Myotherapist Career

Myotherapy is a method of relieving muscle pain and spasms and improving overall circulation through applied pressure to trigger points. Pressure is applied using fingers, knuckles, and elbows. Those who practice myotherapy are called myotherapists.

Myotherapist Career History

Bonnie Prudden, a fitness and exercise enthusiast, first developed myotherapy in 1976. During the 1970s, Prudden worked for Dr. Janet Travell, the former personal phy­sician to President Kennedy. Together they treated chronic pain using trigger point injection therapy. Prudden would identify the trigger points on the patient’s body with ink, then Dr. Travell would inject the sites with a solution of procaine (a type of local anesthetic) and saline. After­wards, Prudden would conduct muscle exercises and teach patients stretching exercises to do at home in order to keep the muscle strong and relaxed. By chance, while working on a patient, Prudden found that by holding the pressure to trigger points for a longer period of time, the same relief was achieved without the use of invasive needles and solu­tions. By 1979, the Bonnie Prudden School of Physical Fit­ness and Myotherapy was established in Tucson, Arizona.

Myotherapist Job Description

Myotherapist CareerMyotherapy, also called trigger point therapy or neuromuscular massage therapy, is a method of relieving pain, improving circulation, and alleviating muscle spasms. Myotherapists identify the source of pain, called a trigger point, and erase it by the use of applied pressure to these tender spots.

Through the Bonnie Prudden School of Physical Fit­ness and Myotherapy, students are taught the Prudden method of myotherapy, in addition to anatomy, physiol­ogy, exercise, and physical fitness. Classes such as mod­ern dance, drawing, and live sculpture are also offered to encourage students to analyze how the human body moves. After completion of the program, students are given an exam and are required to undergo recertification at the school every two years. (See the Certification and Licensing section for more information.)

A first-time consultation begins with a thorough his­tory of the patient. “Many times pain is the result of an old injury or accident,” says Janice Stroughton, a cer­tified myotherapist. “It could also occur as the result of the patient’s background and lifestyle.” Stroughton explains that weakness and muscle injury is accumu­lated throughout a lifetime. The average age of patients is between 35 and 55 years—”about the time a person’s bucket of accumulated trigger points starts to overflow.” Once weak spots are created in the muscle, both physical and emotional stress can cause the spots to go into pain­ful spasms. Myotherapists get rid of spasms by using their fingers, knuckles, or elbows to apply pressure to these trigger points. As muscles relax, the patient is relieved of pain. Afterwards the muscle is taught to remain loose and lengthened through the use of exercises. Myotherapists also teach the patient several corrective exercises to do at home.

Myotherapy works on pain as long as the source is muscular, not systemic. It has shown to be effective for alleviating pain caused by arthritis, bursitis, scoliosis, sciatica, and even pain associated with lupus, AIDS, and muscular dystrophy.

Stroughton collected her own trigger points from years of playing tennis. Complications from scoliosis gave her more pain than she could endure. “I first learned about myotherapy from a tennis instructor who had undergone treatments and persuaded me to give the method a try.” Stroughton was so convinced of the benefits of myotherapy that she became a myotherapist. Today, Stroughton is a certified myotherapist at the Myotherapy Pain Control Center in Maryland.

Patients are referred to the Pain Control Center by a medical physician, osteopath, chiropractor, or acupunc­turist. Usually, patients have already undergone the bat­tery of X rays, tests, and procedures to ensure pain is not structural in origin. For new patients, history and assessment is taken. “Many times chronic pain is caused by occupation, disease, past accident, surger­ies, or participation in sports,” says Stroughton. Patients then take the Kraus-Weber Minimum Muscular Fitness Test for Key Posture Muscles. Divided into six tests for different muscle masses, it gauges the flexibility and strength of a person’s muscles.

Myotherapists use a trigger point pain chart to mark down the sources of a patient’s pain. Once a trigger point is found, the patient identifies its intensity by grading it on a scale of one to 10—one being mild, and 10 almost unbearable. Each loca­tion is color marked on the paper chart to indicate the type of pain and the date it is erased.

Patients arrive for treatments barefooted and wearing loose clothing. “Patients are encour­aged to bring a friend or family member to observe how treat­ments and exercises are done,” explains Stroughton. “That way, the exercises may be repeated correctly at home. Treatments are 50 percent myotherapy and 50 percent corrective exercises.” Using the completed pain chart, trigger points are identified and erased. The location of a trigger point determines the amount and length of pressure applied—on the average seven seconds for most body areas and four to five seconds for the face and head. Tools such as the crook (a metal rod shaped like a shep­herd’s hook) and the bodo (a wooden dowel) are used to give the myotherapist greater extension and also to help fight fatigue. Small bodos are used to work the hands and feet, while larger bodos are helpful in working larger muscle masses such as the quadriceps and gluteus.

Once the muscles are relaxed, they need to be main­tained with exercises specially designed for the patient’s problem areas. Patients and their helpers are instructed in the proper way to conduct maintenance exercises to help keep the muscles strong and flexible. These exercises also help improve coordination, strength, and posture.

Stroughton’s work schedule varies. Phone consultations with patients take up a large part of the day, as does paper­work. She limits herself to two or three patient treatments a day. Myotherapy is physically taxing on the practitioner. “You always risk injuring yourself,” says Stroughton. “You need to be aware of how you use your own body.”

Myotherapist Career Requirements

High School

Enid Whittaker, a certified myotherapist and instructor, suggests taking anatomy and physiology classes if you are interested in a career in myotherapy. This will help you understand how the human body works. Also, creative classes such as drawing and sculpture, especially of the human body, will foster good hand coordination skills. Physical fitness classes and dance classes are helpful in developing a strong and flexible body. This is impor­tant because myotherapy is physically demanding on the therapist. If you are interested in setting up a private practice, Whittaker also suggests taking business classes, such as marketing, accounting, bookkeeping, and com­puter science.

Certification or Licensing

There are other schools offering classes in myotherapy, but the Bonnie Prudden Myotherapy School is consid­ered the most reputable program available. The school offers a nine-and-a-half month certification program for its graduates. A total of 1,300 hours of program work is completed at the school after which you may sit for the board exam. For recertification every two years, you are required to take continuing education classes (about 45 hours total) covering new techniques.

Certification is also available from other massage therapy schools, usually requiring completion of a series of workshops or seminars. In some states, you must also become a licensed massage therapist before practicing myotherapy.

Other Requirements

“Working with people in pain can sometimes be unpleas­ant,” says Janice Stroughton. “Don’t expect cheery faces and pleasant conversation.” Patients, many of whom have been suffering pain for some time, will be grouchy and in a foul mood. Sometimes a good sense of humor is enough to erase a patient’s crankiness. Despite having to deal with bad tempers, Stroughton finds reward in helping patients with their problems and offering them relief from pain. “The best part of my job is knowing I made a difference in someone’s life, in regards to pain. It is like giving someone new hope.” Stroughton quotes her mentor, Bonnie Prud-den, when she says, “Pain, not death, is the enemy.”

Questions arise during treatment, such as, Should pressure be kept a few seconds longer? Is the patient ready to end his or her sessions? Are these exercises challenging enough? Good intuition is another important quality you will need in order to answer such questions on the spot. While you will learn the basics of myotherapy in school, you’ll need instincts and intuition to help you in actual practice.

Because of the repetitive movements used in myother­apy, many practitioners often run the risk of self-injury. It’s important to be aware of your body’s limitation and not overuse your own muscles and joints. Sometimes, myotherapists need treatment for their own repetitive stress problems.

Exploring Myotherapist Career

If you can afford it, consider going to several different massage therapists who offer different types of massage. Ask if you can set up an informational interview with various kinds of massage therapists, including myotherapists. Explain that you are interested in pursuing this career and come to the interview prepared to ask questions. What is your educational background? Why were you drawn to the job? What is the best part of this work?

A less costly approach is to find books on massage instruction at a local public library or bookstore. Mas­sage techniques can then be practiced at home. Books on self-massage are available. Many books discuss in detail the theoretical basis for the techniques. Videos that dem­onstrate massage techniques are available as well.

Consider volunteering at a hospice, nursing home, or shelter. This work will give you experience in caring for others and help you develop good listening skills. As a myotherapist, it is important for you to listen well and respond appropriately to your clients’ needs. The thera­pist must make clients feel comfortable, and volunteer work can help you learn the skills necessary to achieve this.


Myotherapists are employed in a number of health care settings. They may work at a physician’s clinic, especially one that treats patients with nerve damage or arthritic pain. Others choose to open up their own practice. Remember, though, that in addition to giving treatments, myotherapists are also responsible for all duties associ­ated with running a business, handling tax concerns, organizing the office space and supplies, and hiring sup­port staff. The reward is having the freedom to determine their own workdays and hours.

Myotherapists can also join an established clinic. Because of the growing interest and acceptance in myotherapy, many clinics have found it necessary to hire more therapists.

Another option is to combine myotherapy training with other disciplines, such as acupuncture, chiropractic, or massage therapy. These therapists can work for massage clinics, day spas, and alternative medicine practices.

Starting Out

It may be difficult for new myotherapists to immediately set up their own businesses. Consider applying to clin­ics or physician’s group practices to see if they might be interested in offering myotherapy as part of their services. Your chances of finding opportunities are better at orga­nizations that concentrate on alternative and integrative medicine. Working in an established clinic or practice will give you experience, help you build a clientele, and generate publicity for your services.


Career advancement depends on how myotherapists choose to practice. If they opt to open a private prac­tice, then the obvious advancements would be a larger office, a bigger client base, and perhaps having a staff of myotherapists working for them. Those who choose to join an existing practice advance by growing their client base, gaining seniority, or perhaps establishing their own pain clinic. Myotherapists who join a medical practice advance in the form of more responsibilities, a larger sal­ary, or better benefits. Experienced myotherapists may go on to become instructors in massage therapy schools.


Salaries for this occupation vary depending on the work setting. Enid Whittaker sees four to seven patients per day. The average patient, depending on the type of pain, needs about four to eight visits, with each treatment cost­ing an average of $75. On the high end, a patient may spend up to $600 to finish pain treatment. Of course, some myotherapists opt to schedule more patients daily and may work with different treatment fees. Because of the physical demands of the job, myotherapists often work less than 40 hours a week. A large percentage of practitioners practice part time, from 10 to 20 hours a week.

A report by stated that massage therapist is one of the “hottest emerging job titles of 2005.” Accord­ing to the report, massage therapists’ hourly earnings ranged from $50 to over $100. Well-established thera­pists who manage to schedule an average of 20 clients a week for one-hour sessions can earn more than $40,000 annually. The U.S. Department of Labor reports that the median annual salary for massage therapists was $32,270 in 2004, and salaries ranged from less than $15,000 to $68,060 or more annually.

Myotherapists in private practice must also be respon­sible for overhead costs, in addition to acquiring health insurance and other benefits. A myotherapist employed full time at a hospital or other clinical setting may enjoy benefits such as health insurance and paid vacation and sick time. Though employed myotherapists may have greater job security and better benefits, they do not have the option of setting their own work schedules and hours that independent myotherapists enjoy.

Enid Whittaker sums it up best when she stresses, “One becomes a myotherapist because of a desire to help others, not to get rich.”

Work Environment

Massage therapists, including myotherapists, work in clean, comfortable settings. It is important to maintain a hygienic working area. This involves changing sheets on the massage table after each client, as well as clean­ing and sterilizing any implements used, and washing hands frequently. Myotherapists use massage tables and a variety of tools to manipulate muscles. Their offices have adequate space for teaching exercises and simple exercise equipment.

Since the physical work is sometimes demanding, myotherapists need to take measures to prevent repeti­tive stress disorders, such as carpal tunnel syndrome. The workweek of a myotherapist is typically 35 to 40 hours, which may include evenings and weekends to accom­modate working clients.

Myotherapist Career Outlook

Even though there are no official figures, the field of myotherapy has grown. The public, especially in the past few decades, has become more proactive when it comes to their bodies and health. Many people are tired of the dependence on traditional medi­cine and are looking for alternative methods of pain relief. There is a growing acceptance of myotherapy from the public and the medical field. Many physi­cians, especially those specializing in neurology and rheumatology, are referring patients for myotherapy treatments more and more. Insurance companies, though slowly, are beginning to cover myotherapy treatments.

About 85 percent of the population experiences some sort of pain, most commonly back pain and headaches. Many people’s work involves developed movements that are highly repetitive, with little flexibility. A fairly sed­entary occupation such as computer programming will usually result in trigger points to the upper and lower back. Construction work, a highly strenuous occupa­tion, will gather trigger points in the back and torso. Chronic pain can also be sports-related. Beside tradi­tional activities like tennis and golf, some people are fas­cinated with extreme sports such as mountain and rock climbing and snowboarding. Many athletes turn to the benefits of myotherapy as a form of injury prevention and maintenance.

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