Myotherapy treatment - Brisbane MSK Clinic

Myotherapists have advanced manual therapy training to treat work and sports injuries, restricted mobility, musculoskeletal and myofascial pain conditions. Myotherapy comes from the Latin words "Myo", meaning muscle and the "Therpia". "Therpia" or therapy in English means "healing" or "curing". A Myotherapist is somebody trained in the practice of Myotherapy, a hands-on method of assessment and treatment. Myotherapists use a wide range of soft-tissue therapy skills and hands-on treatment techniques well-suited for treating musculoskeletal (MSK) and myofascial pain. Although pain relief can prove relaxing, Myotherapy treatment focuses on dealing with the reason for symptoms of symptoms. Base-level massage is more suited to relaxation than addressing more clinical conditions, with training and education reflecting this. Also, massage therapists have a relatively narrow scope of practice, meaning the type of things they have the training to treat. Remedial massage therapists have additional training covering some conditions and a greater scope of practice. However, sadly, some therapists go beyond their scope of practice and training, which has ethical, safety and insurance coverage implications. Such situations can typically occur due to unethical financial motivations or a desperate need to help, which can have consequences for the patient. Observing a technique online or from a friend or other therapist does not make one qualified, competent, professional or insurable.

Research has consistently shown the involvement of myofascial trigger points in a diverse range of MSK and myofascial pain conditions.Pain is one of many types of "stressor", which can lead to muscle tension (See the article on the Human Stress Response). Myotherapists tend to specialise in treating myofascial pain and Chronic Pain conditions such as myofascial pain syndrome and fibromyalgia. Myotherapy is not a form of massage, as some Remedial Massage therapists who lack the training think and nor is it "Physical Therapy". It is a "manual therapy" which uses evidence-based and clinically relevant assessment and treatment techniques, including soft-tissue therapy (STT) skills from many disciplines.

The main differences between a Myotherapist and a Remedial Massage therapist relate to the additional skills, training and knowledge gained during a Myotherapy course. Typically, a Remedial Massage therapist will have completed a Cert IV in massage therapy and a Diploma in Remedial Massage Therapy. A Myotherapist will have completed the same training, plus an Advanced Diploma in Myotherapy or a Degree in Myotherapy. The extra training provides myotherapy practitioners with additional and more detailed knowledge of specific conditions, assessment methods (orthopaedic, neurological and movement-based), rehabilitation, and advanced soft tissue therapy techniques.

Most courses involve a combination of classroom, home study and student clinic work treating members of the public. The following details provide a rough example of the differences in the duration of training between the two types of therapists:-

• Cert. IV 6 months full-time (typically 2 days a week)
• Dip. 12 months full-time (typically 2 days a week)
• Adv. Dip. 18 months full-time (typically 2-3 days a week)

As with all professions, the qualification alone provides a rough guide to likely acquired knowledge. However, there can still be significant differences between practitioners trained at the same provider or academic institution. Somebody could have years of clinical experience before undertaking further training. Equally, it would be possible to complete training quickly and only have course-related clinical expertise. Individual therapists' interests can also influence additional learning and, thus, clinical experience.

For example, the principal practitioner, Terry, has previously spent 6 years training at the McTimoney Chiropractic, which provides him with a wealth of additional assessment training, diagnostic knowledge and treatment options. Sadly he left the Chiropractic profession after moving to Australia from the UK due to skills recognition issues with all of his UK education and training. However, he still uses much of his previous clinical training and assessment knowledge to benefit patients, such as neurological and orthopaedic testing, differential diagnosis, joint mobilisation techniques and prescriptive exercises above and beyond those taught to Myotherapists. He also possesses a UK equivalent qualification to the Australian Advanced Diploma of Myotherapy, though that education is not recognised. Hence, he does not hold the Australian Myotherapy qualification. However, he was more than qualified to teach as a senior course coach on one of the first Myotherapy courses in Brisbane. Many of the longest-qualified myotherapists in Brisbane learnt under him. Hence Terry understands the knowledge and skills required to qualify as a Myotherapist. He also taught at Diploma level remedial massage and, to a lesser extent, cert IV and has a broad knowledge base. Terry completed a formal Kinesiology Taping (sports taping) course in 2020 due to his work as part of the UK Invictus Games medical team and for insurance purposes. He was already familiar with strapping and taping from his military experience, sports, and remedial massage training, but he just needed a specific piece of paper for insurance cover. A practitioner with over sixteen years of clinical experience, he works in an evidence-informed way with patients due to research limitations. In addition, he has training in a broad range of soft tissue therapy (STT) and fascial release treatment methods.

Additional Soft Tissue Therapy Training

The following is a list of additional Soft Tissue Therapy techniques and training available at the TotalMSK Brisbane Clinic:-

• Soft Tissue Release - STR
• IASTM treatment - Instrument Assisted Soft Tissue Mobilisation
• Gua Sha treatment
• Muscle Energy Technique - MET
• Neuromuscular Therapy - NMT
• Positional Release Technique - PRT
• Kinesiology Taping (KT)
• Advanced Myofascial Release - MFR

Training and clinical experience enable practitioners to choose the most relevant "tool" within their knowledge base or "toolbox" for the task at hand and meet the patient's treatment goals. Occasionally, patients may have had a bad experience with a one treatment type and therapist, such as Trigger point Dry Needling. Some patients simply do not like needles, though they are very different to hypodermic needles. Although a patient may have had a bad experience before does not mean they will experience the same with another practitioner. Myotherapy treatments at Brisbane clinic can include Dry Needling, though similar results are possible without needles. Equally, as with any manual or soft tissue treatment, a specific technique may not be an option. One therapy might be contraindicated in one situation, while another is not. Hence, knowledge and experience of various techniques allow one to provide treatment for more complicated conditions and pain.

Myotherapist training is either at Advanced Diploma or undergraduate degree level. It can take 2-3 years to complete and depends on the end Myotherapy qualification. A degree may not require any experience and just year 12 grades. Advanced diplomas tend to require prior massage training before studying as a myotherapist. Usually, there is a base level diploma of remedial massage requirement. Some therapists may have years of practical experience treating and then study Myotherapy. Others may have purely completed the necessary qualifications as fast as possible. Hence, as with other manual-therapy professions, there can be big differences between therapists. Myotherapists learn more methods of assessment and treatment. A wider skillset means a broader scope of practice or the type of conditions one is trained to treat. Training covers some diagnostic testing methods, though myotherapists are not able to diagnose. Diagnostic tests can help a myotherapy practitioner form an educated guess, whereas only specific professionals can provide a legal diagnosis. For example, a registered Chiropractor can diagnose, and that ability goes along with the honorary Doctor title on deregistration.

There can still be differences in the subjects taught on a myotherapy course from one training provider to the next. Some courses may teach Kinesiology Taping, while others may not. There are also Myotherapists who say that they offer "Physical Therapy" treatment and yet are not trained as such. The terms "Physical Therapy", "Physiotherapist", and "Physiotherapy" are legally protected titles. Protected titles have been used in most countries for decades and refer to regulated professions. Such health professions can usually diagnose as part of their scope of practice. The terms Myotherapy and Myotherapist are not protected titles, effectively meaning anybody can use them. Myotherapy courses also require students to complete learning in a clinic setting. Most training providers run a student clinic, where the general public can receive treatment from myotherapy students. Other health professions also have similar arrangements, where students complete placements in clinics or hospitals. Most allied health professionals have to complete clinic entry and exit exams. Such exams aim to test the learning and knowledge in their entirety and the required standards at clinic entry or exit level. Such exams are not commonplace in the field of myotherapy, as many exams are competency-based. Hence, a myotherapy student may pass an exam on the shoulder and then move to the next area or subject. Thus, there is no real test of complete (the entire body) knowledge and understanding.

Physiotherapy training and other primary and allied health care professionals typically train to degree level minimum, and sometimes masters. The more extended training period provides Physiotherapists with a greater depth and breadth of knowledge than that of a Myotherapist. Physiotherapists also have a broader scope of practice and can diagnose, much like other regulated health professionals. Physiotherapy training covers some massage and soft-tissue therapy skills, though the courses focus on other skills and knowledge. Massage and soft-tissue skills are a relatively tiny part of Physiotherapy training. Hence, the actual practical massage and soft tissue skills experience can vary. One could say the same for other Allied Health professionals. That said, prior experiences and interests also shape how each of us works. There are a lot of people who learnt massage before more extensive training. Also, there is a lot of scope for more training later and based on interests. In many respects, a Physiotherapist is qualified to do everything within the remit of a Myotherapist and more. However, Myotherapist may have more practical experience of the soft tissue therapy (STT) treatment techniques taught on a Myotherapy course than a Physiotherapist. That said, there are many specialisms in Physiotherapy, and a Sports or MSK Physiotherapist may have far more (STT) practical experience.

When seeking treatment, there are many things to look for, and just picking a specific profession, or relying on on-line reviews is not always the best option. The article on Finding a good, ethical Musculoskeletal health professional includes some of the things to look for and avoid.

There is a lot of overlap between skills and treatment methods within the MSK Therapy profession. Such overlaps cover primary care, allied health and other therapies. However, there can be significant differences in how each discipline approaches a problem. There can even be wide variations between professionals within the same profession or trained at the same academic institution. Differences between practitioners exist due to specific occupations, education providers, philosophy, personal experience, and interests. Some such differences are more historical, which one can see when looking at differences between Chiropractors, Osteopaths and Physiotherapists.