By Fatskills Exam Guides Team — the exam nerds behind 28,500+ quizzes and 2.1M practice questions across 500+ global exams.
Key Topics: - Therapeutic modalities - Work flexibility - Licensing requirements - Federation of State Massage Therapy Boards (FSMTB) - National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) - Job responsibilities - Personal traits - Work environments - Tools of the trade - Education - Salary and benefits - Advancement opportunities - Related occupations
A massage therapist is a health practitioner who manipulates the muscles and soft tissues of a client’s body to affect a positive physical outcome for the client.
Massage is a popular means of relaxation that also improves body circulation, relieves anxiety and stress, reduces muscle soreness and pain, promotes a greater range of motion in the joints, and facilitates a variety of other health benefits.
If you are interested in massage therapy as a career, you will find this field to be an excellent way to provide the type of meaningful personal services that can genuinely improve quality of life for other people. You will learn how to use your personal qualities and strengths to directly affect how other people are feeling. You will use your hands and fingers to touch others with a high degree of care and consideration. As you learn about this new career field, you will come across many new concepts and terms. For example, some people refer to their work as massage therapy while others call it bodywork. Although these terms are sometimes used interchangeably, massage therapy is generally a legally protected term that cannot be used by a practitioner unless he or she has been granted a massage therapy license from the state of residence. Bodywork is more of an umbrella term, encompassing a wider variety of alternative therapies and holistic practices.
Massage therapy tends to focus on soft tissue work, relaxation, and the relief of physical symptoms, while bodywork might focus not only on physical relief but also on promoting emotional and spiritual wellness and helping clients achieve a greater mind-body connection.
Therapeutic Modalities When you think about the practice of massage, you probably picture a room in a day spa, dim lighting, soft music, aromatic oils, and a body skillfully kneaded and stroked into a state of great relaxation. The techniques pictured in this scenario are known as Swedish massage and are sometimes called traditional or Western massage therapy.
Swedish massage is the most popular, well-known style of massage. Swedish massage techniques use long gliding movements along with kneading, compressing, and rocking of the body. Swedish massage is the practice you will learn in massage school, and you will find that it forms the basis of many other massage treatments as well.
What Is a Modality? As you launch your career as a massage therapist, you will come across the term modality quite frequently. Modality is most often used to describe various broad categories of massage theory or technique, such as Swedish massage, myofascial therapy, connective tissue massage, and so on. The word modality is also used to refer to a narrower, more specifically defined therapeutic practice, such as Rolfing® or the Feldenkrais Method. To further confuse matters, modality can also describe a specific application of tools or materials in the healing process, such as thermal modalities (hot/cold therapy) or electromagnetic modalities (practices such as infrared or ultrasound). This latter treatment of the term is derived from the physical therapy and chiropractic fields, where its usage is more specifically defined.
The bodywork field is wide and quite varied. At least eighty individual techniques can be identified in current practices, and some of these are of quite ancient origin. Some therapists are generalists while others are trained and certified to offer more advanced techniques. Some therapists even combine different techniques to form their own unique style. However, at any time, the type of massage provided is driven by the therapist’s education and experience and the needs of the client. Some of the more commonly practiced techniques are outlined below. Most of these techniques are beyond the scope of an entry-level therapist and are unlikely to be part of your initial training, but they are practices with which you may want to become more familiar through advanced training opportunities. - Acupressure: During an acupressure session, the fingers are used to press key healing points in the client’s body. Acupressure reduces muscular tension, increases circulation, relieves pain, and enables the client to achieve states of deep relaxation. Acupressure is focused on balancing body energy and facilitating both spirituality and physical health. - Connective tissue massage (CTM): CTM techniques are designed to release the connective tissue (commonly referred to as myofascial tissue) in the body and break up scar formations. CTM practitioners believe this therapy relieves chronic tension, facilitates greater range of motion, promotes the attainment of deep relaxation states, and even improves client posture. - Deep tissue massage: During a deep tissue massage, slower strokes are applied with deeper pressure to access and realign underlying layers of muscles and connective tissue. Deep tissue massage is particularly helpful for areas afflicted with tension and chronic pain, such as a stiff neck, tight hamstrings, a tense lower back, sore shoulders, and so on. - Hot stone therapy: Hot stone therapy involves the placement of flat heated stones at specific sites on the client’s body. River stones are generally selected for this type of therapy due to their smooth surface. The stones retain heat because they are made of basalt, a type of rock that is rich in iron. (Useful fact: iron conducts heat.) Hot stone massage alleviates stress, promotes relaxation, and opens the body’s meridians, or energy pathways, forging a stronger sense of wellness in the client. - Myofascial (trigger point) therapy: Myofascial, or trigger point, therapy focuses on relieving chronic pain by working on the myofascial trigger points in the body. Myofascial literally refers to muscle tissue (myo) and the connective tissue that surrounds it (fascia). - Neuromuscular therapy (NMT): NMT is a type of soft tissue manipulation that focuses on correcting imbalances among the nervous, immune, and musculoskeletal systems. NMT therapists use their fingers, knuckles, elbows, and tools such as pressure bars to stretch, lengthen, and strengthen muscles. - Reflexology: During a reflexology session, the reflexologist applies varying degrees of pressure to the client’s hands and feet using specialized techniques. - Prenatal massage: Prenatal massage techniques are practices expressly designed to meet the special needs of pregnant women. Prenatal massage can help relieve back pain and other discomfort or soreness related to pregnancy. - Shiatsu massage: Shiatsu massage is a popular technique in which specific pressure is applied to the client using the fingers, palms, and thumbs. Shiatsu massage practices can vary widely as they rely on a combined knowledge of physiology, traditional Japanese massage, and Chinese medicine. - Sports massage: Sports or athletic massage is a specialized form of therapy that is utilized before, during, and/or after an athletic event. This type of massage is designed to prevent injuries by relieving swelling, reducing muscle tension, and promoting flexibility during or after an athletic event.
Work Flexibility One of the benefits of working as a massage therapist is the flexibility you have with where you work and who you work with. Therapeutic massage opens many career options because it is conducted in a number of different settings for a number of different purposes. - Hospitals, medical centers, and clinics frequently offer massage therapy services to patients in order to minimize patient stress and discomfort during illness or while recovering from injury and surgery. - Nursing homes and assisted living centers provide therapeutic massage to their elderly residents to relieve residents’ chronic pain, decrease muscle stiffness caused by age and/or limited activity, and increase general mobility. - Sports facilities and physical therapy centers focus on providing deep tissue massages for targeted areas of the body or on relieving general muscular tightness that occurs as a normal part of physical fitness training. Sports therapists also concentrate on injury rehabilitation, usually with the collaboration of other health-care providers such as physicians and physical therapists. - Cruise ships, spas, resorts, and similar venues offer massage as a luxury treatment or service for their clientele. Massage therapy is a burgeoning career field with many options available to suit all kinds of lifestyles, needs, and interests. Which option seems the most interesting to you?
Licensing Requirements As with many other professional occupations, most massage therapists are required to be licensed by their state or local government before they are allowed to practice. Licensing is the means by which the industry is regulated and the public protected from predatory business practices. Licensing provides some assurance that parties offering particular services are actually qualified to render them. Operating without a license when one is required is considered a criminal act punishable by law.
Note: Throughout this discussion, we use the word state to describe the level of the government body that regulates the practice of massage therapy. This term is used for ease of reference; in actuality, local ordinances may also apply. Therefore, the term state is meant to be inclusive of any regulatory body at any level of government responsible for setting standards for practicing massage therapists.
Today, no single national standard or process is in place to manage the licensing and practice requirements for all members of the massage and bodywork professions. Rather, standards and requirements vary—sometimes quite dramatically—by geographic location. For an aspiring therapist, this means the minimal requirements you must meet in order to practice may differ depending on where you intend to practice. Requirements may vary at the state, county, or even municipal level. Due to this variability, you will find the greatest opportunities for success by making sure you are aware of all requirements before you launch your massage career. Although every state has its own rules and regulations regarding the practice of massage therapy, most state regulatory bodies require therapists to become licensed before opening for business. Licensing means the aspiring therapist is formally approved to practice by the regulatory board that oversees the profession in that location. As part of this process, you will apply for a license by providing personal and professional information such as number of education hours, work experience, character references, and so on. Most regulatory boards compel you to possess a minimal amount of education and/or experience in order to be licensed. You may also have to demonstrate entry-level skill by taking and passing a written examination. In addition, you will probably need to undergo both credit and criminal background checks. Note that most regulatory boards also require you to renew your license at some regular interval (annually, for example).
Note: Before launching your massage therapy career, it is critical to understand the laws and regulations in place in your state. Please make sure you familiarize yourself with any and all regulations that apply.
Each state can select the examination it uses in the licensing process. This examination can be one that has been developed by the state in question, or it might be one of the examinations available through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) or the Federation of State Massage Therapy Boards (FSMTB). The most-used examinations for licensing purposes are the National Certification Examinations for Therapeutic Massage and Bodywork (NCETMB) offered by NCBTMB and the Massage and Bodywork Licensing Examination (MBLEx) offered by the FSMTB. Because licensing requirements vary so much by location, it is important that you understand those that apply to you.
Federation of State Massage Therapy Boards (FSMTB) The Federation of State Massage Therapy Boards (FSMTB) was created in 2005 to “ensure that the practice of massage therapy is provided to the public in a safe and effective manner.” The FSMTB is made up of state regulatory boards who manage the rules and regulations of the massage profession at the state level (the Pennsylvania State Board of Massage Therapy or the California Massage Therapy Council, for example) as well as other agencies that have a vested interest in the profession. Besides its mission to protect the public from predatory or dangerous practices, FSMTB also exists to protect the needs of the regulatory community. By providing the means by which state boards can participate in the decisions that ultimately affect the way the profession is managed, FSMTB gives the individual boards a voice in the process even as standardization becomes the norm across the country. The mission of FSMTB is to facilitate consistency in both the scope of practice and entry-level standards across the country; develop a valid, reliable licensing exam that will be accepted by all jurisdictions; and create a single database to store licensing and disciplinary information across all jurisdictions.
Massage and Bodywork Licensing Examination (MBLEx) As part of its mission to serve the interests of its member boards, FSMTB developed the Massage and Bodywork Licensing Examination (MBLEx). The MBLEx has been carefully designed to reflect current standards of professional practice across the country. MBLEx content was developed from an extensive job task analysis survey conducted across the country and further validated by input from nearly 8,000 practicing professionals. The MBLEx is currently accepted by 29 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. This wide acceptance gives the FSMTB and state member boards considerable control over the national entry-level standards for the profession as well as the ability to oversee and standardize the licensing process. For participants, the connection between the FSMTB and the state regulatory boards means a shorter process from application to examination to licensing. In addition, it is easier to move your practice from one location to another, since the examination is recognized by the regulatory boards of so many different locations. FSMTB also provides the means by which you can easily share your exam results with states other than the one in which you originally tested.
Examination Content The foundation for the MBLEx is actual practice, meaning that the core competencies, skills, and knowledge being tested have been identified by current practitioners as necessary for safe and effective entry-level practice. The MBLEx covers a variety of subject matter areas from assessment and treatment to ethical practices and the benefits of soft tissue work. The examination content breaks down as follows: - Overview of massage and bodywork history/culture/modalities: 5 percent - Guidelines for professional practice: 10 percent - Kinesiology: 11 percent - Ethics, boundaries, laws, regulations: 13 percent - Pathology, contraindications, areas of caution, special populations: 13 percent - Anatomy and physiology: 14 percent - Client assessment, reassessment, treatment planning: 17 percent - Benefits and physiological effects of soft tissue techniques: 17 percent
Eligibility Requirements You can request to take the MBLEx in two different ways: 1. Applying directly to the Federation of State Massage Therapy Boards (FSMTB). (Submitting an application directly to FSMTB does not guarantee your eligibility to take the examination. Your application will be reviewed by FSMTB personnel. You will then be notified by FSMTB as to your eligibility.) 2. Applying via your state regulatory board/agency.
Apply to FSMTB To apply for the examination directly to FSMTB, complete the MBLEx application, either by filling out and mailing in a paper form or by completing the application online. Both options are available from the FSTMB Web site (www.fsmtb.org).
You will be required to do the following: - Confirm your review and understanding of the content outline. - Include information about your massage/bodywork education. - Agree to abide by FSMTB’s policies and procedures. - Indicate the state in which you intend to practice, so your exam results can be sent to the correct regulatory board. - Pay the required fee, by certified check/money order, Visa, or MasterCard.
Apply via Your State Regulatory Board To apply for the examination via your state’s regulatory board, first check the state’s Web site to make sure the state allows you to apply through them. Unless your state board directs you to proceed otherwise, you will then do the following: - Apply for your license. You will need to meet all of the requirements in your state/location. You will have to provide all necessary documentation, school transcripts, etc., before you will be allowed to schedule the MBLEx. - Agree to abide by FSTMB’s policies and procedures. - Pay the required fee, by certified check/money order, Visa, or MasterCard.
Educational Requirements FSMTB does not set a minimum number of educational hours to be completed in order to be eligible for taking the MBLEx. Instead, FSMTB allows each individual state regulatory board to continue determining the number of educational hours appropriate for practice in that state. National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) The written examinations offered by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) are accepted for licensing in over 39 states, the District of Columbia, and various local licensing bodies. Along with being accepted as part of the licensure process, successful completion of either of NCBTMB’s examinations confers national certification on the test-taker. NCBTMB was founded in 1992 to “define and advance the highest standards in the massage therapy and bodywork profession.”
As a private, independent organization, NCBTMB strives to - establish national certification as a recognized credential of professional and ethical standards. - promote the worth of national certification to health, therapeutic massage and bodywork professionals, public policymakers, and the general public. - assure and maintain the integrity, stability, and quality of the national certification program. - periodically update the program to reflect state-of-the-art practices in therapeutic massage and bodywork.
As part of its mission to promote national standards for the massage and bodywork professions, the NCBTMB offers massage therapists and bodyworkers two different national certification examinations. 1. National Certification Examination for Therapeutic Massage (NCETM) 2. National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) To take either of these examinations, you must meet certain eligibility requirements. In addition, the examination you opt to take depends upon your expertise and areas of interest as well as requirements set by your local regulatory body.
Which Exam Is Right for You—NCETMB or NCETM? If you choose to become certified via NCBTMB, you will need to indicate if you wish to take the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) or the National Certification Examination for Therapeutic Massage (NCETM). Both examinations are sponsored by NCBTMB and successful completion of either results in the granting of national certification by NCBTMB. However, some important differences exist. First, the content of the exams differ. While neither examination covers specific massage or bodywork techniques in depth, they both measure related knowledge and skills required to practice massage and/or bodywork competently at the entry level. The questions on the NCETM focus exclusively on those subject areas related to the practice of massage therapy (i.e., soft tissue manipulation). The questions on the NCETMB, on the other hand, cover all of the subject areas from the NCETM plus additional questions about the assessment and application of other types of bodywork. This broader focus is meant to give you the opportunity to demonstrate a deeper level of therapeutic expertise. In addition, it simplifies the certification process since you only have to take one examination and maintain a single certification.
The content breakdown of the examinations also differs slightly. It looks like this:
NCETMB - General knowledge of body systems: 16 percent - Anatomy, physiology, kinesiology: 19 percent - Pathology: 13 percent - Therapeutic massage & bodywork assessment: 18 percent - Therapeutic massage & bodywork application: 22 percent - Professional standards, ethics, business and legal practices: 12 percent
NCETM - General knowledge of body systems: 16 percent - Anatomy, physiology, kinesiology: 19 percent - Pathology: 13 percent - Therapeutic massage assessment: 16 percent - Therapeutic massage application: 24 percent - Professional standards, ethics, business and legal practices: 12 percent
Second, and this is important, not all regulatory bodies recognize the NCETM. This means that even if you pass the NCETM, if your state’s regulatory board does not accept it as part of its conditions for licensing, you will not qualify for a license in that state. This type of variability is one of the reasons you must make sure you understand the requirements of the location where you intend to practice before registering for or taking any examination.
Eligibility Requirements You must meet the following minimum requirements in order to take either of the national examinations: - You must be at least 18 years of age at the time of testing. - You must agree to a background check. - You must agree to abide by NCBTMB’s professional standards for behavior, as outlined in the NCBTMB Standards of Practice and Code of Ethics. - You must possess the appropriate level of education and/or experience to demonstrate mastery of core skills, abilities, and knowledge at the entry level. This requirement can be met in one of three ways:
1. Education/Training You must satisfactorily complete a minimum of 500 hours of formal instruction from an NCBTMB-assigned institution. Satisfactory completion generally means you have achieved a passing grade in all courses and have successfully graduated from the program. At a minimum, your instruction should include the following:
2. Portfolio Review Process The portfolio review process is for individuals who have attended school outside of the United States or for those persons who have trained at institutions that are not designated as NCBTMB-assigned schools. The portfolio review process involves an individualized review of your education and experience. If you intend to pursue this option, you can find more information and complete instructions on this option on the NCBTMB Web site.
3. National Examination for State Licensing (NESL) Option The National Examination for State Licensing (NESL) option is available for individuals who plan to practice in states that recognize the validity of NCBTMB exams but do not require applicants to become certified by NCBTMB in order to be licensed. The primary difference with the NESL option is that it allows the individual to take either of the national examinations at any time during the student’s training. (In other words, you generally do not need to graduate from your training program before taking the exam.) Successfully passing the examination allows you to become immediately eligible for licensing in your location, as long as you have met all other requirements set by the regulatory body in question. If you pursue the NESL option, under certain circumstances, you can later convert this to full certification.
NCBTMB Code of Ethics and Standards of Practice Massage therapy and bodywork present unique challenges to practitioners due to the close physical contact inherent in therapist-client relations. To ensure that all NCBTMB members understand and follow appropriate standards of professional conduct, the NCBTMB has developed both a formal code of ethics as well as standards for professional behavior. A code of ethics outlines the ethical and moral standards and practices members of a sponsoring organization are expected to uphold. The NCBTMB Code of Ethics deals specifically with many of the challenges massage therapists and bodyworkers face on the job. Standards of practice provide a blueprint for expected professional conduct. According to the NCBTMB Standards of Practice, these are “the guiding principles by which certificants and applicants for certification conduct their day-to-day responsibilities within their scope of practice. These principles help to assure that all professional behaviors are conducted in the most ethical, compassionate, and responsible manner.”
Note: NCBTMB-assigned schools are those institutions that meet the operational and educational standards developed by NCBTMB. These institutions have been carefully reviewed by NCBTMB and formally designated as NCBTMB-assigned. You can locate a list of NCBTMB-assigned schools on the NCBTMB Web site (www.ncbtmb.org).
The NCBTMB Standards of Practice address the following key areas: - Professionalism - Legal and ethical requirements - Confidentiality - Business practices - Roles and boundaries (including the forbidding of sexual contact)
As part of the certification process, certificants must pledge to uphold both the NCBTMB Code of Ethics and the NCBTMB Standards of Practice. For your convenience, these items are reprinted in full in Appendix A: NCBTMB Code of Ethics and Standards of Practice. You should familiarize yourself fully with the expectations and requirements to which you will be expected to conform in your practice. If ethical violations are alleged against an individual certified by NCBTMB, a committee will carefully examine the charges and determine the appropriate action. Depending upon what comes out of this review, the committee might dismiss the case, issue letters of warning or reprimand, place the individual on probation, require retraining in particular areas of practice, suspend the certificant’s membership in NCBTMB, or revoke certification altogether. In the event of serious violations, NCBTMB is empowered to turn the case over to the appropriate law enforcement officials.
Job Responsibilities Now that you know a little about the profession, understand the degree of variability that exists in regulatory requirements, and recognize the benefit of successfully completing one of the national examinations, you are probably wondering, what is it that a massage therapist actually does? Massage therapy is a client-centered profession focused on general health and well-being. While the goals of individual clients differ, generally most clients are looking for relief from stress, pain, or general anxiety; they are hoping to find tools to help them relax or better manage a chronic physical condition; or they may simply want to indulge in an hour or two of personal pampering. Some therapists, such as those who work for spas or resorts, work from a limited menu of services. Clients select the treatment they would like and this is administered by the therapist during the session. Typical services offered in such environments include Swedish massage, shiatsu massage, deep tissue massage, hot stone therapy, and others. The therapist will then customize the service as necessary so it is appropriate for the physical condition of the client. Other therapists, such as those who are self-employed or those who work in institutional settings like hospitals and assisted living centers, are expected to first conduct a more formal assessment of the individual. In an institutional setting, this intake interview is often coordinated with other caregivers such as physicians and physical therapists. The therapy to be administered is then planned in an individualized manner as part of the holistic treatment plan for the particular client-patient. To administer treatment, therapists use their fingers, hands, forearms, and elbows to work superficially or more deeply on a client’s body. The therapist can and frequently does employ any number of massage techniques based on his or her education as well as what the client needs or wants. Therapists also employ other agents during these sessions, including lubricants such as oils or lotions; assistive devices such as vibrators and massage wheels; thermal agents including hot or cold therapy packs; and so on.
Some of the duties you can expect to complete once you are ready to practice include: - Assessing and documenting the client’s condition and needs by completing/reviewing client intake forms, observing the client’s posture and movement patterns, palpitating the client’s body, formally assessing the client’s range of motion, and possibly consulting and coordinating with other care providers - Using this information to determine if massage therapy/bodywork is indicated or if the client would be better served by referral to another type of health-care practitioner - Developing an individualized treatment plan based on assessment findings - Understanding and accurately performing standard soft tissue massage techniques:
- Facilitating treatment by applying friction-reducing products such as oils, gels, lotions, creams, powders, rubbing alcohol, liniments, antiseptics, ointments, or other preparations - Utilizing hot and cold applications such as heat lamps, compresses, ice or hot packs, or hot stones - Applying other topical nonprescription treatments such as herbs, salts/sugars, poultices, and mudpacks - Using assistive tools and/or electric massagers as needed - Utilizing aromatherapy as appropriate - Drawing on other techniques to enhance the client’s overall wellness and facilitate the feeling of wholeness or the mind/body connection - Following ethical business practices, such as fully explaining procedure risks and benefits to clients, allowing clients to stop treatment at any time, maintaining appropriate professional boundaries, acting in an ethical manner, complying with all current health legislation, securely storing patient records, and responding appropriately to insurance companies as required
Personal Traits One of the characteristics that makes massage therapy such a unique profession is the connection between the massage therapist and the client. This connection is called a therapeutic relationship. It is therapeutic in the sense that your goal is to effect a positive change in the client’s health and well-being. It is a relationship in that it produces the most positive outcomes when both you and the client feel safe and comfortable in relation to each other. Touch transmits feelings and intentions to and from the giver and recipient on both conscious and unconscious levels. If you are operating out of altruistic love and a real desire to help people, your clients will sense this. However, if you are operating from some other motivation, your clients will also sense that. Even if he or she does not consciously realize it, if the client has felt on some level that you do not have his or her best interests at heart, that person is less likely to become a regular in your practice or to recommend you to others. People like you who are interested or involved in health-care–related careers tend to choose such paths not only because of interest in the well-being of others, but also because they (and you) have a strong sense of empathy and compassion. This is especially true in massage and bodywork fields, where success is almost entirely based on the ability to produce meaningful change in others through your sense of touch.
The most successful massage therapists and bodyworkers possess most or all of the traits described here. - Patience: To perform bodywork effectively, you must be patient and comfortable taking the time to carry out the treatment successfully. Rushed bodywork has limited benefits and a rushed client is unlikely to return for repeat business. - Calm demeanor: Because one of the key benefits of massage therapy is relaxation, clients need to be able to reach a comfortable, tranquil state. Your demeanor before and during treatment will either facilitate or impair the client’s ability to relax. In addition, a calm demeanor is especially effective when dealing with clients who are nervous or agitated. - Effective communication skills: Good communication skills are essential in any profession, but especially so in those that are other-centered like massage. It is critical to practice active and reflective listening skills so that you really hear and understand what clients are telling you verbally or otherwise as they share their issues with you. In addition, if you wish to be self-employed, it is important to develop an authentic rapport with your client base. - Good general health: Bodywork is a wellness-oriented career; therefore, it is assumed that individuals interested in working in it have a good understanding of wellness that they apply to themselves. You will be most inspiring to others if they sense that you take as good care of yourself as you promise to take of them. - Physical strength and dexterity: Bodywork is a physical profession. It requires you to stand on your feet for extended periods of time. It requires you to use your body as a tool to administer treatment to others. You must be able to utilize your hands, fingers, elbows, and forearms when working on clients; therefore, physical stamina and manual dexterity are very real requirements. - Flexibility: Because massage therapists frequently deal with a cross-section of the public, you can expect to encounter many different types of people. A good massage therapist is skilled at making anyone comfortable no matter the client’s personality type. In addition, clients may have specific needs that require you to adjust your approach. You need to be able to think on your feet and adapt to the needs of the person on your table. - Professionalism: Last but certainly not least, therapists and bodyworkers should possess a high degree of professionalism. Clients will be mostly unclothed in your presence and they need to be confident that you are not judging them, gossiping about them with others, or looking at them in an inappropriate way. Making offensive remarks about the client’s physical or emotional state or about other clients’ physical or emotional states will teach people that you are not worthy of their trust. In addition, over-sharing personal information about yourself or acting in a belittling way will make it difficult for clients to relax in your presence. It is necessary to remain objective, personable, and approachable while avoiding the temptation to chat or become friends. Your office should be run as a business, not a social club.
Work Environments Massage therapy is a burgeoning career field offering opportunities in a wide array of settings, both private and public. Factors that influence where you might work include your degree of education/training, your professional interests and goals, and your lifestyle choices. - Independent practitioners provide services to the community at large. If you go into business for yourself, you may own or rent a dedicated facility and/or travel to your clients’ homes or workplaces. - Therapists in fitness centers or sports facilities work with amateur and professional athletes to improve athletic performance and prevent or rehabilitate injuries. If you work in a fitness center or sports facility, you will have many opportunities to work with people who are interested in athletics or general physical fitness. - Therapists in hospitals or medical clinics provide palliative (soothing) care for patients with particular injuries or conditions, such as cancer patients in an oncology clinic. This career field requires a high degree of patience, empathy, and interest in others. - Therapists in other types of clinics are generally geared toward injury rehabilitation. For example, if you work in a physical therapy clinic, your services will be used to help clients regain range of motion or otherwise rehabilitate from injury or illness. - Therapists in multidisciplinary health centers might offer a holistic, integrated health-care experience in conjunction with acupuncturists, medical doctors, physical therapists, chiropractors, psychotherapists, or alternative health-care providers. - Therapists in airports or shopping malls provide chair massage for travelers, with a focus on providing brief stress relief and relaxation. Clients remain fully clothed and receive massage on the back, neck, shoulders, arms, and/or hands. - Therapists in spas generally offer an array of relaxation services designed to pamper, invigorate, and refresh clientele. - Therapists in retreat centers work with participants on self-actualization activities and fostering a stronger mind-body connection.
Tools of the Trade Once you begin working in the field, you will use a variety of tools and equipment in your work. Many specialties include specialized tools specific to the discipline. What follows are some of the more common tools and pieces of equipment you will need to become familiar with as a massage therapist. - Massage tables: A quality massage table is one of the most fundamental pieces of equipment for the massage therapist. Massage tables should be comfortable for the client and ergonomically correct for the therapist’s body, which means they should be the correct height and width to give you access to the client without being overstretched. Tables should be able to support the client’s weight even while you are exerting strength on it during various therapeutic techniques. If you are an independent practitioner and intend to travel to client locations, the table should also be easy to set up and break down and lightweight. Generally, the type of practice and volume of clients play a large role in determining the type of massage table required. - Massage chair: Traveling therapists or those who work in airports or shopping malls sometimes utilize massage chairs to provide bodywork to clients. Some standard features include wheels, removable kneepads, and side-entry access for the elderly and women wearing dresses or skirts. - Linens and pillows: Surprisingly, you’ll find that appropriate linens are an important aspect of your practice as they provide the client with both warmth and modesty and contribute to the feeling of luxury. Part of your training involves learning to drape clients appropriately so the more personal aspects of their bodies remain covered and only the part you are working on is exposed. Pillows give support to the head and neck when the client is in a reclined position, either facedown or face-forward. Pillows come in a variety of shapes and sizes. Since you’ll be working with many different body shapes and sizes, you may need to have several pillows on hand. - Lubricants and emollients: Oils, creams, gels, and lotions allow easier movement of your hands over the client’s body. Oils are frequently warmed prior to use, so you should be familiar with the operation of a warmer machine. Therapists select oils or lotions for their practice based on personal and professional preference. It is important to use products formulated specifically for bodywork as these are the least likely to irritate the client’s skin or cause allergic reactions. In addition, the selected product(s) should not have an excessively strong odor as these may sicken either the client or you. Finally, you may also work with lubricants designed specifically for special conditions or particular body parts. For example, at some point in time, you might use foot/leg lotion, cuticle oil, sunburn creams, and others. - Aromatherapy oils: Massage therapists with advanced training might incorporate aromatherapy into their sessions. Aromatherapy is the practice of inhaling the aroma of essential oils extracted from flowers and plants. Aromatherapy is widely believed to enhance psychological and physical well-being by stimulating brain function and promoting whole-body healing. Safety precautions must be followed and consent from the client is required. - Hot stones: Hot stone massage is a therapeutic technique that involves placing smooth, heated flat stones on key points along the body. The heat warms and softens the tissues, allowing the therapist to work effectively while providing the client with a sense of deep relaxation. The warmth also improves circulation and calms the nervous system. Stone therapy requires the use of stones and an electric heating device, which assures they are within a safe temperature range. - Assistive tools: A variety of electric and handheld tools is available to support any number of therapeutic approaches. These tools can facilitate the goals of the session while minimizing the therapist’s risk of hand injury. Handheld tools are commonly used to apply concentrated pressure to trigger points in the body and act as percussion instruments to promote deep muscular relief. - Thermal agents: Hot (thermotherapy) and cold (cryotherapy) agents are used to soothe inflammation, relieve pain, improve range of motion, reduce joint stiffness, and accelerate healing. Commonly used thermal agents include ice packs, cold gel packs, heat packs, heat lamps, and moist heat packs. The use of such items is dependent upon the therapeutic setting and the goals of the session as well as the therapist’s level of education and training. It is important to understand how these agents work on the body so that the appropriate one is selected for the client’s condition.
Education As you already learned, educational requirements for massage therapists vary greatly by location. However, most states require aspiring massage therapists to complete some type of formal education program before they are licensed to practice. The actual number of educational hours varies by state and is usually a reflection of licensure requirements. This number can vary from 200 hours to over 1,000 hours. Topics covered include anatomy and physiology, kinesiology, ethics, general business management, and hands-on massage techniques. Practitioners are also required to complete a certain amount of continuing education (CE) courses each year (or every two to three years) to maintain standing. As with any career training, it is important for potential students to select a school that is appropriately accredited. Accreditation indicates the school has met at least the minimal educational standards that qualify graduates to practice professionally or to continue their studies at a more specialized/advanced institution. Many schools are accredited by the states in which they are located. You should make sure any school you are considering is accredited by the state. In addition, many schools also choose to be accredited by a voluntary regulating body, such as the Commission on Massage Therapy Accreditation (COMTA) or the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). This level of accreditation indicates the school’s program meets the rigorous standards set by the accrediting organization. These organizations seek to promote the standardization and professionalism of the massage and bodywork fields. This level of accreditation means the school and the program have undergone and passed a stringent review process. As mentioned earlier in the text, many states require massage therapy practitioners to be licensed to practice. Licensure requirements vary by state, but most compel the candidate to possess a certain amount of education and experience as well as attain a passing score on a written examination. The examination is meant to demonstrate that the candidate possesses the appropriate professional knowledge to practice at the entry level. The examination may be one that has been developed by the state, or it may be one of the examinations offered by other bodies: the Massage and Bodywork Licensing Examination (MBLEx), the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB), or the National Certification Examination for Therapeutic Massage (NCETM). Check Appendix C: Helpful Resources for more information on finding specific requirements for your location.
Salary and Benefits According to the U.S. Department of Labor, the job outlook for the bodywork field is excellent. It is likely you will be able to find work immediately after completing your training and becoming licensed in your state. In addition, the rate of growth for this occupation is expected to increase faster than the average for all occupations. In 2006, 118,000 massage therapists were in the workforce; by 2016, it is anticipated the workforce will consist of 142,000 massage therapists, which represents a growth rate of about 20 percent. Obviously, this is a promising field for aspiring therapists. The salary outlook is quite positive, although pay can vary greatly based on - geographic location. - years of experience and knowledge of specialties. - employment status (if you work for yourself or for someone else). - type of facility (if you work for someone else). - per-massage pricing/ability to collect tips.
Massage therapists generally work either by the hour in a facility or on a per-massage basis if they are self-employed or working for a spa or resort. According to the U.S. Department of Labor, the top 10 percent of massage therapists, who tend to be self-employed massage therapists with a large client base built over time, earn upward of $69,000. The bottom 10 percent of therapists earn an average of $16,000—these are generally entry-level workers fresh out of school. On average, a massage therapist with a reasonable amount of experience and training can expect to earn about $35,000 annually. If you are employed on the staff of a facility such as a spa, hospital, or sports clinic, you may be eligible for typical employment benefits: - Sick leave - Vacation pay - Holiday pay - Health benefits - 401k plan If you are self-employed and/or if you contract your services to other facilities, generally the only employment benefits you receive will be those you grant yourself. This lack of benefits, however, is offset by the ability to make a full-time wage working part-time hours and by the convenience of setting your own hours and working at those times that are most convenient for you.
Advancement Opportunities Many massage therapists work only part-time because of the physical demands of the work; it would be physically exhausting to perform massages 40 hours a week! Because it is possible to pursue this work quite effectively on a part-time basis, some people choose to become massage therapists as a secondary career and source of income. Advancement opportunities as we typically think of them are somewhat limited in this field due to the nature of the work; however, advancement is possible and can be achieved by gaining experience and pursuing advanced knowledge and skills. The most successful massage therapists work for themselves, pursue educational opportunities, and have acquired a significant number of clients over time.
Related Occupations Massage therapists provide services that focus on human movement patterns and the physical well-being of their clients. Some other occupations provide similar types of services. - Personal (sports) trainers: Personal trainers provide individualized fitness instruction to clients looking for exercise programming tailored to their specific needs. Trainers assess the fitness level of clients and monitor their progress over time to ensure the programming is working as designed. Personal trainers usually work directly with clients to motivate them and make certain they are performing exercises safely and in the correct sequence. Sessions are typically conducted at health clubs or in the client’s own home. Some trainers work with individuals who are physically challenged by medical conditions or those who are rehabilitating from specific kinds of injuries. Some personal trainers are even certified to provide nutritional counseling to clients, thus enabling those trainers to address all of the client’s diet and exercise needs in a holistic fashion. - Physical therapy assistants and aides: Physical therapy assistants and aides work under the supervision of physical therapists. They follow prescribed procedures to help patients improve mobility, relieve pain, and minimize physical disability caused by diseases or injury. Physical therapy assistants and aides generally work in hospitals, nursing homes, and clinics that provide physical therapy as a service on an in-patient or out-patient basis. They usually work closely with physicians, occupational therapists, social workers, and others. Physical therapist assistants generally work more closely with patients using massage, exercise, and thermal agents such as heat, cold, and light. Patients frequently rely on physical therapist assistants to educate them on the use of durable medical equipment such as wheelchairs, walkers, or braces.
Summary: - Massage therapists manipulate the muscles and soft tissues of a client’s body to effect a positive change in that person’s physical state. Massage has been shown to improve body circulation, relieve anxiety and stress, reduce muscle soreness and pain, promote a greater range of motion in the joints, and facilitate other health benefits. - Massage therapy is a skilled profession requiring knowledge of anatomy, physiology, kinesiology, and pathology as well as specific therapeutic techniques. Many different massage techniques, some of which may require specialized training before they can be used, are available to practitioners. - Massage therapists work in a variety of settings, such as hospitals, clinics, sports facilities, and spas. Many massage therapists are self-employed and contract their services to another facility or offer therapy to the community at large. Self-employed therapists may work in their own facility, out of their home, or they may travel to the client. - Due to the unique nature of the work, most massage therapists are licensed by regulatory bodies at the state level. Licensing usually requires a minimum amount of education and training or work experience. Requirements vary greatly by location. You should understand requirements in the state in which you intend to practice before you start on your massage journey. - To obtain a license, many regulatory bodies also require you to successfully complete an examination that proves you possess entry-level skills and knowledge. Regulatory bodies may develop their own examination or they may utilize examinations offered by the Federation of State Massage Therapy Boards (FSMTB) and/or the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). - The salary outlook for the profession is good, with the average therapist earning about $35,000 a year, frequently working only part-time hours. The most successful practitioners tend to be those who are motivated, experienced, knowledgeable, self-employed, and capable of handling a large clientele.
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