Occupation Profile for Massage Therapists

Massage customers for hygienic or remedial purposes. Massage therapy has a long history in cultures around the world. Today, people use many different types of massage therapy for a variety of health-related purposes.

 
 

Significant Points

  • Employment is expected to grow faster than average over the 2006-16 period as more people learn about the benefits of massage therapy.
  • Many States require formal training and national certification in order to practice massage therapy.
  • This occupation includes a large percentage of part-time and self-employed workers.

 

 
 
Overview
$33,400.00 Median Annual Wage 4,000 Average Job Openings Per Year
1.3 Average Unemployment Percentage 18.7 Percentage That Completed High School
118,000 Employment Numbers in 2006 49.1 Percentage That Had Some College
142,000 Employment Numbers in 2016 (est.) 32.2 Percentage That Went Beyond College Degree

Sample Job Titles
Bodywork Therapist
Certified Massage Therapist (CMT)
Clinical Massage Therapist
Integrated Deep Tissue Massage Therapist
Licensed Massage Practitioner
Licensed Massage Therapist
Massage Operator
Massage Therapist
Masseur
Masseuse
Massotherapist
Mechanotherapist
Medical Massage Therapist
Registered Massage Therapist
Swedish Masseuse
Therapeutic Massage Technician

Training
  • These occupations usually involve using communication and organizational skills to coordinate, supervise, manage, or train others to accomplish goals. Examples include funeral directors, electricians, forest and conservation technicians, legal secretaries, interviewers, and insurance sales agents.
  • Most occupations in this zone require training in vocational schools, related on-the-job experience, or an associate's degree. Some may require a bachelor's degree.
  • Previous work-related skill, knowledge, or experience is required for these occupations. For example, an electrician must have completed three or four years of apprenticeship or several years of vocational training, and often must have passed a licensing exam, in order to perform the job.
  • Employees in these occupations usually need one or two years of training involving both on-the-job experience and informal training with experienced workers.

In 2007, 38 States and the District of Columbia had 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 a national certification examination or a State exam. It is best to check information on licensing, certification, and accreditation on a State-by-State basis.

Education and training. Training standards and requirements for massage therapists vary greatly by State and locality. There are roughly 1,500 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. 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 approved by a State board, and may also be accredited by an independent accrediting agency. In States that regulate massage therapy, graduation from an approved school or training program is usually required in order to practice. Some State regulations require that therapists keep up on their knowledge and technique through continuing education.

Licensure. After completion of a training program, many massage therapists opt to take the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB). Many States require that therapists pass this test in order to practice massage therapy. The exam is administered by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), which has several eligibility requirements. In States that require massage therapy program approval, a candidate must graduate from a State-approved training institute or submit a portfolio of training experience for NCBTMB review to qualify for the test. In locations that do not require accredited training programs, this is unnecessary.

When a therapist passes the NCETMB, he or she can use the recognized national credential: Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). The credential must be renewed every 4 years. In order to remain certified, a therapist must perform at least 200 hours of therapeutic massage and complete continuing education requirements during this time. In 2005, the NCBTMB introduced a new national certification test and corresponding professional 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.

Recently, a second multi-State examination program has begun to take shape. The Federation of State Massage Therapy Boards offers a licensure program that is also accepted by many States.

Massage therapy licensure boards decide which certifications and tests to accept on a State-by-State basis. Therefore, those wishing to practice massage therapy should look into legal requirements for the State and locality in which they intend to practice.

Other qualifications. 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. Massage can be a delicate issue for some clients and because of this, making clients feel comfortable is one of the most important abilities for massage therapists.

Advancement. Membership in a professional massage therapy association may help therapists network and in turn, find new clients. Some of these associations require that members graduate from a nationally credentialed training program, have a State license, or be nationally certified by the NCBTMB.

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. In addition, those who are well organized and have an entrepreneurial spirit may go into business for themselves. Self-employed massage therapists with a large client base have the highest earnings.

Nature of Work

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 done by manipulating the soft tissue muscles of the body in order to improve circulation and remove waste products from the muscles.

Clients may seek massage for medical benefit or for relaxation purposes, and there is a wide range of massage treatment available to meet these distinct needs. Massage therapy that aims to improve physical health typically differs in duration and technique from massage that is intended to simply relax or rejuvenate clients. The training background of those who perform the two types of massage therapy differs as well.

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 2 hours or as short as 5 or 10 minutes. Usually, the type of massage given depends on the client’s needs and the client’s physical condition. For example, therapists may 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 to 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 giving the massage, therapists alter their approach or concentrate on any areas of particular discomfort 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 being massaged. Some types of massage are done without oils or lotions and are performed with the client fully-clothed.

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.

Work environment. 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 basis.

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. Most therapists who work 15 to 30 hours per week consider themselves to be full-time workers, because when time for travel, equipment set-up, and business functions, such as billing, are added, a massage therapist’s hours per week may very well be more than 40 hours. About 42 percent of all massage therapists worked part time and 20 percent had variable schedules in 2006.

Sources: Career Guide to Industries (CGI), Occupational Information Network (O*Net), Occupation Outlook Handbook (OOH)
Career Information

Massage Therapy is often thought of as a complementary and alternative medicine

In the United States, massage therapy is often considered part of complementary and alternative medicine (CAM), although it does have some conventional uses. This fact sheet provides a general overview of massage therapy and suggests sources for additional information.

seated massage
© Bob Stockfield

Key Points

  • Scientific evidence on massage therapy is limited. Scientists are not yet certain what changes occur in the body during massage, whether they influence health, and, if so, how. The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring studies to answer these questions and identify the purposes for which massage may be most helpful.
  • Massage therapy appears to have few serious risks if it is used appropriately and provided by a trained massage professional.
  • Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

History of Massage

Massage therapy dates back thousands of years. References to massage appear in writings from ancient China, Japan, India, Arabic nations, Egypt, Greece (Hippocrates defined medicine as "the art of rubbing"), and Rome.

Massage became widely used in Europe during the Renaissance. In the 1850s, two American physicians who had studied in Sweden introduced massage therapy in the United States, where it became popular and was promoted for a variety of health purposes. With scientific and technological advances in medical treatment during the 1930s and 1940s, massage fell out of favor in the United States. Interest in massage revived in the 1970s, especially among athletes.

Use of Massage Therapy in the United States

According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 18 million U.S. adults and 700,000 children had received massage therapy in the previous year.

People use massage for a variety of health-related purposes, including to relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and depression, and aid general wellness.

Defining Massage Therapy

The term "massage therapy" encompasses many different techniques (see box for examples). In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows, or feet.

Types of Massage Therapy: A Few Examples

In Swedish massage, the therapist uses long strokes, kneading, deep circular movements, vibration, and tapping. Sports massage is similar to Swedish massage, adapted specifically to the needs of athletes. Among the many other examples are deep tissue massage; trigger point massage, which focuses on myofascial trigger points—muscle "knots" that are painful when pressed and can cause symptoms elsewhere in the body; and reflexology, which applies pressure to the feet (or sometimes the hands or ears), to promote relaxation or healing in other parts of the body.

The Practice of Massage Therapy

Massage therapists work in a variety of settings, including private offices, hospitals, nursing homes, studios, and sport and fitness facilities. Some also travel to patients' homes or workplaces. They usually try to provide a calm, soothing environment.

Therapists usually ask new patients about symptoms, medical history, and desired results. They may also perform an evaluation through touch, to locate painful or tense areas and determine how much pressure to apply.

Typically, the patient lies on a table, either in loose-fitting clothing or undressed (covered with a sheet, except for the area being massaged). The therapist may use oil or lotion to reduce friction on the skin. Sometimes, people receive massage therapy while sitting in a chair. A massage session may be fairly brief, but may also last an hour or even longer.

Research Status

Although scientific research on massage therapy—whether it works and, if so, how—is limited, there is evidence that massage may benefit some patients. Conclusions generally cannot yet be drawn about its effectiveness for specific health conditions.

According to one analysis, however, research supports the general conclusion that massage therapy is effective. The studies included in the analysis suggest that a single session of massage therapy can reduce "state anxiety" (a reaction to a particular situation), blood pressure, and heart rate, and multiple sessions can reduce "trait anxiety" (general anxiety-proneness), depression, and pain. In addition, recent studies suggest that massage may benefit certain conditions, for example:

  • A 2008 review of 13 clinical trials found evidence that massage might be useful for chronic low-back pain. Clinical practice guidelines issued in 2007 by the American Pain Society and the American College of Physicians recommend that physicians consider using certain CAM therapies, including massage (as well as acupuncture, chiropractic, progressive relaxation, and yoga), when patients with chronic low-back pain do not respond to conventional treatment.
  • A multisite study of more than 300 hospice patients with advanced cancer concluded that massage may help to relieve pain and improve mood for these patients.
  • A study of 64 patients with chronic neck pain found that therapeutic massage was more beneficial than a self-care book, in terms of improving function and relieving symptoms.

There are numerous theories about how massage therapy may affect the body. For example, the "gate control theory" suggests that massage may provide stimulation that helps to block pain signals sent to the brain. Other examples include theories suggesting that massage might stimulate the release of certain chemicals in the body, such as serotonin or endorphins, or cause beneficial mechanical changes in the body. However, additional studies are needed to test the various theories.

seated massage
© Bob Stockfield

Safety

Massage therapy appears to have few serious risks—if it is performed by a properly trained therapist and if appropriate cautions are followed. The number of serious injuries reported is very small. Side effects of massage therapy may include temporary pain or discomfort, bruising, swelling, and a sensitivity or allergy to massage oils.

Cautions about massage therapy include the following:

  • Vigorous massage should be avoided by people with bleeding disorders or low blood platelet counts, and by people taking blood-thinning medications such as warfarin.
  • Massage should not be done in any area of the body with blood clots, fractures, open or healing wounds, skin infections, or weakened bones (such as from osteoporosis or cancer), or where there has been a recent surgery.
  • Although massage therapy appears to be generally safe for cancer patients, they should consult their oncologist before having a massage that involves deep or intense pressure. Any direct pressure over a tumor usually is discouraged. Cancer patients should discuss any concerns about massage therapy with their oncologist.
  • Pregnant women should consult their health care provider before using massage therapy.

Training, Licensing, and Certification

There are approximately 1,500 massage therapy schools and training programs in the United States. In addition to hands-on practice of massage techniques, students generally learn about the body and how it works, business practices, and ethics. Massage training programs generally are approved by a state board. Some may also be accredited by an independent agency, such as the Commission on Massage Therapy Accreditation (COMTA).

As of 2007, 38 states and the District of Columbia had laws regulating massage therapy. In some states, regulation is by town ordinance. [ Source - National Center for Complementary and Alternative Medicine ]

Earnings

Median wage and salary hourly earnings of massage therapists, including gratuities, were $16.06 in May 2006. The middle 50 percent earned between $10.98 and $24.22. The lowest 10 percent earned less than $7.48, and the highest 10 percent earned more than $33.83. 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.

As is typical for most workers who are self-employed and work part-time, few benefits are provided.

For the latest wage information:

The above wage data are from the Occupational Employment Statistics (OES) survey program, unless otherwise noted. For the latest National, State, and local earnings data, visit the following pages:

  • Massage therapists
  • Job Outlook

    Employment growth for massage therapists is expected to be faster than average for all occupations with very good job prospects, particularly for those seeking part-time work.

    Employment change. Employment for massage therapists is expected to increase 20 percent from 2006 to 2016, faster than average for all occupations. Employment will grow as more people learn about the benefits of massage therapy.

    Increased interest in alternative medicine and holistic healing will translate into new openings 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 have the greatest impact on new job growth for massage therapists.

    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.

    Older citizens in nursing homes or assisted living facilities 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.

    Job prospects. In States that regulate massage therapy, those who complete formal training programs and pass the national certification exam are likely to have very good opportunities. However, new massage therapists should expect to work only part-time in spas, hotels, hospitals, physical therapy centers, and other businesses until they can build a client base of their own. 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.

    Female massage therapists will continue to enjoy slightly better job prospects, as some clients—both male and female—are uncomfortable with male physical contact. In 2006, 84 percent of all massage therapists were female.

    Employment

    Massage therapists held about 118,000 jobs in 2006. About 64 percent were self-employed. There are many more people who practice massage therapy as a secondary source of income. As a result, some industry sources estimate that more than 200,000 people practice massage therapy in some capacity.

    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. While massage therapists can find jobs throughout the country, employment is concentrated in metropolitan areas, as well as resort and destination locales.

    Knowledge
    • Mathematics — Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
    • Engineering and Technology — Knowledge of the practical application of engineering science and technology. This includes applying principles, techniques, procedures, and equipment to the design and production of various goods and services.
    • Sales and Marketing — Knowledge of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.
    • Medicine and Dentistry — Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.
    • Physics — Knowledge and prediction of physical principles, laws, their interrelationships, and applications to understanding fluid, material, and atmospheric dynamics, and mechanical, electrical, atomic and sub- atomic structures and processes.
    Skills
    • Equipment Maintenance — Performing routine maintenance on equipment and determining when and what kind of maintenance is needed.
    • Coordination — Adjusting actions in relation to others' actions.
    • Active Learning — Understanding the implications of new information for both current and future problem-solving and decision-making.
    • Writing — Communicating effectively in writing as appropriate for the needs of the audience.
    • Troubleshooting — Determining causes of operating errors and deciding what to do about it.
    Abilities
    • Near Vision — The ability to see details at close range (within a few feet of the observer).
    • Stamina — The ability to exert yourself physically over long periods of time without getting winded or out of breath.
    • Explosive Strength — The ability to use short bursts of muscle force to propel oneself (as in jumping or sprinting), or to throw an object.
    • Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.
    • Hearing Sensitivity — The ability to detect or tell the differences between sounds that vary in pitch and loudness.
    Tasks
    • Core — Treat clients in professional settings or travel to clients' offices and homes.
    • Core — Consult with other health care professionals, such as physiotherapists, chiropractors, physicians, and psychologists, to develop treatment plans for clients.
    • Core — Prepare and blend oils and apply the blends to clients' skin.
    • Core — Confer with clients about their medical histories and problems with stress or pain to determine how massage will be most helpful.
    • Core — Massage and knead muscles and soft tissues of the body to provide treatment for medical conditions, injuries, or wellness maintenance.
    Activities
    • Monitoring and Controlling Resources — Monitoring and controlling resources and overseeing the spending of money.
    • Guiding, Directing, and Motivating Subordinates — Providing guidance and direction to subordinates, including setting performance standards and monitoring performance.
    • Assisting and Caring for Others — Providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients.
    • Repairing and Maintaining Electronic Equipment — Servicing, repairing, calibrating, regulating, fine-tuning, or testing machines, devices, and equipment that operate primarily on the basis of electrical or electronic (not mechanical) principles.
    • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
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