A Comprehensive Guide to Massage Therapy School
If you have arrived at this article, you have an interest in becoming a professional massage therapist. We applaud you!
The career you are considering can be rewarding on a number of levels: You can make money while helping people ease stress, pain and other conditions in a way that is natural and drug-free.
As a provider of holistic health care, you will contribute to the well-being of humanity by offering the gift of your positive touch to the world.
By becoming a massage therapist you will have the opportunity to help make people feel better, naturally.
You might be wondering how you go about becoming a professional massage therapist. MASSAGE Magazine has put together this comprehensive guide to answer all your questions and get your prepared to begin your journey through massage therapy school.
But first, a little background on massage therapy.
What Is Massage Therapy, Exactly?
Massage therapy is the systematic manipulation of the body’s muscles and soft tissues for wellness-related purposes, such as relief of pain and tension.
Specific techniques vary widely depending on the massage type, or modality, practiced; the most common technique, known as Swedish massage, involves combinations of these basic movements:
• Effleurage (long, gliding strokes)
• Petrissage (kneading)
• Tapotement (tapping with the sides of the hands)
• Friction (vigorous rubbing)
• Shaking (gentle jostling)
Swedish massage can also be called classic massage—and despite its name, it did not originate in Sweden. While many textbooks attribute the invention of massage to Peter Henry Ling (1776-1837) of Sweden, Ling’s technique is actually the Swedish Gymnastic Movement System, practiced in the Royal Central Gymnastic Institute he founded, according to Robert Noah Calvert (1946–2006), founder of MASSAGE Magazine and author of The History of Massage (Healing Arts Press).
A technique called the Swedish Movement System, developed by Dutch practitioner Johan Georg Mezger (1838-1909), represents the beginning of Swedish massage therapy as we know it today; over the years this term intermingled with Ling’s and credit for the development fell erroneously to Ling. (Read more about this complicated history in “Pages from History: Swedish Massage,” an excerpt from Calvert’s book.)
Classic, or Swedish, massage is the type of massage most people think of when the term massage therapy is mentioned, and most massage therapy schools teach it as their primary modality.
However, many other modalities exist that schools may or may not touch on, including such techniques as prenatal massage, sports massage, craniosacral therapy, myofascial release, pediatric and infant massage and many others.
Further, Asian bodywork is considered its own body of knowledge and has schools and certifications dedicated exclusively to its techniques. Asian bodywork, according to the American Organization for Bodywork Therapies of Asia (AOBTA), encompasses techniques including traditional Thai massage, shiatsu, acupressure and several others.
Professionals who practice massage therapy are most properly referred to as massage therapists. You may hear the terms masseuse or masseur used to denote female or male massage practitioners, but these words carry negative connotations for many people.
You can read more about the history and evolution of these terms in “The Archetypes of Masseuse and Masseur,” an excerpt from massage expert Patricia J. Benjamin’s book The Emergence of the Massage Therapy Profession in North America (Curties-Overzet Publications).
With that brief history out of the way, let’s tackle some of the big questions you might have about getting your new massage therapy career started.
What Are the Prerequisites for Attending Massage Therapy School?
Most schools of massage therapy require enrollees to have a high school diploma or its equivalent.
However, many people enter the massage therapy profession as a second or third career, or after retiring from another field. Having education and experience beyond high school can greatly enrich what you bring to your massage career.
While schools may not conduct criminal background checks on their applicants, many states do require criminal background checks in order for you to obtain a professional massage therapist license.
If there is any reason you feel you might not pass a background check, it is best to bring it up at the time you enroll so you can avoid graduating from a school but being barred from licensing.
Another thing that’s not necessarily a prerequisite, but is definitely something you should know before choosing this path, is that a career as a professional massage therapist can be very physically demanding.
Doing too many massages too often for too long, performing massage without practicing proper body mechanics or skimping on self-care can easily result in injuring yourself.
Staying in good physical shape, working out and stretching, maintaining a healthy diet, getting your own massages regularly, and being vigilant about using proper form and posture when you work will help you extend your career and get the most out of your massage education investment.
Speaking of your massage education investment:
How Much Does Massage School Cost, and Can I Get Financial Aid?
The total cost of massage therapy school depends partially on where you live and on where you plan to practice once you finish school.
In order to become licensed, most states require you to graduate from a program of at least 500 hours, but may require fewer or more hours, which will affect cost. You’ll have expenses in several areas, including:
• Massage table, if not included in a fee
• Student liability insurance, if not included in a fee (read more about this in “Do I Need Student Liability Insurance?, below)
Educator and author Cherie Sohnen-Moe, who is also president of the Alliance for Massage Therapy Education, told MASSAGE Magazine that both the length and the cost of massage therapy education can vary quite widely from school to school.
You may find a broad range, from six-month programs costing a few thousand dollars to one- or two-year programs that cost upward of $15,000.
For example, Nevada School of Massage Therapy, which is operated by Steiner Education Group, owner of multiple schools across the U.S., offers a disclosure on its website listing tuition and fees.
Most massage schools offer some form of financial aid. As a first step, make sure that any schools you apply for are accredited—you can look up this information on the U.S. Department of Education’s website, which will tell you both if the school is accredited and by which organization.
You’ll find more detailed information on accrediting associations in “I’m Researching Massage Therapy Schools. What Should I Be Looking for?”, below.
Next, complete the Free Application for Federal Student Aid (commonly abbreviated as FAFSA), which is typically a prerequisite to applying for grants, loans and scholarships. These funds may come from the federal government, from your state, from your individual school or from private entities.
For example, to attend one massage school in Gainesville, Florida, you could use any of numerous federal or state grants and loans, as listed on their website, as well as apply for an individual scholarship directly from the school.
For more detailed information on the process of financing your education, and the different types of aid that may be available, check out “How to Afford Massage School” on MASSAGE Magazine’s online resource for massage students, futureLMT.com.
How Long Does Massage Therapy School Take—and What Will I Study?
Again, this partially depends on how many hours your state requires for licensing, as well as how many hours you take at a time. Most massage schools offer a choice of day or evening programs, which may have different starting and ending dates.
Massage therapy programs range in length from several months to two years, said Sohnen-Moe.
Beyond learning and practicing massage techniques, you will also study the history and origins of massage; anatomy and physiology; pathology; kinesiology; contraindications to massage; business; ethics; and self-care, among other topics.
I’m Researching Massage Therapy Schools. What Should I Look For?
There’s only so much you can find out about a massage therapy school online. For example, you can discover:
• if it’s accredited;
• estimated costs, and if it has financial aid available;
• what massage therapy programs are available, their starting and ending dates, and what hours massage therapy classes and clinics take place;
• important statistics, such as the school’s reported job placement rate for graduates;
• information about the faculty and campus.
In addition to reading official information on the school’s website, also check out the school’s social media pages, such as their Twitter feed and Facebook business page, to see what others are saying about it.
This information may be biased, but it should give you an idea of what kind of general reputation the school has amongst current and former students, or people who have applied but not been accepted. You can also get a sense of the school’s level of community involvement by reading up on its public events and outreach.
Speaking with schools’ admissions staff and faculty in person can also provide you valuable information. Before applying, arrange to take a tour of the school and talk with staff members (and current or former students, if possible). Schools may also offer open house days for prospective students.
As you gather information, Sohnen-Moe suggests asking many questions, including:
• Is the school accredited through an organization such as the Commission on Massage Therapy Accreditation (COMTA), National Accrediting Commission of Career Arts & Sciences (NACCAS), or Accrediting Bureau of Health Education Schools (ABHES)? If not, do they at least have COMTA-approved curriculum?
• Do they model their curriculum around the Entry-Level Analysis Project (ELAP) standards? ELAP standards were created by a consortium of massage organizations to to define minimum standards for preparing massage school graduates for entry-level professional work.
• What is the number of faculty and the length of time faculty members have been teaching? Some schools have many faculty members, while some may have all classes taught by one instructor, said Sohnen-Moe.
• What are the school’s requirements for teachers? For example, must they have a bachelor’s degree, a certain number of years of experience in the field if they are teaching hands-on courses, or informal and formal teacher training?
• What type of space does the school have for personal belongings, break areas and study areas? Does it have a library? Lockers? A student lounge?
• What types of textbooks do they require? How many?
• How do instructors grade students? What percentage do tests, projects and participation count toward your grade?
• How is the massage clinic space set up? Is it clean and well-stocked?
• How many supervisors per shift work during clinic practicums?
Get an impression of the school’s overall environment and culture, too. For example, Sohnen-Moe once saw a school that did not use tables and chairs—instead, students sat on floor cushions during class. “That really appeals to a certain personality, and not to another,” she said.
“What kind of technology do they have in the classroom?” she added. “Do they have things like LED projectors and smart boards?”
Ask specifically, Sohnen-Moe recommended, about how massage clinics are handled. “Some of them hardly do any follow-up with the students after their clinic shifts,” she explained. “The whole point is not for students to just do massage, because they can practice on anybody. It’s to get educated feedback.”
You’ll get the most out of the clinic portion of your education if there’s a chance to ask questions afterward and find out how you can improve.
In addition to massaging clients, some clinics also offer students the chance to schedule and confirm client appointments, which can give you good customer service experience, Sohnen-Moe said.
Ask how long the massage school has been in business. “Prospective students should be looking for a school that has a long, established record for success,” said Margaret Sharenko, L.M.T., C.P.T., massage program director at the Atlanta School of Massage in Atlanta, Georgia.
Sharenko said it’s a good idea to ask questions about how the school contributes to the massage industry, such as, “Is the massage school involved in the legislative concerns for the professional licensure process in their state?” and “Is this school teaching and developing curriculum that supports the growing need for massage therapy in research?”
She also suggested visiting local massage establishments that have employees and asking managers if there is a massage school from which they prefer hiring graduates.
Lisa Garofalo, L.M.T., program director at the Oregon School of Massage, recommended looking for a school that offers strong instruction in the health sciences, and asking staff what percentage of its graduates pass their massage licensing exam.
This percentage can tell you a lot about the quality of the school’s curriculum. (More information on licensing exams is coming up, in “What Is the MBLEx Test, and How Do I Prepare for It?”, below.)
Don’t forget purely practical aspects of your massage education either, such as how far away the school is from where you live and work. How long will it take you to get there on school days? Will you have to adjust your working hours or other responsibilities in order to attend the program? What method will you use to pay for school? If you don’t have a handle on these details beforehand, you may end up regretting your choice.
Finally, decide if the school resonates with you personally—all details considered, the environment should just feel like the right fit for you.
“Can you imagine yourself spending 640 hours here with these people?” Nicole Spears, admissions coordinator for the Oregon School of Massage campus in Portland, Oregon, suggests you ask yourself.
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Do I Need Student Liability Insurance?
The short answer is: Yes.
In massage school, part of your education will be performing actual massage therapy on your fellow students and, most likely, on members of the public during portions of your training.
Most massage schools offer student massage clinics, with clients paying rates discounted from what they would pay licensed therapists. These clinics will offer you the chance to practice your skills on and get feedback from real people and represent an invaluable part of your education.
Unfortunately, no matter how careful you are during massage sessions, things happen. You may make a mistake and hurt someone during a massage. (It’s rare, but it occurs.) A client may have an allergic reaction to an ingredient in your massage oil. Someone may trip and fall as she gets up from your table.
Whether or not what happened is your fault, student liability insurance can protect you in the event that a client decides to sue.
Student liability insurance may be included as part of your tuition and fees; check and make sure. If it is not included, you will want to obtain your own student policy. These are typically fairly inexpensive, but offer you protection in the event someone is injured during a session.
For example, Massage Magazine Insurance Plus offers a student policy for $25 that provides coverage for professional liability/malpractice (injury during massage), product liability (injury caused by a product you use), and general liability (accidents unrelated to massage, like trip-and-fall situations). Other companies offer similar policies.
Student liability insurance will end once you are no longer a student. At that point, you will need professional liability insurance. You can read about the different professional massage therapist liability insurance options available to you at MASSAGE Magazine’s Massage Liability Insurance Resource Center, which compares information about insurance offered by MASSAGE Magazine Insurance Plus and other companies.
What Is the MBLEx Test, and How Do I Prepare for It?
As you research your career as a massage therapist, you’ll see the abbreviation MBLEx quite a bit. This is short for the Massage & Bodywork Licensing Examination, a test controlled and administered by the Federation of State Massage Therapy Boards (FSMTB).
Passing the MBLEx is required in almost all U.S. states as part of obtaining a license to practice massage therapy. Some states may require additional or alternate exams, but most have adopted the MBLEx as their standard licensing exam.
The MBLEx is a two-hour-long, computer-based test consisting of 100 multiple-choice questions, according to the FSMTB’s website. You must apply to take the test, which involves a fee; click here for full application requirements.
If you do not pass the MBLEx the first time you take it, you can re-take it after 30 days, but you must re-apply and pay another fee. (The FSMTB does not limit your number of re-takes but does note that some state licensing boards may have a limit to the number of times you can take the exam.)
According to the FSMTB’s website, the MBLEx includes questions about:
• Client Assessment, Reassessment & Treatment Planning (17 percent)
• Ethics, Boundaries, Laws, Regulations (15 percent)
• Benefits and Physiological Effects of Techniques That Manipulate Soft Tissue (14 percent)
• Pathology, Contraindications, Areas of Caution, Special Populations (13 percent)
• Guidelines for Professional Practice (13 percent)
• Anatomy & Physiology (12 percent)
• Kinesiology (11 percent)
• Overview of Massage & Bodywork Modalities/Culture/History (5 percent)
A more detailed breakdown of the above MBLEx categories is available for download at the FSMTB’s website.
How can you make sure you pass the MBLEx? Sharenko’s advice for preparing for this exam is simple. “My motto is ‘if you are in class you will pass!’” she said. “Students who are absent for vital information during their schooling tend to struggle more when it comes time to test.”
Sohnen-Moe offers several pieces of test-preparation advice:
• Learn the why and how of the material, not just the basic facts. “Why is it this way? How does it work?” she said.
• Build your critical thinking skills; create MBLEx practice tests that consist of scenario questions that require you to decide the best massage treatment plan in a certain situation. “A great number of questions on the MBLEx are scenario-based,” Sohnen-Moe said. She recommends getting a study group together and coming up with your own scenario questions and multiple-choice answers.
• Practice taking multiple-choice tests where you answer a question and move on—without being able to go back and look at previous questions.
Many massage organizations have created special exam review help, MBLEx practice tests and MBLEx study guides. You can choose from a variety of premium or free resources on the MBLEx exam—one of which, Massage Study Buddy, was created by MASSAGE Magazine. This 100-percent free online resource can be used on any computer or mobile device, so you can study for the MBLEx test anytime, anywhere.
MASSAGE Magazine’s website for massage therapy students, futurelmt.com, also features a test prep section with advice written by educators and other experts in the massage field.
Once I Graduate, What Do I Need to Practice Massage Therapy Legally?
Graduating from massage therapy school is just the beginning. To practice legally, you’ll need to get licensed in any state(s) in which you will practice.
The first step to licensure is to graduate from an accredited massage therapy school with at least the minimum number of hours your state requires. For example, the state of Illinois requires graduation from a program of at least 600 hours, whereas Florida requires a minimum 500-hour program.
Once you graduate, you will have to take and pass the MBLEx, or whatever exam(s) your state mandates. (See “What Is the MBLEx Test, and How Do I Prepare for It?”, above.)
Once you pass your licensing exam, you will submit an application and pay a licensing fee to your state’s massage therapy board, or whichever government entity handles massage licensing in your state. Most states also require fingerprinting or a criminal background check; many also require you to carry professional liability insurance, which will protect you from financial loss in the event that you are sued by a client. See our Massage Liability Insurance Resource Center for helpful information on choosing a policy.
For full, detailed licensing requirements, you will need to consult the website of the massage therapy board of the state in which you want to practice.
Once you are licensed in your state, you will need to maintain your license. In most states, this means paying a renewal fee and meeting renewal requirements, which typically include a certain number of hours of continuing education, once every two years, or however often your state mandates.
If you move from one state to another, you will need to get licensed in your new state. At this point, each state regulates massage therapy differently, so it is not safe to assume that you will qualify for licensing. Consult your destination state’s requirements to make sure you have what you need to practice legally there.
How Much Money Will I Make as a Massage Therapist?
The typical massage therapist salary depends both on where you work and the type of massage therapy in which you specialize. Your income will also be affected by the demand for your services in your area, as well as factors such as what you charge per hour, if you accept and bill insurance for your sessions, and if you sell retail products in addition to your massage therapy services.
According to the U.S. Department of Labor’s Bureau of Labor Statistics, the median pay for a professional massage therapist was $39,860 per year in 2016—that’s $19.17 per hour. Most massage therapists’ income is a combination of wages and tips.
Keep in mind that if you are an employee, your taxes should be withheld from your pay by your employer; if you are self-employed and work as an independent contractor, you will be responsible for withholding and paying estimated quarterly taxes yourself.
If you are a business owner, you will also have to factor into your total income the expenses of doing business, such as supplies, employee wages, and property and sales taxes.
Once I Graduate and Get Licensed, Where Do I Look for Work?
The demand for massage therapists is increasing. According to the Bureau of Labor Statistics, the number of massage jobs is expected to grow by 22 percent by 2024, which it notes is “much faster than average” for a profession. This growth trend suggests more members of the public are seeking out massage, as well as a greater variety of venues where massage takes place.
Depending on your interests, skills and personality, you may find any number of job placements appealing. For example, you might choose to work in:
• private practice. Being your own boss is the goal of many massage therapists. You’ll work for yourself and may or may not have employees.
• spas. These can either be stand-alone establishments or be located in places such as theme parks, cruise ships, airports, hotels, shopping malls, resorts or any destination people go to relax.
• massage franchises. Small or large massage chains offer you the chance to work as an employee for an established company.
• hospitals. Many hospitals now offer massage and other complementary services for patients, families and staff.
• physicians’ or chiropractic offices.
• college, professional or other athletic teams.
• offices and other workplaces, providing seated, or chair, massage.
• a massage-on-demand company. Several companies specialize in dispatching massage therapists to homes, hotels and offices on request from clients, usually via an app.
What Will My Massage Therapy Career Be Like?
If you work in private practice, you may work alone as an independent contractor or you may choose to have employees.
Either way, you will have complete control over how you work, but be aware that you will also be responsible for making decisions for and funding all aspects of your business, including but not limited to booking and confirming client appointments; marketing your services; setting prices and collecting client payments; renting a space for your business and paying for its utilities; hiring, training and firing employees; withholding and paying income tax; collecting and paying sales tax if you sell retail products; handling details of business licensing and permits; dealing with laundry; and purchasing supplies such as tables, linens, bolsters, lubricants and uniforms.
Choosing to work as an employee may mean not making as much money per massage as an independent contractor, but it also means having many business-related issues and associated expenses handled for you.
As an employee, you may not have control over how many clients you massage each day, the massage techniques and routines you use, marketing tactics, or details such as how you dress or what hours you work.
Many massage therapists choose to work as employees to gain experience and save money before opening up their own private practices. Others may work part-time for an employer while also seeing clients privately in their off hours. Still others build a fulfilling career working for an employer
As your body of experience grows, you may want to enhance your income stream while avoiding adding more massages to your schedule. You can do this in several ways, such as:
• Buying massage- or wellness-related items wholesale and selling them to clients at retail prices. This is a great way to make more money without doing more massage.
• Becoming certified in complementary offerings, such as aromatherapy or energy work; or lower-impact techniques, such as craniosacral therapy or lymphatic drainage. This will make some of your massage work less physically taxing.
• Hiring employees as your client list grows, to reduce the number of massages you must handle yourself.
• Developing and offering continuing education classes, either online or in-person.
• Training to become a massage therapy school instructor.
If you find you really enjoy working with a certain type of client, you might also choose to seek further training that allows you to focus on one particular population. Some types of massage therapy certification you could pursue include myofascial release, lymphatic massage, sports massage, pediatric massage, infant massage, geriatric massage, pregnancy massage and oncology massage.
If you love animals, training is also available in equine, canine, feline and small-animal massage therapy. Regulation of the animal massage industry varies widely by state, so research your area’s requirements thoroughly before pursuing education in this field.
“Explore all the modalities and find what resonates with you,” said Garofalo. “Master that craft.”
Is Continuing Education Required Once I’m Licensed?
As with initial licensing requirements, the amount and type of continuing education you need varies by state.
Some states require both a certain number of hours of continuing education, and education in certain areas—for example, on the subject of ethics or HIPAA compliance.
For full details on the continuing education you need and how often it must be completed, contact the massage therapy board of the state in which you practice.
Depending on your career aspirations, you may choose to take continuing education above and beyond what your state requires. Such massage education can allow you to expand the modalities you offer, reach a new clientele or become eligible to work in a different type of environment.
For example, training in oncology massage might enable you to offer special massage sessions to cancer patients, market your practice exclusively to this population, or obtain a job offering massage in a hospital’s oncology department.
The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) offers a Board Certification program for therapists who want to distinguish themselves in the field of massage therapy. Board Certification, states the NCBTMB’s website, is “the highest voluntary credential attainable in the massage therapy and bodywork profession with a distinct level of achievement beyond entry-level licensure.”
This credential requires passing a certification exam, 750 hours of education from an approved program, 250 hours of professional experience, a background check, agreeing to uphold the NCBTMB’s Standards of Practice and Code of Ethics, and agreeing to oppose human trafficking.
(One big problem in the massage industry is illegal massage establishments that serve as fronts for human trafficking; the NCBTMB, along with other massage organizations and local law enforcement, continually work to combat this situation.)
The NCBTMB also offers specialty certificates, including those in Massage Therapy for Integrative Healthcare, Sports Massage, Military Veteran Massage (New York only), and Clinical Rehabilitative Massage, with additional certificate programs planned for the future.
Ready, Set ... Massage!
We wish you the best of luck as you start on your path to a career as a professional massage therapist.
It will take hard work and dedication, but know that many resources are available to you on your journey—and that you will be making our world a better place, one massage at a time.
About the Author
Allison Payne, a former online & associate editor for MASSAGE Magazine, is now a freelance writer and editor based in central Florida. She has written many articles for massagemag.com and MASSAGE Magazine, including “What Do the New Hospital Massage Competencies Mean for Massage?“ (June 21) and “Your Video Toolbox: Take Online Marketing to the Next Level” (June).
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