- Employment is expected to grow faster than average over the
2004-2014 period as more people learn about the benefits of
- Many States require formal training and a national certification
in order to practice massage therapy.
- This occupation contains a large number of part-time and self-employed
Many physicians have been recommending massage therapy for years.
Nearly 2,400 years. The medical benefits of “friction” were first
documented in Western culture by the Greek physician Hippocrates
around 400 BC. Today, massage therapy is being used as a means
of treating painful ailments, decompressing tired and overworked
muscles, reducing stress, rehabilitating sports injuries, and
promoting general health. This is accomplished by manipulating
a client’s soft tissues in order to improve the body’s circulation
and remove waste products from the muscles.
While massage therapy is done for medical benefit, a massage
can be given to simply relax or rejuvenate the person being massaged.
It is important to note that this type of massage is not intended
for a medical purpose, and provides medical value only through
general stress reduction and increased energy levels. Massage
therapy, on the other hand, is practiced by thoroughly trained
individuals who provide specialized care with their client’s medical
health in mind.
Massage therapists can specialize in over 80 different types
of massage, called modalities. Swedish massage, deep tissue massage,
reflexology, acupressure, sports massage, and neuromuscular massage
are just a few of the many approaches to massage therapy. Most
massage therapists specialize in several modalities, which require
different techniques. Some use exaggerated strokes ranging the
length of a body part, while others use quick, percussion-like
strokes with a cupped or closed hand. A massage can be as long
as two hours or as short as five or ten minutes. Usually, the
type of massage therapists give depends on the client’s needs
and the client’s physical condition. For example, they use special
techniques for elderly clients that they would not use for athletes,
and they would use approaches for clients with injuries that would
not be appropriate for clients seeking relaxation. There are also
some forms of massage that are given solely to one type of client,
for example prenatal massage and infant massage.
Massage therapists work by appointment. Before beginning a massage
therapy session, therapists conduct an informal interview with
the client to find out about the person’s medical history and
desired results from the massage. This gives therapists a chance
to discuss which techniques could be beneficial to the client
and which could be harmful. Because massage therapists tend to
specialize in only a few areas of massage, customers will often
be referred or seek a therapist with a certain type of massage
in mind. Based on the person’s goals, ailments, medical history,
and stress- or pain-related problem areas, a massage therapist
will conclude whether a massage would be harmful, and if not,
move forward with the session while concentrating on any areas
of particular discomfort to the client. While giving the massage,
therapists alter their approach or concentrate on a particular
area as necessary.
Many modalities of massage therapy use massage oils, lotions,
or creams to massage and rub the client’s muscles. Most massage
therapists, particularly those who are self-employed, supply their
own table or chair, sheets, pillows, and body lotions or oils.
Most modalities of massage require clients to be covered in a
sheet or blanket, and require clients to be undressed or to wear
loose-fitting clothing. The therapist only exposes the body part
on which he or she is currently massaging. Some types of massage
are done without oils or lotions and are performed with the client
Massage can be a delicate issue for some clients, and those clients
may indicate that they are comfortable with contact only in specified
areas. For this reason—and also for general purpose business risks—about
half of all massage therapists have liability insurance, either
through a professional association membership or through other
Massage therapists must develop a rapport with their clients
if repeat customers are to be secured. Because those who seek
a therapist tend to make regular visits, developing a loyal clientele
is an important part of becoming successful.
Massage therapists work in an array of settings both private
and public: private offices, studios, hospitals, nursing homes,
fitness centers, sports medicine facilities, airports, and shopping
malls, for example. Some massage therapists also travel to clients’
homes or offices to provide a massage. It is not uncommon for
full-time massage therapists to divide their time among several
different settings, depending on the clients and locations scheduled.
Most massage therapists give massages in dimly lit settings.
Using candles and/or incense is not uncommon. Ambient or other
calm, soothing music is often played. The dim lighting, smells,
and background noise are meant to put clients at ease. On the
other hand, when visiting a client’s office, a massage therapist
may not have those amenities. The working conditions depend heavily
on a therapist’s location and what the client wants.
Because massage is physically demanding, massage therapists can
succumb to injury if the proper technique is not used. Repetitive
motion problems and fatigue from standing for extended periods
of time are most common. This risk can be limited by use of good
technique, proper spacing between sessions, exercise, and in many
cases by the therapists themselves receiving a massage on a regular
Because of the physical nature of the work and time needed in
between sessions, massage therapists typically give massages less
than 40 hours per week. Therapists who give massages anywhere
from 15 to 30 hours per week usually consider themselves to be
|Training, Other Qualifications, and Advancement
Training standards and requirements for massage therapists vary
greatly by State and locality. In 2004, 33 States and the District
of Columbia had passed laws regulating massage therapy in some
way. Most of the boards governing massage therapy in these States
require practicing massage therapists to complete a formal education
program and pass the national certification examination or a State
exam. Some State regulations require that therapists keep up on
their knowledge and technique through continuing education. It
is best to check information on licensing, certification, and
accreditation on a State-by-State basis.
There are roughly 1,300 massage therapy postsecondary schools,
college programs, and training programs throughout the country.
Massage therapy programs generally cover subjects such as anatomy;
physiology, the study of organs and tissues; kinesiology, the
study of motion and body mechanics; business; ethics; as well
as hands-on practice of massage techniques. Most formal training
programs require an application and some require an in-person
interview. Training programs may concentrate on certain modalities
of massage. Several programs also provide alumni services such
as post-graduate job placement and continuing educational services.
Both full- and part-time programs are available.
These programs vary in accreditation. Massage therapy training
programs are generally accredited by a State board or other accrediting
agency. Of the many massage therapy programs in the country, about
300 are accredited by a State board or department of education-certified
accrediting agency. In States that regulate massage therapy, graduation
from an approved school or training program is usually required
in order to practice massage therapy.
After completion of a training program, many massage therapists
opt to take the national certification examination for therapeutic
massage and bodywork. This exam is administered by the National
Certification Board for Therapeutic Massage and Bodywork (NCBTMB),
which has eligibility requirements of its own. Several States
require that a massage therapist pass this test in order to practice
massage therapy. In States that require massage therapy program
accreditation, an exam candidate must graduate from a State-licensed
training institute with at least 500 hours of training or submit
a portfolio of training experience for NCBTMB review; in locations
that do not require accredited training programs, this is unnecessary.
After the applicant is approved for testing, the applicant may
schedule a test time at a local testing center. Tests are available
six or seven days a week, depending on the test site, and are
entirely computer based with multiple choice questions. The exam
covers six areas of content: general knowledge of the body systems;
detailed knowledge of anatomy, physiology and kinesiology; pathology;
therapeutic massage assessment; therapeutic massage application;
and professional standards, ethics, business and legal practices.
When a therapist passes the national certification exam for therapeutic
massage and bodywork, he or she can use the recognized national
credential: Nationally Certified in Therapeutic Massage and Bodywork
(NCTMB). The credential must be renewed every four years. In order
to remain certified, a therapist must perform at least 200 hours
of therapeutic massage during the four year period, and complete
a minimum of 48 credit hours of continuing education. In 2005,
the NCBTMB introduced a new national certification test and corresponding
professional credential. These are the national certification
exam for therapeutic massage and the Nationally Certified in Therapeutic
Massage (NCTM) credential. The new test covers the same topics
as the traditional national certification exam, but covers fewer
modalities of massage therapy. Recognition of this new national
certification varies by State.
Many of the national, State, and local requirements coincide.
States that require the national credential also require accredited
training programs to comply with NCBTMB standards of training.
Professional associations require that a professional member graduate
from a training program that meets NCBTMB standards, have a State
license, and/or have a national certification from the NCBTMB.
Actual requirements differ on a State-by-State basis.
Because of the nature of massage therapy, opportunities for advancement
are limited. However, with increased experience and an expanding
client base, there are opportunities for therapists to increase
client fees, and therefore income. Both strong communication skills
and a friendly, empathetic personality are extremely helpful qualities
for fostering a trusting relationship with clients and in turn,
expanding one’s client base. In addition, those who are well organized
and have an entrepreneurial spirit may even go into business for
themselves. Self-employed massage therapists with a large client
base have the highest earnings.
Massage therapists held about 97,000 jobs in 2004. About two-thirds
were self-employed. Of those self-employed, most owned their own
business, and the rest worked as independent contractors. Others
found employment in salons and spas; the offices of physicians
and chiropractors; fitness and recreational sports centers; and
hotels. About three-quarters of all massage therapists worked
part-time or had variable schedules, although as mentioned earlier
many massage therapists who work 15 to 30 hours per week consider
themselves to be full-time workers.
Employment for massage therapists is expected to increase faster
than average over the period from 2004 to 2014 as more people
learn about the benefits of massage therapy. In States that regulate
massage therapy, therapists who complete formal training programs
and pass the national certification exam are likely to have very
good job opportunities. Because referrals are a very important
source of work for massage therapists, networking will increase
the number of job opportunities. Joining a State or local chapter
of a professional association can also help build strong contacts
and further increase the likelihood of steady work.
Massage is an increasingly popular technique for relaxation and
reduction of stress. As workplaces try to distinguish themselves
as employee-friendly, providing professional in-office, seated
massages for employees is becoming a popular on-the-job benefit.
Increased interest in alternative medicine and holistic healing
will mean increased opportunities for those skilled in massage
therapy. Healthcare providers and medical insurance companies
are beginning to recognize massage therapy as a legitimate treatment
and preventative measure for several types of injuries and illnesses.
The health care industry is using massage therapy more often as
a supplement to conventional medical techniques for ailments such
as muscle problems, some sicknesses and diseases, and stress-related
health problems. Massage therapy’s growing acceptance as a medical
tool, particularly by the medical provider and insurance industries,
will greatly increase employment opportunities.
Older citizens who are in nursing homes or assisted living homes
are also finding benefits from massage, such as increased energy
levels and reduced health problems. Demand for massage therapy
should grow among older age groups because they increasingly enjoy
longer, more active lives and persons age 55 and older are projected
to be the most rapidly growing segment of the U.S. population
over the next decade. However, demand for massage therapy is presently
greatest among young adults, and they are likely to continue to
enjoy the benefits of massage therapy as they age.
Median hourly earnings of massage therapists, including gratuities
earned, were $15.36 in May 2004. The middle 50 percent earned
between $9.78 and $23.82. The lowest 10 percent earned less than
$7.16, and the highest 10 percent earned more than $32.21. Generally,
massage therapists earn 15 to 20 percent of their income as gratuities.
For those who work in a hospital or other clinical setting, however,
tipping is not common.
Other workers in the healthcare industry who provide therapy
to clients include physical therapists, physical therapists’ assistants
and aides, chiropractors, and workers in other occupations that
use touch to aid healing or relieve stress.
|Sources of Additional Information
General information on becoming a massage therapist is available
from State regulatory boards.
For more information on becoming a massage therapist, contact:
- Associated Bodywork & Massage Professionals, 1271 Sugarbush
Dr., Evergreen, CO 80439.
- American Massage Therapy Association, 500 Davis St., Suite
900, Evanston, IL 60201. Internet: http://www.amtamassage.org/
For a directory of schools providing accredited massage therapy
training programs, contact:
- Commission on Massage Therapy Accreditation, 1007 Church St.,
Suite 302, Evanston, IL 60201. Internet: http://www.comta.org/
- Accrediting Commission of Career Schools and Colleges of Technology,
2101 Wilson Blvd., Suite 302, Arlington, VA 22201. Internet:
Information on national testing and national certification is
- National Certification Board for Therapeutic Massage and Bodywork,
1901 S. Meyers Rd., Suite 240, Oakbrook Terrace, IL 60181.
Source: Bureau of Labor
Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2006-07 Edition