Massage Therapists

Significant Points

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.

Qualifications

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.

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.

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.

Projections Data

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.

Related Occupations

Other workers associated with the healthcare industry who provide therapy to clients include athletic trainers, physical therapists, physical therapist assistants and aides, chiropractors, and workers in other occupations that use touch to aid healing or relieve stress.

Sources of Additional Information

Source: Bureau of Labor Statistics Occupational Outlook Handbook