M1TI Osteopathic Manipulative Medicine (OMM) Practice Test

For how long should the tender point be held after reduction in counterstrain?

5 seconds 90 seconds 30 seconds 180 seconds

Correct Answer:

90 seconds

Explanation:

Holding the tender point for about 90 seconds after achieving the reduction is the standard approach in counterstrain. This pause lets the muscle spindle activity and Gamma motor neuron output settle, reducing unnecessary reflex tension and allowing the fascia and muscle to relax into the shortened position. With the point stabilized, nerves and nociceptive input calm, so the tender point often becomes less tender or pain-free as you then slowly return the body to neutral and recheck. Shorter holds, like 5 seconds, don’t give enough time for neuromuscular reset, and 30 seconds is usually not sufficient either. A much longer hold, such as 180 seconds, isn’t necessary and can increase discomfort and fatigue without added benefit.

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