Significant Points

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

Nature of the Work

Massage therapy is the practice of using touch to manipulate the soft-tissue muscles of the body. It is performed for a variety of reasons, including treating painful ailments, decompressing tired and overworked muscles, reducing stress, rehabilitating sports injuries, and promoting general health. Clients often seek massage for its medical benefit and for relaxation purposes, and there is a wide range of massage treatments available.

Massage therapists can specialize in more than 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 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. Also, some forms of massage are given solely to one type of client; for example, prenatal massage and infant massage are given to pregnant women and new mothers, respectively.

Massage therapists work by appointment. Before beginning a massage therapy session, therapists conduct an informal interview with the client to learn the person's medical history and desired results from the massage. This interview 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-related 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 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 to be undressed or wear loose-fitting clothing. The therapist exposes only 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 common 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. However, 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 lengths of time are most common. These risks can be limited by the use of good techniques, 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 the time needed in between sessions, massage therapists typically work 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, for setting up equipment, and for completing business functions, such as billing, are added, a massage therapist's hours per week may very well be more than 40 hours. About 48 percent of all massage therapists worked part time and 19 percent had variable schedules in 2008.

Training, Other Qualifications, and Advancement

In 2009, 42 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 an examination. As of 2009, States without licensure requirements were Alaska, Idaho, Kansas, Minnesota, Montana, Oklahoma, Vermont, and Wyoming. In these States, massage therapy may be regulated at the local level. Because laws often change, 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. Education programs are typically found in private or public postsecondary institutions and can require 500 hours of study or more to complete. A high school diploma or equivalent degree is usually required for admission. 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 management; ethics; and the 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-time and part-time programs are available.

Massage therapy programs vary in accreditation. Generally, they are approved by a State board, and they also may be accredited by an independent accrediting agency. In States that regulate massage therapy, graduation from an approved school or training program usually is required in order to practice. Some State regulations require that therapists keep up on their knowledge and technique through continuing education.

Licensure. In States with massage therapy regulations, workers must obtain a license after graduating from a training program and prior to practicing massage. Passage of an examination is usually required for licensure. The examination may be solely a State exam or one of two nationally recognized tests: the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) and the Massage and Bodywork Licensing Examination (MBLEx). 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. A fee and periodic renewal of licensure also may be required.

Other qualifications. 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 skills for massage therapists.

Advancement. 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. Therapists also may become managers of the office in which they work and may teach in a training program. 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.

Job Outlook

Employment of massage therapists is expected to grow faster than average. Opportunities should be available to those who complete formal training programs and pass a professionally recognized examination, but new massage therapists should expect to work only part time until they can build a client base of their own.

Employment change. Employment of massage therapists is expected to increase by 19 percent from 2008 to 2018, faster than the average for all occupations. Employment will grow as more people learn about the benefits of massage therapy.

Continued growth in the demand for massage services will lead to new openings for massage therapists. The number of spas, which employ a large number of therapists, has increased in recent years and will continue to do so. At the same time, there are an increasing number of massage clinic franchises, many of which offer massages cheaper than at spas and resorts, making them available to a wider range of customers. In addition, as an increasing number of States adopt licensing requirements and standards for therapists, the practice of massage is likely to be respected and accepted by more and more people.

Massage also offers specific benefits to particular groups of people, whose continued demand for massage services will lead to overall growth for the occupation. For example, 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 also are 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 are enjoying longer, more active lives and persons aged 55 years 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, who lack the concerns about massage that previous generations had.

Job prospects. In States that regulate massage therapy, opportunities should be available to those who complete formal training programs and pass a professionally recognized examination. 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 professional association also can help build strong contacts and further increase the likelihood of steady work.