We asked 10 massage therapists who have sustained their careers for 20-plus years to show you the one most-important decision, protocol or practice they each used to create massage business success.

We asked 10 massage therapists who have sustained their careers for 20-plus years to show you the one most-important decision, protocol or practice they each used to create massage business success.

As a health care provider, marketer and small-business owner, you wear many hats. Add to that the fact that massage therapist is very physically challenging job that can result in injury and burnout, and you have a potent recipe for attrition.

It doesn’t have to be that way.

Ani Papazyan, LMT, CN
Ani Papazyan, LMT, CN

Massage Business Advice: Specialization

Ani Papazyan, LMT, CN

Last Stop 4 Pain; Tarzana, California

Specialty: Pain relief

Years in practice: 27

Clients per week: 15 to 20

Moving to the U.S. from the former USSR, where I studied medical massage in college, I attribute my success and longevity to my unique approach to pain relief, especially neck pain. 

Having a thirst for knowledge, I was fortunate enough to come across amazing doctors and practitioners who dedicated their lives to creating unique approaches to pain relief. After learning from a few of them, I developed my distinctive method for neck pain relief.

I often hear from many massage therapists that everyone needs a massage, which means everyone is a potential client. However, as marketing expert Seth Godin says, “Everyone is not your customer.”

It is essential to have a specialty in this industry. For me, that specialty, and what I market, is pain relief.

You cannot be good at everything, and you should never try to be. When you have a niche, you can stand out from other practitioners and become an expert in your field.

The best way to have a successful, long career is by being good at one specific thing and becoming a high-quality expert in it. You will still be helping your clients with other issues, but your focus will be on one particular area. 

This is what separates the good from the best.

Heather Lever, LMT, PNZROHA, CKTP, RTP
Heather Lever, LMT, PNZROHA, CKTP, RTP

Massage Business Advice: Let 20% of Clients Go

Heather Lever, LMT, PNZROHA, CKTP, RTP

Vital Body Therapy; Cambridge, Waikato, New Zealand

Specialty: Pediatrics, pain relief and muscle therapy for women and children; craniosacral therapy

Years in practice: 30

Clients per week: 24

Every three months I look at 80% of my clients and therapies I liked, did not overload my body and brought me the most profit. And then I look at the 20% left. Why do I not like working with those? Do I need to upskill? Do I need to let those in the 20% go? Does the treatment affect my body too much?

I have progressively used this technique over the years; it led me, after eight years, to drop all male clients. Why? I am five feet, three inches tall. I specialized in deep tissue therapies. I was having shoulder issues. 80% of my clients were female and I could, energy-wise, massage two female clients per one male client.

By asking myself “What are the requirements of 80% of my clients?” I have trained in many modalities that directly address what 80% of my clients want. I also listen to the other 20%.

For example, after 20 years I was struggling getting enough pregnancy massage clients and my body was not enjoying the mechanics of the treatments—but they were all saying what they really wanted was someone to work with their babies. Thus my 20% clientele suddenly became part of my 80% clientele once I trained in pediatric therapies.

From a massage therapist who trained as a deep tissue and holistic massage therapist in 1992 working with all ages and genders, I now have 50% of my clientele being babies under 3 months old, blending craniosacral and massage therapy. Another 30% of my clients are female and are treated using a blend of non-oil massage techniques as well as strength coaching. Twenty percent of my clients receive oiled massage therapy treatments. I work hands-on with my clients in every session.

So, the one thing I recommend as a massage therapist is work with the 80% of your clients and therapies that are the easiest on your body, bring in the most profit and you enjoy the most. Let the other 20% go. Keep training in the areas that cater to these groups. Thirty years later, you will still love your career.

Chad Duvall, LMT
Chad Duvall, LMT

Massage Business Advice: Body Mechanics

Chad Duvall, LMT

I.T. Massage; Wenatchee, Washington

Specialty: Medical massage

Years in practice: 25

Clients per week: 20

The main reason I’ve had such longevity in this career is body mechanics and self-awareness. Besides proper stance, table height and using leverage over strength, I have adopted techniques that have allowed me to use my hands in a passive way for the large body areas of back, hips and legs.

For deep work, I let my hands rest and use my forearm, elbow or a soft fist. I try to use the right tool for the right area, effectively saving my thumbs. For the structural muscle releases (pectoralis minor, iliopsoas, scalenes, etc.), which I feel are my specialty, I have the client participate in the work so the client’s body does half the work for me, using muscle energy techniques combined with specific pressure on those particular muscles. 

I also made it a rule to limit the amount of treatments I do. Even early on I knew if I allowed myself to do too many treatments in a day it could mean disaster in the future. I have set a cap of six massages per day over four to five days a week, for a total of no more than 25 sessions per week.

Irene Diamond, RT
Irene Diamond, RT

Massage Business Advice: Work with Affluent Clients

Irene Diamond, RT

Diamond Pain Relief & Wellness; San Francisco, California

Specialty: Pain relief

Years in practice: 34

Clients per month: Two, equating to four to six clinical hours per week

The biggest one contributor to my three decades in practice is that I completely transformed my business model. Instead of operating as a practice open to everyone, I switched to a Precise Private Practice (PPP). Within this new PPP model, I created an extremely lucrative, bespoke business with everything based on my personal desires and preferences. 

The goal when I started my career was to pack my calendar full to generate as much money as possible. I was an order-taker catering to everyone’s wishes. I scheduled anyone who wanted an appointment, often working six to eight clinical hours a day. My $6-$10k a month income was great, but I nearly burned out. 

Now my Precise Private Practice is sustainable because I only work with a few hand-picked best-fit dream clients to guarantee I can deliver optimum therapeutic outcomes, (and for my own fun.) My PPP is based on value over volume through discernment, not discrimination. Instead of fees that appeal to everyone, I cater to affluent clients who appreciate top-level experiences and happily pay, stay and refer. (This allows me to donate services and funds every month to groups I care about.)

Also, after many years I had a crazy realization about our industry’s typical pricing model that actually financially penalizes efficient, effective therapists who charge by modality or time.

Clients who see fast clinical improvements need fewer and shorter sessions. Charging for less clinical time creates an ethical dilemma because we lose money.

I dropped all of the modalities I had been using and now only offer one specific therapeutic approach. And then, when I started charging for clinical outcomes instead of session time I was financially rewarded for my efficiency, worked fewer clinical hours, and clients were happier. The focus on results also meant I could impact clients over video, digital programs, and other more leveraged means, even without being in the room with clients.

Lorine Dolby Hoffer, LMT
Lorine Dolby Hoffer, LMT

Massage Business Advice: Develop Strong Boundaries

Lorine Dolby Hoffer, LMT

Lorine Hoffer; Arlington, Virginia

Specialty: Customized work that reignites the connection between the body and brain and supports clients in learning the language of their body so they can break habitual patterns and create lasting change. She uses a variety of modalities based on what works for the individual.

Years in practice: 25

Clients per week: Varies; 15-20 clinical hours

Of all the things I’ve learned to practice in my massage career, exploring and honoring boundaries is the one that has most supported my success. Yes, my comprehensive education in body mechanics has helped keep me healthy, but both recognizing and honoring my own boundaries is the key to my longevity.

To me, boundaries are guidelines that honor my needs and allow me to live my most authentic life in a way that feels connected to both myself and others. 

What does that look like in my practice? I honor my own body first by limiting the number of clients I see and the number of days I work weekly. I don’t work evenings or weekends. I learned to listen to and respect my body when it says, “This is too much. I need a break,” and allow it time to rest and recover. I have, and enforce, clear cancellation and change policies. I work with clients who feel like an aligned fit versus working with anyone and everyone out of a sense of duty or desperation. I choose not to work with individuals or organizations who are not respecting my boundaries or their own

 If you’re going to consider me an independent contractor, you will need to follow the law around independent contractor versus employee. These are some of my boundaries I practice, coming from a place of compassionate curiosity.

It can feel so easy to fall into a people-pleasing behavior when helping others. The reality is it doesn’t support your clients and it doesn’t support you. Strong, defined boundaries allow you to set realistic expectations while teaching others how you want, and are willing, to be treated.

To define your boundaries, offer yourself the same compassionate care & kindness you undoubtedly extend to your clients. Ask yourself how you actually want and expect to be treated. What feels good to you? What allows you to show up fully and be present as your most impactful self? What are your core values and how are they showing up in your boundaries with self and others? Boundaries aren’t set in stone. Check in with yourself periodically to see what is working and what needs adjusting.

Don’t misunderstand me; holding boundaries isn’t always easy or comfortable. It takes practice, self-respect and consistency. Your boundaries will be tested by you and others, and they will likely change and evolve.

Boundaries are the foundation upon which all human interaction is built. Not only with clients, but also with your employers, co-workers, family, friends and even strangers. When you choose to explore and uphold your boundaries, you are building a stable foundation based on self-love and self-compassion—and you are inviting in others who will do the same to honor themselves and you.

Michelle Roos, LMT
Michelle Roos, LMT

Massage Business Advice: Commit to Self-Care

Michelle Roos, LMT

Mobile Massage Mastery; Lantana, Florida

Specialties: Mobile massage providing instrument-assisted soft-tissue mobilization (IASTM), MLD and pediatric massage, and cupping

Years in practice: 21

Hours per week: 36-42, with 12-18 hours spent driving

One of the things that has helped me sustain my massage career is making time for myself. This includes taking time for self-care, continuing education and doing things I enjoy, like hiking, kayaking and traveling around the world.

Self-care is a huge part of my routine. I start almost every morning with exercise, a hot yoga, a hot high-intensity interval training class, or a walk in nature. I take my time getting ready for work. I also plan food for the day. I make sure to pack a cooler with healthy snacks to take on the road with me since I am a mobile therapist. I have also found it handy to have a change of clothes and a swimsuit in the car for those last-minute cancellations. Instead of getting frustrated, I made good use of my down time and find a beach or trail near me. At the end of the day after all the work is done, I make time for more great food a social event out with friends or family or a quiet night in.

I make sure to schedule myself a two-hour massage every week and have frequent cupping, acupuncture and chiropractic appointments.

Owning a cupping-education company has allowed me to explore the many types of cups available that can be used on my clients and myself. I can spot-treat myself during the day as needed if something is bothering me and I give myself weekly cupping treatments.

I have found it very useful to take continuing education courses that can save my hands while working on my clients and I can also use on myself, like cupping and instrument-assisted soft-tissue mobilization. Using tools has taken some of the burden off my hands and pressure off my joints.

I created my cupping business as a side hustle to allow me to travel the world with my husband and take time off from doing massage therapy full-time and still have income. Being a mobile massage therapist allows me to create my own schedule while making sure I block time off for self-care. Mobile massage keeps my life exciting, so I never feel like I am doing the same job at the same place over and over again. I also married a massage therapist—which was one of the best things I could have done for myself.

Nancy Waltz Dail, LMT, BCTMB
Nancy Waltz Dail, LMT, BCTMB

Massage Business Advice: Get Involved

Nancy Waltz Dail, LMT, BCTMB

Downeast School of Massage and Downeast Health Spa, Inc.; Waldoboro, Maine

Specialization: Multiple modalities based on the philosophy of Dimensional Massage Therapy: building treatment goals based on the structure, medical history, repetitive actions, posture and gait, and injuries of the client.

Years in practice: 48

Clients per week: 10 to 15

As I look back on my career, from my first convention in 1974, I have been surrounded by like minds. Early on I fell into volunteering (or being volunteered) for any number of committees and projects. From serving in a variety of capacities and pioneering this profession, I have met the most amazing, talented, compassionate, educated practitioners who have supported the future of the massage therapy and bodywork profession.

It has been my privilege to serve with them to create vision and supportive stakeholders and even associations for our field. It has enabled me to start a school, practice, become an author, teach and become a CE provider.

Involve yourself in this great profession. Create your legacy to leave to the profession of massage therapy. Remember, this is your journey, but sometimes you might need a road map, so here are a few suggestions:

• Start small; involve yourself in taking continuing education

• Find a mentor who can help you see the forest through the trees

• Involve yourself in your state chapter – join a committee

• Look at how you can further massage in your community or in your state

• Make a five-year plan. Look at your life as a journey and plan your route.

• Ask yourself, why am I in this profession? What can I do to further the profession?

• Surround yourself with individuals who are visionary.

• Reach out and meet your peers. These are people of like minds.

• Write. Massage publications support writers!

• Present about massage.

• Get massage yourself.

• Attend ethics classes and share your experiences with peers.

• Remember self-care and prevent burn out.

Whatever you do, remember that massage therapy provides a social service that is unquestionably valuable to the human race. Be proud to be a massage therapist. This is a wonderful, satisfying career. Enjoy the ride and give back. Create your legacy.

Melinda Hastings, BCTMB
Melinda Hastings, BCTMB

Massage Business Advice: Double Your Rates

Melinda Hastings, BCTMB

Melinda Hastings; Börsborn, Germany

Specialty: Helping improve function and performance for active-duty military members

Years in practice: 25

Clients per week: Varies; 12-15 clinical hours

As a brand-new therapist and business owner, I was taught (and believed) that building a successful practice would only be possible if my prices were significantly lower than what my competitors were charging. I struggled for years trying to make this mentality fill my bank account, but it never did.

I tried all the discounts and created countless “specials” and rewards programs, only to be disappointed time and time again.

It was during one of my forced relocations that I had a breakthrough. You see, I move a lot as a military spouse. I close my practice every few years and start from scratch in a brand-new location. This is always a fantastic opportunity to completely change up my business structure–and mindset–and for once, I finally took full advantage of that opportunity.

After a lot of years using the same disappointing strategy, I finally found the one thing that has created a sustainable career: I chucked the idea that I had to be the cheapest therapist and fully committed to charging premium prices instead. In fact, I decided that my new rates should be double what the average therapist was charging.

Completely deviating from setting my prices based on what everyone around me was charging to charging based on the value of my service was the game changer my career so desperately needed!

This one seemingly simple change has allowed me to earn more money and bigger profit than ever before, reducing the number of hands-on hours I needed to provide. It has changed my mindset from feeling like I had to accept every client who wanted to book a session with me to knowing I have the power to choose the clients I want to accept into my practice. And it has radically changed my authority position.

A direct result of moving from discount-priced to premium-priced services was that the demand for my work increased so much that I was able to stop accepting new clients within the first month of opening that new practice and lead to being booked out a year in advance.

Charging a premium rate has also changed the perception that clients have of my practice and what they can expect to take away from a session. They no longer seek me out for the most basic of relaxation needs but are demanding (in a very good way) high-level results for their most complex pain problems. Being able to focus on the work I love most has increased my career satisfaction 10-fold.

Patti McQuinn, LMT
Patti McQuinn, LMT

Massage Business Advice: Balance Work & Personal Time

Patti McQuinn, LMT

Luna Massage and Wellness; Edmonds, Washington

Specialty: Pain and injury relief

Years in practice: 23

Clients per week: 20

I feel I have been able to have a 23-year career in massage because I have worked hard to have a balanced home and work life. My life doesn’t revolve around my massage career. I keep very strong boundaries to make sure my time off is my time off from massage.

From the very beginning of my career, I decided on my work schedule, and I have rarely worked outside of that schedule. When I was building my solo practice, I was always in the office during that time. If I didn’t have a massage, I was using that time to build my referral network and making connections. I still do that today.

My hobbies are not massage- or bodywork-related. When I give friends and family massages, they schedule like all my clients do and must come to my office. If I take a class on a weekend or when I wasn’t scheduled to work, I take off extra time during the week so I can still have time off.

I think having a solid work and home life balance has helped me avoid the burnout I see happen so often.

Ceena (Owens) Lund, RN
Ceena (Owens) Lund, RN

Massage Business Advice: Find Education Everywhere

Ceena (Owens) Lund, RN

Fort Hays State University, director of massage therapy; Hays, Kansas

Specialty: Pain management

Years in practice: 27

Clients per week: 15 to 20

If I were to recommend one thing as a way of having a sustained massage therapy career, that would be education.

Education for a professional massage therapist means several things to me. Education in the traditional sense, of always learning-seeking-exploring. Once you have found your passion in the art and science of massage therapy, you find out there is more—much more.

For me, it seemed the more I learned, the more I needed and wanted to learn. For I truly acknowledged humbly, the more I did not know and yearned to know, that I was aching and thirsty for more and picked the minds of mentors, life coaches, counselors, peers and educators.

Other aspects of education I learned along the way was of course the use of tools to save my hands, different creative modalities, and career-saving proper body mechanics. Creating a tool kit of skills that allowed me to be a messenger for more people, not just clients; but friends and loved ones as well.

Education was essential in other aspects of massage therapy that were not my strong points in the beginning. Self-promotion, marketing, ethics, energy fields-mine and others. Asking questions of my mentors, peers, educators—and clients.

Clients have been a great source of education for me. Today’s client is well-traveled, educated, and has experienced a lot of different health care modalities to complete homeostasis in their own bodies for the pursuit of holistic health. Many are business owners who understand the paradigm of running a personal business and have been a great resource with taxes, personal balance, employees or contractors.

Clients are health care professionals whom I network with and work as a synergistic team for overall wellness of a client. Education from both these populations have been a life preserver for me as a professional.

Sustainability for a massage therapist is different for everyone. Education for myself on all aspects of my life, to create the best version of myself to friends, family and clients, has been essential. This includes education on my physical health, mental health, financial health, spiritual health, and having honest conversations with myself on each of these. Seeking and continuing to seek education to continue another 27 years in this great field of massage therapy is my primary focus.

Where one starts on this journey is not where they will be in five, 10 or even 20 years down the road. Do not get in a rut or routine. Be willing to evolve, ask the hard questions, and educate yourself on all the necessary tributaries that make a healthy, sustainable massage practice.