How to Become a Massage Therapist


By Sarah Maurer
massage therapist at work

Nothing feels better than a good back rub. But modern massage is about much more than pleasure and relaxation. A growing number of doctors, physical therapists and chiropractors are integrating massage and bodywork into their care. And as the elderly population grows rapidly in coming decades, massage may help millions to age more comfortably.

Massage therapists are health care workers who manipulate the body’s soft tissues (including muscle, lymph and connective tissue) to promote wellness, relaxation and healing. Most are skilled in several modalities, or massage techniques, such as Swedish massage, sports massage, deep tissue massage or trigger point therapy. Massages can last from five minutes to 90, depending on the setting and the client’s goals.

Here are just a few of the things massage therapists do every day:

  • Take clients’ health history and assess their goals for therapy
  • Deliver massage and therapeutic touch treatments
  • Provide wellness information to clients, which often includes tips on posture and stretching
  • Teach stress management and relaxation techniques

In addition, self-employed massage therapists handle their business operations, which include billing, marketing, scheduling, cleaning and inventory.

The need for trained massage therapists is growing. More and more health care professionals are prescribing massage as a therapy for sports injury, chronic pain and headaches. Skilled massage therapists can help to reduce the side effects of cancer treatments, assist children with sensory disorders, and even ease the pain of childbirth. Gentle massage has been shown to enrich the lives of older people, including those with Alzheimer’s disease and related dementias.

A career in massage therapy can be hugely rewarding, and most therapists report a high level of satisfaction with their jobs. They love helping their clients achieve new levels of healing, relaxation and well-being. The social nature of massage makes it a great choice for "people people" who value interaction and physical contact. Massage also offers a flexible schedule and the chance to practice in a variety of settings, from nursing homes to cruise ships.

Work Environment

Most massage therapists work in several places. According to the American Massage Therapy Association (AMTA):

  • 69 percent run their own businesses
  • 65 percent work in client’s homes or workplaces
  • 39 percent maintain their own offices
  • 36 percent work at home
  • 27 percent work in health care settings (usually physician practices, chiropractic practices, physical therapy practices, hospitals or nursing homes)
  • 25 percent see clients in a spa setting

Therapists are also employed by health clubs, hotels, cruise ships, massage franchises and sports teams. Some travel to private parties, conferences and sporting events to offer their services.

According to the AMTA, massage therapists work an average of 17 hours per week, which includes both massage time and business functions like billing and marketing. About half practice massage as a second job. Schedules are generally quite flexible, especially for self-employed therapists who can set their own hours. (This is less true in health care settings, where scheduling revolves around patient care.)

Most massage therapists serve all types of clients. Advanced training makes it possible to specialize in working with infants, children, pregnant women, the elderly and people with certain medical conditions.

Massage therapy is a hands-on profession. Therapists need to understand the underlying anatomy of the human body and be comfortable with frequent physical contact. They also work with basic tools like tables, massage chairs, heat lamps and oils. In health care settings, it may be necessary to adjust techniques around beds and medical equipment, which can be tough on the therapist’s body.

The physical demands of massage therapy are considerable. The job requires strength, dexterity and the ability to stand for up to 90 minutes at a time. For these reasons, therapists are prone to injury. Good self-care, including proper diet and exercise, is therefore an essential part of the job. Using proper technique can also help reduce the risks.



Formal training in massage therapy is a prerequisite for licensure in most states. Admission to massage training programs generally requires a high school diploma of GED. Aspiring therapists can prepare in high school by taking classes in biology, anatomy, physiology and business.

Massage therapy training programs are available through public and private career colleges and massage therapy schools. Certificate programs take 500-1,000 hours to complete, depending on state requirements. Some schools also offer two-year Associate of Science degrees. Curriculum typically covers anatomy, physiology, pathology, kinesiology, assessment, bodywork techniques, business knowledge and professional ethics.

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) oversees massage schools to ensure that they meet basic curriculum requirements. In many states, candidates must graduate from an NCBTMB-assigned program in order to sit for the licensing exam. The Commission on Massage Therapy Accreditation (COMTA) provides additional voluntary accreditation for massage therapy training programs.


A good massage therapy program involves supervised, hands-on training appropriate to the student’s skill and educational level. Many programs include an internship, and therapists often seek additional supervision and volunteer opportunities before their first paid employment.

Massage therapists who wish to enter private practice may find it helpful to obtain additional business training at a college, career center or small business development center.

The AMTA provides a mentoring program for new massage therapy professionals.

Licensing and/or Certification

Forty-four states and the District of Columbia regulate massage therapists. Depending on where you live, this could mean anything from meeting rigorous licensure requirements to simply registering yourself prior to practice. Please note that some cities and counties have additional requirements.

For licensure, candidates must prove that they’ve met the state’s educational requirements (usually 500 to 1,000 hours of formal training) and pass an exam. The most common tests are:

  • Massage and Bodywork Licensing Exam (MBLEx), administered by the Federation of State Massage Therapy Boards
  • National Certification Examination for Therapeutic Massage (NCETM), administered by NCBTMB
  • National Certification Examination for Therapeutic Massage & Bodywork (NCETMB) administered by NCBTMB

Board Certification as a massage therapist is voluntary, but opens up many opportunities. Certification streamlines the licensure process in many states. Some health insurance policies only cover massage by certified therapists.

NCBTMB administers the NCB, or Board Certification credential. To qualify, candidates must:

  • Pay a $250 fee
  • Complete 750 hours of initial and continuing education
  • Complete 250 hours of hands-on massage experience within six months of graduation
  • Pass a background check
  • Obtain CPR certification
  • Commit to uphold NCBTMB's Standards of Practice and Code of Ethics
  • Pass the Board Certification exam

Certification lasts for two years. NCB therapists must engage in 24 hours of continuing education every two years to maintain the credential.

Various massage schools and programs offer advanced certification. Among the most reputable of these is the Liddle Kidz Foundation, which administers the Certified Pediatric Massage Therapist (CPMT) and Infant Massage Certification (CIMT) credentials. The Compassionate Touch Certified Practitioner credential may be useful for therapists who plan to work with the elderly or in hospice or palliative care settings.

Necessary Skills and Qualities

Above all, a career in massage therapy requires robust physical health. Therapists need excellent stamina in order to remain on their feet for long periods. Many massage modalities require considerable hand and arm strength.

Good mental and emotional health is also crucial. Therapists must know how to build rapport and trust while maintaining appropriate boundaries.

Interpersonal skills are a definite plus. Therapists use their strong listening and communication abilities to understand clients’ goals and preferences. And because most massage practices thrive on repeat business, excellent customer service should always be a priority.

Like all health care professionals, massage therapists need to be good decision-makers. This is especially helpful when evaluating the clients needs and formulating a treatment plan.

Finally, good business skills are helpful, especially for therapists who plan to be self-employed. Marketing, bookkeeping and other business functions play a huge role in success of any massage practice.

Opportunities for Advancement

Massage therapy offers a number of opportunities for growth and personal enrichment. With over 80 massage modalities in existence, there’s always something new to learn. Therapists can also focus on a clinical area like cancer care, sports massage, infant massage and even specialized sensory massage for children with autism spectrum disorders.

The majority of massage therapists eventually establish a private practice, even if they continue to work in other settings on the side. Franchising is another option - chains like Massage Envy, LaVida Massage and Zen Massage provide considerable startup assistance for new owners. Serving as a consultant to hospitals, nonprofits, spas and fellow massage entrepreneurs is also an option.

Many massage therapists find fulfillment in supervising the work of others. Some manage hospital-based massage programs, spa-based programs or cruise ship services. Others enjoy passing along their knowledge as massage instructors.

If you would like to gain the necessary education to become a massage therapist, we highly recommend that you check out our free School Finder Tool located HERE.


According to the US Bureau of Labor Statistics (BLS), the median annual pay for massage therapists is $38,040. The lowest-paid 10 percent of therapists earn less than $18,860, and the highest-paid 10 percent earn more than $74,860.

When considering these figures, it’s important to bear in mind that most massage therapists work part-time and pay varies considerably across settings. Therapists working for a franchise might make as little as $15 per hour. Those in high-end spas can make considerably more, especially with tips. And self-employed therapists charged an average of $68 for an hour of massage, according to the AMTA.

Earning power generally increases with experience. It takes time to build up a robust clientele and repeat business. Certification can also boost earnings by allowing therapists to accept clients' health insurance plans. (The number of plans covering massage is currently small but expected to grow in coming years.)

Job Outlook

The future is looking bright for massage therapists. According to the BLS, employment of these professionals is expected to grow by 22 percent between 2014 and 2024, far faster than average. This trend is driven by a number of factors, including the growth of the spa industry and the availability of affordable massage franchises.

The profession is also getting help from health care professionals. Doctors, chiropractors and therapists increasingly include massage in their treatment plans.

The growth of the elderly population is another boon for massage therapists. Older people are discovering the many physical and emotional benefits of massage. Hospice, palliative care and eldercare programs are increasingly incorporating massage into their services.

To improve their job outlook, massage therapists should consider pursuing Board Certification. Credentialed therapists are listed in NCBTMB’s searchable online database. Certification also allows therapists to accept some insurance plans.

The AMTA Job Bank provides helpful resources for therapists who are looking to advance in their careers.

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