SYNOPSIS Should muscle contraction headache be measured and treated from the traditional bifrontal muscle sites? Fivestudies report significant positive correlations between headache parameters and frontalis surfaceelectromyogram (EMG) levels. In contrast, four sets of authors who analyzed the relationship failed to find asignificant relationship. The purpose of this study is to investigate whether headache and nonheadache EMG levels in chronic musclecontraction headache patients were higher than in nonheadache‐matched controls using both conventional andmore inclusive EMG electrode placement sites. Twenty‐five patients experiencing chronic muscle contraction headache (experimental group) and twenty‐fiveage‐matched nonheadache subjects (control group) comprised this study. Experimental group subjects weremonitored twice while having a headache and twice while not having headache prior to beginning therapy. Datafrom the experimental group were compared with that of the control group who indicated “seldom if everexperiencing headache.” EMG data were collected and statistically compared using the conventional bifrontalmodel, the Cram‐Scan model and a Schwartz‐Mayo profiling method on all persons in this study. Results indicate the Schwartz‐Mayo placement followed by the Cram‐Scan model were superior indisciminating between the headache and nonheadache groups. The most conclusive finding is that the bifrontalplacement model appears antiquated in its ability to provide meaningful diagnostic information and may not besufficient for patient assessment and efficient therapy. Determining the existence of muscle contraction andmodes of treatment may be more effectively reached using multisite EMG monitoring rather than the traditionalbifrontal placement.