how long can someone expect in that first treatment? And then what happens as far as follow up treatments are concerned, if those are actually necessary?

We come from a varied background. So that's one thing to kind of get out of the gate here is we're massage therapists, athletic trainers, PTs, OTs, some osteopaths, some medical doctors, nurse practitioners, chiropractors. So we have a pretty wide swath of allied health. And so accessing an individual practitioner can look a little different. So in my practice it's cash and so people typically just call and schedule an appointment. In other places, if you're seeing a physical therapist, there may be a physician involved and you might have to get a referral. So it can go from you have a 30 minute session with somebody in some states to we'll often see people for an hour or two hours and if they travel in from out of state, sometimes we'll increase it to a three hour session. Then the whole process basically begins with the same kind of question and answer that you would experience. At most pts. We're trying to figure out is there a history here? What is the primary problem? Then when we get into our diagnostic phase, we may look for an area that is in our mind and demonstrated through movements to be the area of greatest restriction or what we would identify as a key lesion. So where is the body locked up the most? We're very motion focused. So I want to make sure that I'm not doing something in an area that works fine. I want to find what's stuck and alleviate it. That's where I think the complexity of applying this, it's hard to get that across in a podcast, but we're looking literally at about 5,000 different locations on the body and probably somewhere in the neighborhood of 1000 to 1100 individual diagnostic locations. There's some overlap obviously, like the thoracic spine, for instance, you have 12 ribs. So there's a lot of things there that are done similarly. So it wouldn't be an individual technique to say I did a rib treatment at T4 and a rib treatment at T5. They're kind of the same thing, but yeah, lots of different locations. And we're looking at what stuck and then identifying through our cranial scan diagnostics and then of course through individual system tender point identification which ones are the primary ones. And then we go right to work and we'll repeat that process multiple times. I think if you remember session that we did back in May, I'd had to get up, move around and see how things felt. And that's how we alleviated four or five different systems. It was like, it's still a little stuck, still stuck. And then we got the fifth one out and you're like, yeah, it seems like that's free now. Then we move on to the next thing. So it's a little bit of a exploration and you're a participant because you're giving constant feedback. A lot of people want to know how painful is it? And really the technique is not painful, but we'll often locate specific locations. And I would say most people want to know that we found something. So even though we can probably feel where something is painful, we often will push on the thing and verify that, yes, that is a pretty painful spot that we're going to treat. And this whole process repeats over and over again throughout the entire session. And we may find single system problems which are kind of rare. Most common is three or four issues. You know, you get a little problem with the arterial supply to something. The nerves are a little bit upset, the venous lymphatic system doesn't drain well, and maybe there's a myofascial chain that's tight, you know, and then you alleviate all of those in that area and people are like, wow. So that that pattern of movement now feels very free. So that's kind of how the process works. Follow up. You know, we generally, unless it's a pretty simple thing, we're going to recommend a follow up. Because you treat a bunch of things, you send the body away, the body does its work. You know, I'd say the vast majority of what the body is going to do with the problem is done after manipulation, not during. So that could be a good 24 to 48 hours of just kind of laying low, not straining the system Allowing the body to fully drain the area and, you know, go to work in terms of repairing things and then follow up. You know, we typically will see people once a week. You know, if it's a local person and they've got a chronic condition, once a week, once every two weeks is not uncommon. If it's more acute, we might want to see somebody a couple times a week and just keep the sessions shorter to get them over the hill faster.

Yeah, it seemed as though, really, when it came to these tender spots, it was like, find one, hunt it down, work on it, Boom, that one's done, move on to the next one, move on to the next one. But I also get the impression that some tender points might not respond right away to the first treatment, and you got to hit them again in subsequent treatments.

I would say that that happens when there are things that you didn't tease out in detail during the diagnostic process. So if I've run into a situation where it's not going away, which this happens, happens to all of us, I instantly just stop what I'm doing, back out, and I re examine, because my expectation is that they will go away relatively quickly. You shouldn't be there for 10 minutes trying to get something to go away. That's just the body saying, you may have missed the correct diagnosis. Go back and look. Because when you alleviate the mechanical problem and it causes that area to open up and dilate and it pulls inflammation out, I should at least feel tissue texture change, like something softened. And then over the course of like, 15 or 20 seconds, the tenderness should be gone, like, just gone. So if you run into stubborn ones, it's like, okay, this one's here, but it may not be the one that is actually generating the pattern, so I need to go find that. So that's a diagnostic thing, and you just kind of go a little bit higher up the chain. Maybe you miss something in the brain. Maybe there's something in the spinal cord itself. And that's usually what that situation means.

Okay, okay, got it. That makes sense. Now, what about somebody who doesn't have any significant injuries or aches or medical conditions, Even though I don't know if that person actually exists. But let's take this theoretical perfect person, let's say like an athlete, and they just want to say, run faster, lift a heavier weight, perform better. Do you think there's any crossover here in terms of performance implications for somebody who's just like, I'm going to do this as an ergogenic aid for performance?

There's Multiple ways to answer this question. So yes, I would say yes, there are applications there and then there's wellness applications as well. So I wouldn't say you have to have a specific complaint to come in and have somebody do this work. And why do I say that? Your body has this insane ability to compensate for all kinds of things. I think you and I were just joking that we were kind of shocked that we survived our teenage years given the kind of physical activity that we put our bodies through. And yet here we are in our 40s and we're still. Okay, we're still here. So do we still carry those histories with us? Well, absolutely. And beyond that normal process of healing, what does your body hold onto? I would say that in many cases the body resolves these situations. Right? It does a good job of healing. And it's the ones that stick around where you're like, oh, I'm going to need to assist that one, because it didn't drain out when it was done scarring down. And so that's where our stuff comes in. But people can have a lot of these that are sub threshold. That really has to do with where is their pain threshold really at. That's a varied gauge of what somebody will tolerate for, you know, 10 years. You know, someone else couldn't do it for 10 minutes. So that's very individual. And someone can come in saying they feel pretty fine and I can do two hours of work on them and they get up and they're like, I had no idea that I could feel better than I did. So people that have literally nothing wrong, that's their perception, obviously, because they're living in their body, but there's probably some sub threshold things that just aren't hitting their consciousness and so they're not even aware that they're there. It's like spotting movement pattern disorders and be like, oh, that's a little tight right there. But the person says, well, I don't really feel anything. So yes, there's definitely performance enhancement. There's a wellness aspect to this. And there are sub threshold dysfunctions that I would say you just want to keep them away. It's like you don't drive your car for five years without doing an oil change and just wait till it breaks. You do preventative maintenance. So I would say that this kind of fits into that role. So if you had no problem whatsoever, you felt great, you're very active or whatever, and you just want to add something to your wellness routine four times a year, I'd say come in with the seasons and work with one of us for one or two hours, and let's just eradicate things that you probably build up over time, and you just keep everything quiet and so that things don't manifest that way. Plus, and this is specifically for you as an athlete and other athletes, you're always pushing the envelope, always. So the likelihood that you tear something during athletic competition if you had one of these latent dysfunctions is higher. You may not be aware of it, but the chance that you push beyond the extensibility of some tissue due to the fact that it doesn't move as well as it could if it was completely healthy, just increases your risk of injury. So I think you probably saw in the book. I worked directly with Diego Valeri, who was a Portland Timbers for nine years. He came up from Argentina when he was 26, I think, left recently, left last year at the age of 35. And when I met him in 2015, his body was full of these things. He was very stiff. His ribcage didn't move very well. He said he could no longer jump because his ankles had been sprained so many times. He didn't have the flexibility to jump. His speed was definitely lower. His endurance was fine. But he's a professional athlete, so I think they manage their expenditures quite well. They know how to get around and not burn themselves out. And he was a master at just seeing the field. So he had a lot of other things that he could dwell upon, but his physical body was definitely not functioning to the best that it could. In fact, he tested, I think he told me he tested last in their functional movement assessment that they do every year, like, last in the entire team. So when that was in 2015, by early 2017, about a year and a half later, he had leapfrogged the entire team and was now the best in terms of his functional movement capacity. And that was after a year of working with us here at Counterstrike Portland, removing, again, all these things that had basically made it difficult for his body to move like a normal one. He accumulated all of these dysfunctions. He also regained the ability to jump. And I don't know if you noticed in 2017, but he got the league MVP. And I think at 21 goals, fully half of those were jumping headers. So performance enhancement? Yes. Functional improvement. Yes. Longevity? Yes. And then, of course, just, you know, just looking at the wellness, like, how do you improve everything so that your body just feels better, performs better? I think all those things fit quite well. We do quite a bit of wellness Work here as well.

Yeah, and that's obviously a pretty good testimonial from a performance standpoint. Back to Tony Robbins, who introduced me to this protocol, and they connected me with you guys. I recall back in the day, he was kind of into this form of somatic therapy for pain called network spinal analysis, or nsa, which I haven't had done. But apparently they kind of put light touch on certain parts of your spine to release tension. And then they say that then that frees up energy and increases flexibility in the spine and decreases back pain and heals the nervous system. It seems to me like this is pretty similar, except you're working higher up in the central nervous system, up in the head instead of the spine. Do I understand that correctly?

I've known a few network providers. Obviously I run into them at Tony's events. And yeah, there's a lot of similarity. There's a lot of overlap in manipulation. And so the areas that they focus on are like spinal cord reflexive centers. Obviously the spinal cord, 69 million nerves, highly sensitive structure, orchestrates everything, has all your preganglionic autonomic nerves to every organ in your body, every vascular structure. So if you wanted to have a full body impact, you're basically left with head or spinal cord, those two things. You will absolutely touch every aspect of the body. As far as them not doing, I'm not sure if there's nothing that they do with the head or if it's just that they focus primarily on the spinal cord itself, but I would assume that there's impact there as well, because every time we do spinal cord work, for instance, you can feel things in the head changing as well. So you can imagine something like a second order motor neuron that actually originates in the motor cortex. And so when you follow the motor from the motor cortex down through the brain stem to the opposite side of the body, that's a one continuous neuron pathway until it lands on whatever nucleus that it's going to communicate with in the spinal cord. So it's not like they're not having an impact on the brain. It's just I think they focus on a little bit more, you know, in the spine. But I think that they're, like I said, very similar in terms of the central aspect, you know, and the whole emotional element. It's like you can't remove certain things from the work that you do because we're, you know, we're kind of a unified being. Right? Our souls, our spirits, and our body are kind of one thing. They may live in, like, different realms, but these are uniform. I would say every. Every person I've seen that has had, like, an emotional trauma when we begin to work, it's like you're not just impacting their physiology. Like, there is an absolute emotional element to this or an energetic element to this. It's just not the intent of many practitioners. Like, they don't intend to work directly with that. And so sometimes that happens during a treatment and they're not exactly sure what exactly is going on, but the connection is extremely strong. They have tapped in far more, I think, to that energetic side, like you said.

Yeah, yeah. This kind of just once again, highlights the fact that there's more than one way to address some of these issues. And I've experimented with a lot of stuff. Folks probably remembered my podcast with the Human Garage, who does all sorts of fascial manipulation. I interviewed my massage therapist. I've had practitioners come over to my house. I had the. Another guy, I'm blanking on his name. He did kind of like a mapping with the eyes and the vagus nerve and an eye movement resensitization type of protocol. And a lot of this stuff's just kind of fun to play with and see what actually works for your body when you throw that noodle against the wall, so to speak, and see if it sticks. So based on that, Tim, could you explain if there's a practitioner listening in who wants to learn how to do this stuff on their patients, where they would go, and then also if there's someone listening who just wants to go and experience counterstring for themselves, where they should go.

Sure. So I would assume you have people on your call here that are global, like an international group. So in cases where you're in certain countries, it's going to be difficult to get access to training. But we do have trainings that occur in Indonesia, in Australia, and throughout Europe. We've got courses running primarily in France, but we've got practitioners in Italy and the UK and Germany. So we're spreading, but it's fairly new. Like I mentioned before, it hasn't been around that long. In fact, the form that we're really discussing here debuted in 2008. So that's a little bit of the history as to why this is still in its infancy. But the best place to go is counterstrain.com and there's a listing there of practitioners, but there's also training. So you can click on the training tab, and then it kind of gives you an overview, like, what the training is like, and where you would do it. And then if it's in a foreign country, it's not the US There are links there that take you directly to the host partners that run courses in those countries. And that's kind of the best first step. If you're curious about what the amount of time is, it's going to vary from one person to the next. But at the moment, there's about 12 courses that span every system in the body. And each one of these lasts about three days. So if you looked at it from a day standpoint, it's limited. But the amount of information that we often present is enough to keep you busy for three to six months. So you could stretch that out over three or four years and then somebody who wants to experience it. Also on counterstring.com is a database of people that have taken our courses. I think there's around 1,000 on there currently. We get people registering all the time for profile. They just have to take at least four of our classes to get on there. So there's likely another thousand out there that haven't achieved that, and so they're not listed on there. But it has grown tremendously since its inception. There were only 22 people in the first class, and that was in 2008. And this thing has grown and grown. So now we're seeing a very healthy introduction of new people into our courses, which we're very excited about. But I know your clientele is likely a good portion of them, I think are probably in this medical field, just based on my own research, looking into who you speak to.

Yeah, a ton of practitioners listening. So what I'll do is I'll link to all the resources as well as previous podcasts. I've done my chat with Tony and Peter about this and then also. And this will be cool for people to see. Like I mentioned, Tim, when you were at the house, we had a videographer capture your entire initial treatment on me. And you guys can kind of see my reaction and perhaps, you know, read by my face how tender or non tender the points were. And you can see Tim actually mapping my head and doing the cranial scan. So I will embed that video. Also, if you go to BenGreenfieldLife.comCounterstrain that's BenGreenfieldLife.com Counterstrain and as I go forward and get a few treatments done, I'll keep you guys posted about anything else that I experience with this pretty cool form of manual therapy. So, Tim, thanks so much for coming on the show and sharing all this with us, man. I think it's fascinating and again, I'm excited to experience a little bit more of it.

Yeah. And Ben, thank you so much for being open to having me up at the house. That was a blast. I loved being able to interact with you and just very appreciative of the opportunity. So thank you very much. Really appreciate it.

Awesome. Awesome. Well folks, I'm Ben Greenfield along with Tim Hodges from Counter Strain, signing out from BenGreenfieldLife.com have an amazing week. More than never these days, people like you and me need a fresh, entertaining, well informed and often outside the box approach to discovering the health and happiness and hope that we all crave. So I hope I've been able to do that for you on this episode today. And if you liked it or if you love what I'm up to, then please leave me a review on your preferred podcast listening channel, wherever that might be, and just find the Ben Greenfield life episode. Say something nice. Thanks so much. Means a lot. Sa.