By Kaitlin Louie
As workplaces expand their benefits packages to include wellness-promoting services, and the number of spas across the country increases, massage therapy has gained stronger footing within the health and wellness industries. Massage therapists use methods of touch and soft tissue manipulation to relieve pain, treat injuries, and promote stress relief and relaxation in their clients. Due to the increasing attention to massage's ability to treat ailments without medication, the demand for and prevalence of massage therapy have grown in recent years. The expected employment growth rate between 2010 and 2020 for massage therapists is 20 percent, a rate that is faster than the national average for all occupations, according to the Bureau of Labor Statistics (bls.gov, 2012).
Massage therapy plays an important role in alternative medicine practices, the rehabilitation of physically injured patients, and the promotion of people's overall wellness. Working as a massage therapist offers flexibility in working location, hours, and specialty. For instance, massage therapists can work in spas, resorts, fitness centers, medical settings, or even specialty massage clinics run by either an individual or a team of massage therapists. Massage professionals may also travel to clients' homes or workplaces.
In order to practice as a massage therapist, one must first undergo training at an accredited institution and take either a state-approved licensing exam or one of two nationally recognized licensing exams. License renewals are often necessary and typically require one to submit a license renewal application as well as enroll in continuing education courses. Additionally, because this career relies heavily on client endorsements and referrals, massage therapists must possess networking skills, professionalism, and a competence in their field.
- How does one become a massage therapist?
- What training programs are available for aspiring massage therapists?
- What are the requirements to obtain a state license in massage therapy
- What licensing exams are available to massage therapist candidates?
- How do I renew my massage therapy license?
- Are massage therapy licenses transferable from state to state?
- What are the main responsibilities of a massage therapist?
- What skills are required to practice massage therapy professionally?
- What tools and technology does the massage therapist generally use?
- What is the typical job environment for the massage therapist?
- What career and advancement opportunities are available to trained massage therapists?
- What massage therapist professional associations are available, and how are they helpful?
- What is the employment outlook for massage therapists?
- What is the average compensation for massage therapists?
- What are some careers that are related to massage therapy?
Read through CareerColleges.com’s interview with massage therapist Julie Azzopardi to learn about her perspective on and experiences at her job. Prospective students can also learn about massage therapy programs by reading our interview with Diane Trieste, a massage therapy instructor.
How Does One Become a Massage Therapist?
The path to becoming a massage therapist varies from state to state, but in general almost all states require massage therapists to undergo some form of training and to take an exam to obtain licensure before practicing professionally. The general steps to become a massage therapist:
- Attend an accredited massage therapy school in one's state of residence.
- Take a state licensing exam or one of two nationally recognized licensing exams for massage therapy.
- Apply for licensure in one's state, sending in the necessary documentation and paperwork.
- Search and apply for jobs in one's region.
- Renew license and other certifications as needed.
- Advance one's career through continuing education courses, networking, and building a strong client base.
What massage therapy schools and training programs are available?
The majority of states in America require prospective massage therapists to complete at least 500 hours of in-person/hands-on training and education at an accredited massage therapy school. Such schools generally provide coursework in the following subject areas:
- Human Anatomy and Physiology. These courses give students a thorough understanding of the form, structure, and function of the human body. Course content includes information on human body systems (i.e. circulatory, digestive, endocrine, etc.), medical terminology, human metabolism, and tissue injury and recovery.
- Kinesiology and Human Biomechanics. These classes help therapists identify the potential physiological needs and limitations of their clients, such as joint stiffness or muscle injuries that limit range of motion. Kinesiology courses generally cover the structure and function of skeletal muscles and joints, as well as the principles behind muscle contractions and movement.
- Safety Practices and Regulations.These courses ensure that students are cognizant of and abide by proper safety laws when servings clients. Courses on this topic will discuss sanitation standards, cleanliness practices, and measures for client and therapist safety.
- Fundamentals of Massage. In this class students learn the basic principles and practices of massage and bodywork therapy. Such classes will often include information on and discussion of the physiological and psychological benefits of massage, as well as the soft tissue manipulation techniques that are essential to massage therapy.
- Specific Massage Modalities. There are many different types of massages—Swedish, Shiatsu, Deep Tissue, Clinical. This course gives students an extensive repertoire of techniques with which they can address the needs and ailments of each of their clients. These specialized classes build off of the massage fundamentals and explain the methods and history behind some of the well-established massage modalities from Western and Eastern cultures.
- Building a Professional Practice. These courses will cover such topics as effective communication with clients and fellow health practitioners, the essentials of business management and accounting, liability insurance requirements, professional associations/affiliations that one can join, and effective record-keeping. The goal is to provide prospective massage therapists with the necessary tools to find a job, promote their services, and connect with the larger community of professional massage therapists.
- Business and Massage Therapist Ethics. Courses discuss and address the potential ethical concerns surrounding this particular field and may involve a discussion of professional boundaries, confidentiality principles, and the code of ethics for massage therapists as defined by national massage therapist certification organizations.
In addition to the coursework described above, accredited massage training schools also often offer one or more of the following programs:
Please note that the programs described below only fulfill one of the requirements for becoming a professional massage therapist; candidates must also take and pass a state-approved or nationally accredited licensing exam before they can practice professionally.
Training for Certification
Massage therapy certification training programs specifically prepare individuals to pass one of two nationally recognized exams that qualify them for professional practice (see section below for licensing requirement and exam details). These training programs can range from several weeks to several months in length and are composed of an overview of the concepts, principles, and practices of massage therapy.
Diploma programs in massage therapy generally last about nine months to a year, and they provide more coursework and cover more subjects in massage therapy than certification training programs do. Diploma programs aim to provide students with targeted technical training in massage therapy that they can then apply to their professional practice.
Associate degree programs offer students the opportunity to take classes that go into even further depth than the courses provided in diploma and certification training programs. As a result of their depth and breadth, associate degree programs usually last about 2 years. In addition to the technical and practical coursework listed above, students may also be expected to take classes in such subjects as the humanities, the social sciences, and written composition.
What are the requirements for massage therapist licensure?
According to the Bureau of Labor Statistics (bls.gov, 2012), 43 states and the District of Columbia require that prospective massage therapists receive licensure in order to practice professionally. The general steps to apply for massage therapy licensure include:
- Submit a licensing application to one's State Licensing Board or Agency.
- Submit proof of having completed an accredited massage therapy training program (i.e. an official transcript) and fulfilled the state-mandated number of training hours.
- Undergo a background check.
- Pass either a state-approved licensing exam or one of two nationally accredited massage therapist licensing examinations, and send the scores to one's state's Licensing Board or Agency.
What examinations must the massage therapist take in order to earn a license?
The two nationally accredited examinations that are accepted by the majority of states in America are the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB), which is provided by the National Certification Board for Therapeutic Massage and Bodywork, and the Massage and Bodywork Licensing Examination (MBLEx), which is provided by the Federation of State Massage Therapy Boards (FSMTB). The details and key differences between these two examinations are outlined below.
Keep in mind that passing the NCETMB, MBLEx, or a state-licensed exam does not automatically provide one with a license to practice massage therapy; rather, passing the exam fulfills one of the criteria necessary to successfully apply for licensure.
National Certification Examination for Therapeutic Massage and Bodywork
The NCETMB grants national certification to candidates who pass. National certification enables massage therapists to practice in any state that administers the NCETMB (38 states plus the District of Columbia), and thus it can increase the mobility and job opportunities for massage therapists between states. Due to the flexibility it grants the therapists it certifies, the NCBTMB has rigorous standards and requirements, and many of these requirements are similar to those for state licensure.
Before one can take the NCETMB, one must complete 500 education hours in the following subjects:
- 125 hours of human anatomy, physiology, and kinesiology.
- 200 hours of massage and bodywork concepts, principles, methods, and their application (includes both theoretical and practical training).
- 40 hours of human pathology.
- 10 hours of business management and ethics.
- 125 hours of additional training and instruction in a field that is related to massage therapy.
In addition to completing the above education requirements and applying online, individuals who wish to take the NCETMB must submit a transcript from their training program, a signed background check, and several other forms to the NCBTMB (see NCBTMB's website for full details) in order to qualify for the exam.
The NCETMB is a written test consisting of 160 questions on the following six topics:
- Body Systems
- Human Anatomy, Physiology, and Kinesiology
- Therapeutic Massage and Bodywork Assessment Methods and Concepts
- Application of Massage and Bodywork Techniques
- Professional Standards, Ethics, Business and Legal Practices
NCBTMB also requires massage therapists to abide by the organization's Code of Ethics and Standards of Practice in order to receive and retain their national certifications.
Maintaining one's NCBTMB certification requires that one gets re-certified every four years, a process that requires certificants to complete 48 continuing education hours with an NCBTMB Approved Provider and 200 hours of work experience within the four year certification cycle. Renewal of one's NCBTMB certification is not required to maintain one's state license. The renewal process for state licensure is separate.
Massage and Bodywork Licensing Examination
In contrast to the NCETMB, the MBLEx does not require 500 hours of training in order to qualify. In order to be eligible for this licensing exam, students must undertake one of the two following routes:
1. Apply directly to FSMTB:
- Submit an MBLEx Application Form to the FSMTB
- Verify that one has education and training in the topics covered on the exam
- Acknowledge and agree in writing to adhere to FSMTB policies
- Pay a fee
2. Apply through the State Licensing Board or Agency of one's state of residence:
- Receive approval from the State Licensing Board or Agency
- Acknowledge and agree in writing to adhere to FSMTB policies
- Pay a fee
The MBLEx is an online exam consisting of 125 questions on the following topics:
- Human Anatomy and Physiology
- Pathologies, Contraindications, Areas of Caution
- Benefits and Physiological Effects of Certain Massage Techniques
- Client Assessment and Treatment Planning
- Massage and Bodywork History and Modalities
- Ethics, Boundaries, Laws, and Regulations
- Guidelines for Professional Practice
After a candidate takes the MBLEx, the FSMTB sends the scores immediately to the state licensing board to which the candidate is applying for licensure.
Additional Examination Requirements for Massage Therapist Licensure
Some states require that massage therapist candidates pass a state-administered jurisprudence examination and/or receive other certifications such as cardiopulmonary resuscitation (CPR) in addition to passing the MBLEx or NCETMB. Due to the variances in state guidelines for massage therapist licensure, one should check the specific requirements for one's state of residence.
As the license examination process can be lengthy and complicated, it is a good idea to consult a faculty member or advisor at one's massage therapy school for guidance.
How does one renew one's massage therapy license?
License renewals are required of massage therapists generally every one or two years, depending on the state where one is employed. For the majority of states, license renewal requires that one complete 12-25 hours of continuing education hours. Continuing education courses that fulfill these requirements are available at both brick-and-mortar and online institutions, and can include classes on business management, various massage modalities, massage therapy ethics, new developments in health care, or an indirectly related subject such as aromatherapy or yoga that expands massage therapists' knowledge of the human body and holistic health practices.
Are massage therapy licenses transferable from state to state?
If one is interested in moving to another state, it is important to check the licensing policies of one's future state of residence and employment. Some states allow massage therapists who are licensed in another state to receive a second license in their jurisdiction, a process called endorsement. Endorsement requires that candidates verify their competency, current licensure, and professional experience in their field. Such verification involves providing one or more of the following: proof that one has completed a state-approved massage therapist training program (including the fulfillment of a state-mandated number of training hours), proof of having passed a state-approved or nationally accredited massage therapist licensing exam, and/or records of having practiced professionally for a number of years in one's former state of residence.
What are the primary job responsibilities of the massage therapist?
The primary responsibilities of a massage therapist include but are not limited to:
- Listen to, discuss, and evaluate clients' physical symptoms and needs
- Locate painful or tense areas of clients' bodies
- Methodically manipulate muscles and other soft tissues of the body in order to relieve pain, discomfort, and tension
- Advise clients on proper posture and care for their physical conditions and complaints
- Apply complementary massage aids such as cold or warm compresses, oils, and lotions
- Use technology such as whirlpool baths, infrared lamps, etc. to enhance clients' experience and benefits
- Create and maintain a working area that promotes relaxation and/or rehabilitation; for example, keeping therapy areas clean and well furnished with relaxation aids or massage enhancement tools
- Keep track of client appointments and maintain an organized schedule
What essential skills must the massage therapist possess?
The massage therapist's role involves addressing people's physical complaints through targeted massage techniques. The massage therapist must therefore possess skills that enable them to understand clients' problems and implement solutions while ensuring the comfort and relaxation of the people they serve.
- Listening—massage therapy requires that therapists listen carefully to clients' symptoms and physical concerns, and address them accordingly.
- Interpersonal—allowing clients to feel at ease and developing friendly long-term relationships with them is an important component of a massage therapist's professional success.
- Verbal Communication—explaining the reasons behind and treatment methods for clients' physical complaints is a task that massage therapists must undertake daily. Verbal communication skills are also important because, in addition to clients, massage therapists regularly interact with spa/resort owners, physical therapists, personal trainers, chiropractors, and massage center managers.
- Observational and Analytical—a massage therapist must be able to observe and correctly diagnose clients' physical conditions.
- Physical Stamina—massage therapists must stay on their feet for much of the day in order to provide treatment services to their clients.
- Physical Strength and Dexterity—massage therapists must be able to exert adequate yet controlled amounts of pressure to clients' muscles and other soft tissues. Dexterity is important for this profession because a massage therapist must be able to skillfully manipulate specific areas of the body in order to release tension or relieve discomfort.
- Problem Solving—massage therapy as a profession requires that one effectively address various physical conditions through a combination of different massage principles and modalities.
What tools and technology do massage therapists routinely use?
Massage therapists who work for a company generally work with equipment provided by their employer, while massage professionals who work independently must generally purchase their own equipment. Examples of the tools and technology massage therapists use include:
- Massage chairs and tables
- Balance beams, boards, bolsters, and other rehabilitation/therapy aids
- Hot and cold compresses
- Medical heat lamps, vibration therapy devices, and other electronic therapy aids
- Hydrotherapy baths and tanks
- Hand and body lotions
- Bath robes and draping materials
- Sanitation equipment and formulas
- Desktop computer software to keep track of appointments and clients
What is the typical job environment for massage therapists?
According to the Bureau of Labor Statistics (bls.gov, 2012), 60% of massage therapists were self-employed in 2010. Self-employed massage therapists often travel to clients' homes and/or offices to provide massages. Massage therapists can also work at spas, hotels, fitness centers, shopping malls, hospitals, and private massage centers.
Job environment is often heavily dependent on the type of massage being provided. For example, a sports massage is often provided in a well-lit recovery or rehabilitation-focused environment, such as a fitness or physical therapy center. In contrast, relaxation-oriented massages may take place in dimly lit settings with aromatherapy and calming music.
Massage therapy is a physically taxing occupation, involving long hours on one's feet and repetitive motions that can result in injuries such as carpel tunnel syndrome, tendinitis, and back pain if one uses improper form or neglects to take adequate breaks. Thus, massage therapists should take care to use proper technique when providing massages, schedule adequate time between appointments, exercise regularly, and even consider receiving regular massages themselves.
What career and advancement opportunities are available to trained massage therapists?
As with many other job fields, massage therapy requires that candidates adequately research available local positions, network, and be proactive. Many massage therapy schools have career advice and/or placement programs for their students. Professional massage therapist associations can also provide helpful resources and guidance for massage therapists who are just beginning their career.
Referrals and client endorsements are very important for developing a strong clientele in this field. As a result, networking and self-promotion are key for not only success, but also career advancement. A friendly, effective, and professional practice, in conjunction with adequate outreach to potential clients through such avenues as referrals/word-of-mouth, an online presence (i.e. a website or blog), advertisements, and attendance at relevant events (such as wellness conventions or expos) can help ensure that one improves his/her career prospects.
Reputable massage therapist associations can also help massage therapy practitioners advance their career by offering marketing materials, educational resources, and a community of fellow massage practitioners to network with as well as exchange knowledge.
What massage therapist associations are available, and how are they helpful?
Joining a massage therapist association can provide numerous benefits, including liability insurance, professional networking opportunities, career resources and marketing materials, continuing education courses, and discounts on services and massage therapy supplies. Examples of such associations include:
- American Massage Therapy Association (AMTA)
- Associated Bodywork and Massage Professionals (ABMP)
In order to qualify for a professional membership with a reputable massage therapist association, such as the two listed above, one must fulfill the following requirements (note: many of these requirements are essentially equivalent to those necessary for licensure and professional practice in one's state):
- Complete a minimum of 500 hours of training and education at a state-approved massage therapy training program
- Pass one of the nationally accredited massage therapist licensing exams, the MBLEx or the NCETMB (AMTA requires the NCETMB specifically, while ABMP accepts either exam)
- Carry a valid massage therapist license
- Pay an enrollment and regular membership fee
- Adhere to the association's code of ethics
What is the employment outlook for massage therapists?
The Bureau of Labor Statistics states that the employment of massage therapists is projected to grow by 20 percent between 2010 and 2020 (bls.gov, year?), which is faster than the national average for all occupations. This rise in employment outlook is partially attributed to the national increase in massage clinic franchises, which often provide more affordable massages than spas and resorts and thus open this service to a wider range of people. In addition, the increase in the number of states adopting licensing requirements and policies has increased, which has helped shift public perception of massage therapy as a luxury to a means of pain treatment and wellness promotion. Companies have also started incorporating more wellness benefits into their workplaces, a development that has increased the demand for massage therapists who travel to worksites to give massages to employees. Furthermore, as older populations in America are living longer and more active lives, they are discovering the benefits of massage therapy as a means of balancing their bodies and alleviating age-related pain.
States with the highest employment levels of massage therapists as of May 2011:
Hourly mean wage
Annual mean wage
Source: Bureau of Labor Statistics, 2012
What is the average massage therapist salary?
According to the Bureau of Labor Statistics, the median salary for massage therapists and instructors in 2010 was $34,900 per year, or $16.78 per hour (bls.gov, year?). The American Massage Therapy Association reports that most massage therapists work part-time, and often supplement their massage therapy income with a second job. In 2010, only 25 percent of massage therapists worked full-time, according to bls.gov. Working hours for massage therapists, particularly for those who are self-employed, are flexible and often depend on clients' schedules. Therapists may also have to work on weekends. For therapists working at established businesses such as spas, resorts or fitness centers, working hours might follow a more regular schedule that abides by company hours.
Percentile wage estimates for massage therapists:
Source: Bureau of Labor Statistics, 2012
Top paying states for massage therapists:
Hourly mean wage
Annual mean wage
Source: Bureau of Labor Statistics, 2012
For those who are interested in the field, but do not want to pursue a career as a massage therapist, the following related careers may be of interest.
- Athletic Trainers specialize in the prevention, diagnosis, and treatment of muscle and bone injuries and illnesses. These professionals work with people of all ages and demographics, from professional athletes to young children.
- Physical Therapist Assistants work under the guidance of physical therapists to help patients recover from body injuries and illnesses. Physical therapist assistants often work one-on-one with patients, helping them with rehabilitation exercises and recording their progress. They also perform clerical work and maintain the cleanliness and organization of a physical therapy space.
- Cosmetologists provide appearance enhancing services such as hair cutting, styling, and coloring, facial and body skin treatments, and nail beautification. Some cosmetologists provide scalp and/or facial massages to enhance their treatment services.
Resources and Additional Information:
"http://www.amtamassage.org/index.html" | American Massage Therapy Association(AMTA)
"http://www.abmp.com/home/" | Associated Bodywork and Massage Professionals (ABMP)
"https://www.fsmtb.org/index.html" | Federation of State Massage Therapy Boards
"http://www.massagetherapy.com/home/index.php" | Massagetherapy.com (an education site powered by ABMP)
"http://www.ncbtmb.org/" | National Certification Board for Therapeutic Massage & Bodywork
"http://www.onetonline.org/link/details/31-9011.00" | O*Net Online: Massage Therapists
"http://www.bls.gov/ooh/healthcare/massage-therapists.htm" | Bureau of Labor Statistics: Massage Therapist
"http://www.massagetherapy.com/careers/index.php" | Your Massage and Bodywork Career(an ABMP publication)
Kaitlin is a content writer and editor for CareerColleges.com and CityTownInfo.com. She received her Bachelor's and Master's degrees in English Literature, and aspires to be a writer of fiction and creative nonfiction. She enjoys tutoring students in writing and social dancing on the weekends.