Starting a Career in Massage Therapy: What You Need to Know

One of the most frequent comments massage therapists make about their occupation is, "I feel fortunate to have found work I love!" They feel this way because a career in massage therapy allows them to help people in a meaningful way with a high degree of personal contact. Massage therapy provides an opportunity to express very positive values about caring and well-being in their work in a way that is both personally and professionally rewarding.

Massage is a healing art as well as a science. It requires a balance of academic and technical knowledge, clinical skills, manual dexterity, sensitivity, and awareness. Nearly everyone has the innate resources to touch another with care and confidence. However, it takes a sincere desire to help others, along with a commitment to the time, energy, and focus necessary for the training process in order to become a solid practitioner.

The field of massage therapy is growing rapidly in response to the public’s expanding interest in forms of healthcare that promote well-being and a higher quality of life. Consequently, massage therapy has the attributes of an emerging profession undergoing relatively fast-paced change. For example, professional standards for both individuals and massage training programs have markedly advanced and increased over the past five years. Standards in the field are not always uniform, though this article will point out the most prevalent standards.

Entering the Field of Massage Therapy - Enrolling in a Training Program

The vast majority of individuals entering the field now complete an educational training program. Prior to 1989, when the massage therapy profession was smaller and there were fewer schools, some people prepared by taking a number of workshops from different independent instructors or studying with a practitioner in an apprenticeship.  Now it is important for those who want to work as massage therapists to complete effectively-designed training programs that offer a well-rounded curriculum that prepares them for the work environment they are seeking.  Visiting campuses, calling graduates and employers about the schools that interest you will help you select a school most appropriate for your career goals.  It also is important to prepare during your initial massage therapy training to pass the National Certification Exam for Therapeutic Massage and Bodywork after you graduate. 

Regulation and licensing requirements vary from state to state.  Currently 33 states and the District of Columbia regulate massage therapy.  In states without statewide regulation of massage, municipalities tend to have requirements for a business license.  Potential massage therapy students need to become familiar with the regulatory requirements in cities and states where they may wish to practice.  Eligibility requirements range from 300 to 1,000 hours of in-class training.  Frequently, states require a specified number of hours training in specific subjects.  Some states also require training from an accredited massage training program or school.  While most states require a minimum of 500 or more hours of massage training, there is a trend toward increasing the number of hours required.

Training programs in massage therapy generally require a high school diploma, though postsecondary education is useful. Previous studies in broad subjects such as science (especially anatomy and physiology), psychology, humanities, and business are helpful because of massage therapy’s nature as both a science and an art. Many schools also require a personal interview. Personal qualities and characteristics, such as excellent communication skills and a capacity for empathy, are important due to the high degree of personal interaction involved in massage therapy. Selectivity at schools varies widely, with the better schools, not surprisingly, being moderately selective. When being selective, schools usually are basing admission on whether an individual has the potential to succeed in studies and as a massage therapist.

It is recommended to enroll in a training program that is accredited or approved by a credible, national accreditation agency. One such agency is the Commission on Massage Therapy Accreditation (COMTA). Currently, approximately 70 training programs and institutions are accredited by COMTA. For more information about accreditation and credentials, see What Are Certification, Licensing, and Accreditation? and Credentials Used for the Massage Therapy Profession.

It is important to select an accredited training program because that tells you the program has gone through a rigorous process of objective inspection by outside experts in massage therapy and education, demonstrated that it meets high standards, and can adequately prepare a student to perform massage therapy. Also, a growing number of states require graduation from a training program that meets accreditation standards. If you live in or will work in a state that has such requirements, this can be a critical consideration. It can be quite frustrating to invest time and money in training only to find out that the training isn’t recognized when you need it to be, so it is important to be sure your training will qualify you to practice.

It is emphasized that the accreditation agency be credible, because some schools may be affiliated with groups that have the appearance of being accrediting agencies, but are actually controlled by private, for-profit businesses and do not have the strict requirements that credible agencies have. As a result, the assurances one relies on through accreditation may not exist.

The training program curriculum should cover such subjects as anatomy, physiology, kinesiology, theory and practice of massage therapy, hands-on practice under faculty supervision, ethics and business practices. Many schools offer a supervised student clinic that is open to the public and gives students the opportunity to work with a variety of people. Training programs may emphasize certain styles of massage, so it is useful to find out if a school teaches a style you feel comfortable with. Schools often offer both full and part time programs.

Be sure to read the catalog for a training program carefully. Feel free to ask a school about its accreditation, along with its philosophy regarding teaching and massage therapy. Many schools offer an open house or a short introductory course, which can be a useful way to find out what the school is like. For tips on how to choose a training program, go to Hints for Choosing the Right Massage Training Program.

What You Need Besides Your Graduation Certificate

Legal standards vary across the country. As mentioned above, massage therapists are currently regulated by 33 states and the District of Columbia, also by a number of localities. To see a list of which states regulate massage therapists, go to Regulation. Almost all of these states require 500 hours or more of training and/or passing an exam. Some require a minimum of 1,000 hours.  You may want to find out in advance what the requirements are in the area in which you want to practice.

As part of the advancement of standards in the field, a national certification program began in 1992, administered by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Similar to the "national boards" given in other healthcare fields, the exam is given at test centers across the country. Those who pass the exam become eligible to use the title Nationally Certified in Therapeutic Massage and Bodywork and may use the initials NCTMB. Most states that regulate massage therapists have adopted this exam as a state exam. You must meet certain eligibility requirements to sit for the exam, including education, which is another reason to be sure that graduating from a training program you are considering will allow you to meet such requirements.

It is becoming increasingly common for graduating students to take the national certification exam shortly after completing school. For more information about certification see the section on certification in Credentials Used for the Massage Therapy Profession. For information about the NCBTMB exam, go to www.ncbtmb.com.

It can be very helpful to your career to belong to a professional association. AMTA membership offers benefits, programs, and services that can help your practice thrive. In addition, membership support of AMTA allows AMTA to promote and build the massage therapy profession. After all, the strength of the profession is the bedrock of a successful massage therapy practice.

AMTA also offers a student membership, so it is possible to get a head start on becoming familiar with the massage therapy profession and getting ready to begin a practice. AMTA student membership, offers a combination package of benefits, support, and price designed with the student’s needs in mind. For more information on AMTA membership, go to Join AMTA.

Finally, simply gaining experience will help your massage work. Many massage therapists find that their skills improve during the first few years after school because they are integrating what they have learned with hands-on practice in the field. It is also quite common to continue to take classes and workshops - often in specific and/or advanced techniques - and add to one’s portfolio of skills and techniques. It is common to find successful massage therapists with several years experience who have taken hundreds of hours of additional training. In addition, some states, the NCBTMB (national certification), and AMTA all require continuing education credits to maintain your status.

Practicing Massage Therapy: Career Opportunities

Massage therapists practice in a variety of settings, such as private offices or massage therapy clinics, chiropractors’ or doctors’ offices, holistic health clinics, health clubs and fitness centers, spas, nursing homes and hospitals, with sports teams, and sports medicine facilities. Some massage therapists have portable equipment and work at their clients’ offices or homes. Recently, massage therapists have appeared in some rather innovative settings, such as storefronts, shopping malls, and airports.

Some practitioners specialize in their practices. The variables one finds regarding specialization include type of application, clientele, and technique. Massage therapy has a broad number of applications. Its range includes relaxation, stress reduction, health promotion, pain management, injury recovery, and working with specific maladies. Practitioners may choose to focus on one of these areas. Another specialization factor is clientele. Some examples are athletes, the elderly, office workers, and performers (e.g., dancers). Another area of specialization is technique. Some practitioners focus on a particular modality or technique and base their practice on that. However, the majority of massage therapists use several techniques and modalities in their work and may place the emphasis of their practice on something other than technique.

Massage therapists may work as self-employed practitioners in private or group offices, or as salaried or commissioned employees, or independent contractors. Earnings vary widely, depending on variables such as the area of the country, type of practice, skills, and experience. Those who work for an hourly wage generally earn the least. Independent contractors commonly split their fees on a percentage basis. Usually the percentage split is based on what services are provided for the massage therapist, such as working space, making appointments, and providing supplies and equipment. Practitioners with their own facilities usually earn the most and have the most responsibility, including building and maintaining a sufficient clientele.

A massage therapist in a major metropolitan area may charge $60 to $100 an hour, and $50 to $75 elsewhere. Those working for an hourly wage may earn less, but do not have overhead expenses. Because of the physical and emotional demands of doing massage therapy, massage therapists usually provide massage less than 40 hours a week. Each individual’s capacity will vary, of course. A relatively large percentage of practitioners practice part-time, i.e., generally considered as less than 10 hours a week of actual massage.  AMTA surveys of its members show that most massage therapists consider 27 hours of massage to be full-time work. 

Massage therapy does not have the typical career ladder, in that advancements are not achieved through promotions and progressively taking on higher levels of responsibility. Instead, one may increase his or her ability and effectiveness, along with clientele and fees, over time. It takes much time, commonly six months to a year, effort, and persistence to build a practice. Business and entrepreneurial skills can be a factor in practice building. Besides raising fees or getting raises, income can be increased by higher productivity, however, this is limited by the relatively intensive one-on-one nature of massage therapy.