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Discover the massage therapy profession’s current landscape to help you chart a successful course for your business.

March 21, 2010

woman sitting in a circle in mediation pose

You Are Here

It’s an old saying: You can’t know where you’re going until you know where you’ve been. And that's true.

Whether it's repeating an activity that proved successful or avoiding mistakes, we all count on past experience to help guide future direction and action.

To this end, having a clear view of the massage therapy profession’s landscape allows you to see, at once, the changes that have occurred over the past few years while also allowing you to chart a course for your business that has the most promise of success.

The Big Picture

Over the last 10 years, there has been about an 83 percent increase in the number of practicing massage therapists in the United States.

Total growth of the profession from the beginning of 2008 to the beginning of 2009 was 3 percent, which is in line with the previous year. In February 2009, the number of massage therapists in the United States was approximately 288,546, of which about 203,380 were licensed practitioners.

Based on the 2009 AMTA Industry Survey, these are the main characteristics of massage therapists in the United States: Massage therapists continue to be largely female, making up 85 percent of the profession’s population, a fact that hasn’t changed much over the last few years.

For many, massage therapy is not their first profession. This year, 83 percent of respondents indicated they held a different occupation prior to becoming a massage therapist, with only 17 percent having massage therapy as a first career. Those individuals who make massage therapy their first profession are comparatively more likely to work in a spa/salon or health club setting, suggesting these workplace settings may attract younger massage therapists new to the profession.

The non-massage-related education of massage therapists held steady, with 38 percent reporting they have a bachelor’s or higher degree and 12 percent having a high school diploma or less. Specific to massage therapy, respondents indicated specializing in an average of seven modalities/techniques, roughly the same as last year but up from five in previous years.

Similarly to last year, the top modalities remained Swedish massage, deep tissue, chair massage, trigger point and hot stone. At the same time, specialization in myofascial and craniosacral techniques significantly increased as compared to previous years, which may indicate massage therapists are looking into specializing in more modalities to expand their marketability to consumers.

Business outlook for many massage therapists has, perhaps not surprisingly, declined with the current state of the economy. Business declined for 38 percent of massage therapists, as compared to 27 percent in 2008. This year, only 28 percent of respondents reported an improvement in business compared to 42 percent in 2008. The decline in business outlook was indicated across all work settings, again suggesting the economy is a challenge.

Among massage modalities, Swedish and deep tissue continue to rank as the most frequently practiced modalities, with 84 percent and 77 percent of massage therapists practicing these techniques respectively.

Employment Trends

2009 saw more massage therapists referring to themselves as sole practitioners—74 percent compared with 67 percent in 2008. Overall, the number of locations practiced at also increased. This may indicate that massage therapists working in spas and health clubs are branching out and also working as sole practitioners. When compared with 2008, more massage therapists reported working at “my office” and “my home” in 2009. Fewer therapists are traveling to a client’s home and working in a spa/salon setting when compared to previous years. Employment at health care and health club settings remained consistent.

The number of hours massage therapists work increased slightly from 19.5 hours in 2008 to 20.4 hours in 2009. The average amount of time a massage therapist spends actually performing massage increased as well, from 15 hours per week in 2008 to 15.8 hours per week in 2009. Overall, massage therapists spent 26 percent of their workday on business-related activities and approximately 74 percent of their work day performing massage.

Massage therapists holding multiple occupations decreased from 58 percent in 2008 to 54 percent in 2009. Sources of secondary income include other forms of bodywork (26 percent), health care related jobs (22 percent), education (21 percent), business/professional occupations (13 percent) and fitness (12 percent).


The 2009 AMTA Industry Survey results show clients pay an average of $63 per one-hour massage, with spas/salons charging the most at $64.40 and health clubs charging the least at $61.10.

This year showed there was less discrepancy in hourly pay among different workplace settings, suggesting a convergence in the amount various settings are charging for massage.

These figures are national averages, so remember that prices for one-hour massages can vary considerably.

Massage therapists, on average, earn $44.90 per hour, which includes a $35.40 average hourly rate and a $9.50 gratuity. This year, however, the average gratuity received by a massage therapist decreased, dipping to $9.50 from $10.20 in 2008. Some studies suggest that a recession negatively affects consumers’ tipping behavior, so it’s possible the decrease is tied to the economy.

Additionally, how often massage therapists receive a gratuity from a client has declined from 53 percent in 2008 to 44 percent this year. Massage therapists working in a spa/salon setting continue to receive the most generous gratuities and sole practitioners come in at the lowest, declining from $9.70 in 2008 to $8.90 this year.

Bartering is still used heavily by massage therapists, with three-quarters of respondents reporting they barter massage services. The average dollar value of services bartered dropped significantly this year, from $596 in 2008 to $535 in 2009. On average, massage therapists barter services about nine times per year, slightly less often than noted in previous years.

Therapists in health care and health club settings reported the highest average value of bartered services.


Massage therapists responding to the 2009 AMTA Industry Survey indicate that the perception of massage therapy continues to be the biggest challenge they face. Second to perception this year is business/economic issues, coming in at 43 percent. Included in the business/economic issues is the poor economy, marked as the most pronounced challenge at 19 percent.

Another sign the current economic environment is negatively affecting massage therapists is the fact that more than ever massage therapists are relying on repeat clients for income, while the percent of new clients continues to trend downward.

Survey respondents also indicated they’d like to work more hours in massage therapy than they currently do. On average, massage therapists would like to work 14 more hours per week than they do now.

Other challenges mentioned by massage therapists include difficulty communicating the benefits of massage therapy to the public, low income, avoiding personal injury and education.

Working an average of 20.4 hours per week, massage therapists are paid for 15.9 hours, indicating that approximately four hours per week are nonbillable hours.

Who gets massage?

According to the 2009 AMTA Consumer Survey, women receive massage at double the rate of men. In 2009, 18 percent of American men received a massage compared to 26 percent of women. The percentage of men is up from 12 percent in 2008 and one of the main reasons overall massage use increased from 2008 to 2009. As much as 45 percent of males receive massage for medical reasons, indicating a growing acceptance of massage for medical reasons among this demographic.

Older baby boomers (ages 55 to 64) have doubled their use of massage over the past 10 years, and those 65 and older have nearly tripled their use.

By comparison, only 24 percent of younger consumers (age 18 to 34) had a massage in 2009, decreasing from 37 percent in 2008.

This fall accounts for the steepest decline in massage use and may point to a struggling economy leaving this age group with less disposable income.

Education and household income are both strong indicators of massage use. Consumer use of massage increases according to level of education, with college graduates four times more likely to get a massage than those who haven’t completed high school. Additionally, 10 percent of adults within households making $35,000 per year or less received a massage in the past 12 months. This number more than quadruples to 43 percent in households with a combined income of $100,000 or more.

Why Consumers Get Massage

Although pampering is still one of the top three reasons consumers receive massage, this year marked a slight increase in massage being used for medical reasons—up to 32 percent in 2009 from 31 percent in 2008. Relaxation/stress relief rounded out the top-three list.

At 32 percent, medical reasons tied this year with stress reduction as a top reason consumers seek massage therapy. Males seeking massage therapy for medical or health reasons saw a 12 percent increase, rising to 45 percent.

Additionally, it’s older Americans who are most likely to seek massage for medical and health benefits rather than relaxation or stress reduction. Among those who have had a massage in the past five years, 41 percent of individuals 65 years of age and 41 percent of those between the ages of 55 and 65 received their last massage for medical or health reasons. In contrast, only 13 percent age 65 or over and 28 percent aged 55 to 64 had a massage for relaxation or stress reduction.

A full 86 percent of Americans believe that massage therapy can be effective in reducing pain, and 85 percent feel that massage can be beneficial to health and wellness. To this end, this year’s numbers seem to suggest that consumers are talking to their health care providers in increasing numbers—and their providers are responding. Of Americans between the ages of 35 and 44, 25 percent talked to their doctor about massage therapy, compared to 14 percent in 2008. Of those who discussed massage therapy with their health care provider, 52 percent say their doctor strongly recommended them to get a massage.

Stress reduction is big this year, as evidenced in 57 percent of consumer survey respondents reporting they are more stressed out this year than last. For 42 percent of Americans, the economy is at the top of their list of worries, and this number grows to 55 percent for those between the ages of 45 and 54. In the 18 to 34 age population, 66 percent are more stressed at this time than they were one year ago. Up from 38 percent in 2008, 40 percent indicated they considered massage therapy to manage stress.

Women are who primarily use massage therapy for stress reduction, with 39 percent citing this reason as opposed to 22 percent of males.

In general, 32 percent of Americans that received a massage in the past five years said their last massage was to reduce stress or relax, compared to 36 percent last year.

Pampering, the third most prevalent reason consumers receive massage, accounts for 17 percent of recent massage purchases. At 19 percent, women are more likely to say they received their last massage for pampering reasons than men, who come in at 15 percent. Those in the Northeast and North Central part of America are also more likely to have received massage for pampering, with 28 percent and 19 percent of respondents from these regions indicating this reason respectively.

Consumer Expectations

Consumer use of massage is expected to stay the same or grow slightly next year, with 26 percent of consumer respondents expecting to get a massage next year as compared to 23 percent reported last year.

Additionally, more women expect to receive massage next year, up to 33 percent, while men’s use of massage therapy may hold steady at 18 percent. The expected use of massage therapy for younger consumers, those 18 to 34 years old, dropped considerably—from 58 percent last year to 35 percent in 2009.

However, more consumers in non-metro areas plan on getting a massage next year, up from 12 percent in 2008 to 26 percent in 2009.

What This All Means To You

The strain of the economy bears out in some numbers, but certainly doesn’t indicate massage therapists can’t continue to thrive in the profession. The overall use of massage therapy increased by 2 percent in 2009, and numbers show regular clients are continuing to get massage.

These results suggest that satisfaction among your clients who regularly schedule massage is very important. The AMTA 2009 Industry Survey shows that repeat clients are at the heart of many massage therapy practices, even moreso than in the past—74 percent in 2009 versus 65 percent in 2007.

This phenomenon may suggest that more casual recipients of massage therapy might be tightening their purse strings and making tougher choices as to where to spend their discretionary income.

Even with frequent massage users being the heart of many practices, attracting new clients is still important. The numbers suggest, too, that promoting the health benefits of massage therapy can be an effective way to reach both regular and new clients. More than two thirds of massage therapists (76 percent) indicated they receive referrals from health care professionals, averaging 1.5 referrals per month, a significant increase from the 69 percent in 2008.

Word-of-mouth advertising, however, still comes in as the most effective source of new clients for massage therapists. There was a significant increase in success with online marketing—double when compared to last year—probably due to the increasing use and acceptance of social media.

Consumers are also responding well to massage therapy as a medical benefit, so educate your clients about how massage therapy can help with pain relief. Also, stress relief, perhaps because the economy is struggling, is a big driver for consumers, so remind clients how you can help them manage these levels.