I’m going to answer this question based on years of watching students as a massage-therapy instructor. The answer is a resounding, “You bet.” Many students have begun the yearlong program happily non-pregnant and then life happens and a little one is on the way. Our faculty always strongly advises the student to stay in school until she is ready to deliver. We could not do so if it were not safe for the pregnant student and if we had not seen repeated success stories. Two students who were also best friends got pregnant within one week of each another, walked across the graduation stage at nine months, and delivered within one week of each other the week after the ceremony.

Our program is 50 percent hands-on, so we tell the student we will adapt the curriculum to her needs. The amazing fact is we rarely have to alter much of the curriculum at all for the pregnant student.

Pregnancy is not an illness. If you are fortunate enough to experience a normal pregnancy and go into the nine months healthy, strong and fit, then that’s probably what your body will be like for nine months—healthy, strong and fit. If anything, the relaxin coursing through your joints is going to make you more flexible, so massage therapy offers little challenge for you other than the obvious alteration in body mechanics necessary to accommodate the size of your abdomen.

Let’s handle the two elements of your pregnancy that will create your biggest challenges. The first is your growth spurt and the second is the level of fatigue you will experience in your first trimester. Both are only challenges and should not stop you from successfully practicing massage therapy.

Thankfully, you do not develop a large abdomen overnight. This allows the body plenty of time to adjust, for your posture to adapt and for you to learn how to be creative in working at a massage table. Here are some ingenious methods pregnant students have used in their third trimester in order to adapt their bodies to the work at the table:

1) Get a footstool and place one foot on it while you work at the table. This takes pressure off the lower back and provides more space between the table and your tummy.

2) Sit on a large exercise ball and gently roll around the table while you give the massage. This way, you need to stand only rarely, the ball forces the pregnant pelvis into a constant state of alignment, there’s no pressure on your knees or back, and you truly get to relax a little while you roll around the table. (Try it; it’s amazing. You can actually reach 99 percent of the body you are working on with this method. I have a colleague with horrible knees who uses this method all the time.)

You will need to adapt slightly so that you aren’t laying your pregnant stomach anywhere on the client, yet simultaneously being careful not to torque your shoulders forward and jut your buttocks out in an attempt to keep your tummy from resting on the table. You have to be a little creative here. Have someone else watch you to make sure you aren’t working at an odd angle and thus hurting yourself.

The more pressing factor, over and above any harm to yourself and any body mechanics, is the real issue of the raw fatigue that hits during the first trimester. You might have been used to working at full throttle from morning until night, but you may have to alter that aggressive schedule early on in your pregnancy until your energy returns. You could schedule one or two massages, stop and take a nap on your massage table, and then schedule one or two more.

If you view pregnancy as an athletic event rather than an illness, you can approach both the pregnancy and your practice with creativity and energy. And just think of the example you are setting for your colleagues and other pregnant women by saying, “Here I am, in all my glory! Want a massage?”

A 5-foot-tall woman who must have weighed 95 pounds wringing wet performed one of the first professional massages I received. She had a sign in her waiting room: “Beware of tiny massage therapist.” When I asked her what her sign meant, she said, “People underestimate my strength; I’ve got something to prove!” Her massage was one of the deepest I have ever received.

It doesn’t matter what size you are; all that matters are body mechanics and creative tableside aides. Massage is an athletic profession; so you need to train properly.

Are you tiny? Use a footstool. Get a knee up on the table. Get up on the table. (Tell the client what you’re doing and why.) Lowering the massage table is one of the most effective means for short people to work. It gives you the leverage you need and allows you to use your entire body’s weight when needed. Who could ask for a better massage? I taught one student who lowered her table so much that we teased her about “working on a futon,” but it worked for her body and her clients thought she was a powerhouse.

No one starts out in massage school as strong as they will be when they graduate. Everyone asks the first week if they will be able to handle the 300-pound linebacker who walks into their practice, or if they will be able to handle five clients, day after day. As with any athletic event, you can do it if you train for it. By working hard in massage school and slowly adding weekly clients while you are training, your strength will improve and in a few months you will be amazed at your own stamina.

Now, about obesity. If there is one deal-breaker in massage school, I’d have to say it’s obesity. I’ve done my best to work with obese students, and it rarely works out. Why? Because, as I’ve said, massage therapy is an athletic profession. If you come to it slightly out of shape, well, we can work with you and get you ready. But if you come to the profession out of shape and obese, it’s going to be tough on you.

For one thing, with the high ethical standards we have regarding steering clear of inappropriate client body contact, it is very difficult for an obese massage therapist not to lay part of her body on the client while working. Usually, with obese students, I have to constantly remind them that their bosom or belly is touching the client. It is embarrassing for the student, the instructor, the client, and fellow students.

Body mechanics can only do so much when oversized bosoms, bellies and arms make inappropriate contact with the body on the table.

If you are obese and seriously thinking of becoming a massage therapist, I will tell you the program will be tough for you, if not impossible. Before you start the program, why not use it as your incentive to get down to a healthier body weight? Then you can dive right in with strength and confidence.

Charlotte Michael Versagi, L.M.T., N.C.T.M.B., M.L.D./T., is president of the American Massage Therapy Association’s Michigan chapter, a clinical supervisor in a hospital oncology-massage program, a lymphedema specialist, and on the faculty of a massage-therapy program teaching pathophysiology and massage modalities.