Massage and other body therapies promote physical, emotional, mental, and spiritual health through the use of human touch. Massage therapists use their hands and arms to manipulate and stimulate the body's muscles and tissues. In addition to feeling good, massage can alleviate or improve common health problems by stimulating lymph fluids, increasing blood flow, and eliminating toxins. It is a healthy, drug-free method for addressing various health problems, relieving stress, preventing disease, and maintaining health.
Philosophy
Massage therapy is an ancient and sacred healing method that began thousands of years ago. To touch someone in comfort or to rub an aching muscle is a natural instinct valued as a healing method throughout history and the world. Massage developed from Eastern folk traditions of China and India. Peter Heinrik, a Swedish athlete and educator, brought massage to Western culture by developing Swedish massage, still the most popular form of massage. Today's massage has branched out into many forms, each with their own traditions. The philosophy that underlies and connects all massage is the belief in the healing power of human touch. Touch is believed to comfort, care, relax, and improve the body's ability to heal.
In addition, massage offers many physical, emotional, and mental health benefits. Some of the physical benefits include the following:
- increases circulation of blood and lymph fluids
- increases joint flexibility and range of motion
- relaxes nervous system and reduces the negative effects of stress
- reduces blood pressure
- nourishes skin
- stimulates endorphins, the body's natural painkillers
- improves body posture
- strengthens immune system-prevents disease
- improves healing of sprained or pulled muscles and ligaments
- reduces spasms, swelling, pain, and formation of scar tissue
- promotes deeper and easier breathing
- increases excretion of wastes products-improves digestion
- promotes deep relaxation and reduces mental stress
- increases capacity for clear thinking
- creates a relaxed state of awareness
- creates a feeling of well-being
- reduces anxiety
- enhances self-image and self-esteem
- satisfies need for caring touch
- increases the mind/body connection
- eases emotional expression
It should be noted that although the word therapist is in the job title, massage therapists are not trained in psychology and do not provide talk therapy. Massage therapists who have additional schooling in psychology or counseling may combine their services, but as a rule massage therapists do not provide therapy. They are often caring and empathic people who will listen to their clients, but they are not trained to do psychotherapy.
Types of Massage
Although massage therapists don't diagnose health problems, they spend time in the beginning of each session asking clients about their health, medical history, previous or current medical treatments, stress levels, work, and social factors. They want to find out why a client is seeking massage therapy and what he or she hopes to get out of it. This information helps the massage therapist decide what to focus on during the massage.
The field of massage therapy has blossomed, and there is a wide variety of therapeutic massage methods. Each massage method has its own techniques, theories, and philosophies. Some massage therapists focus on one method of massage, while others use a combination of techniques for working with clients. Typically, massage therapists are trained in one method of massage but may incorporate other techniques depending on their training and client needs. Listed below are some of the popular therapeutic massage and bodywork methods.
Swedish massage: The most common massage method in the United States used for general relaxation and muscle tension. A soothing full body massage that uses long strokes and kneading techniques, it improves circulation and range of motion, removes muscle wastes, and increases flexibility. Swedish massage works from the belief that you always massage toward the heart for circulation benefits.
Neuromuscular/Trigger Point Therapy: A deeper form of corrective massage used to restore muscles to proper functioning. It uses concentrated finger pressure on specific areas to relieve pain or break spasms. It is also used for clients seeking deeper relaxation.
Deep Muscle Massage: Through the use of slow strokes and deep finger pressure on specific areas, it releases tension in the body. Often used for treating muscle spasms, scar tissue, and chronic tension, it also can be used for specific problem areas or for a full body massage.
Sports Massage: Sports massage therapists enhance an athlete's performance by increasing muscle flexibility and removing muscle waste. Using massage as a warm-up supplement can decrease the risk of injury. Sports massage is also used to reduce stress on the body that occurs from vigorous exercise and to assist in the healing of soft tissue injuries.
Reflexology: Similar to acupuncture, reflexology applies pressure to specific points on the hands and feet that are thought to correspond to different organs and areas of the body. Some massage therapists specialize in reflexology (called reflexologists), while others incorporate reflexology into a full body massage.
Chair massage: Chair massage is a type of massage that is showing up in workplaces, shopping malls, health fairs, and trade shows. Therapists use their preferred massage techniques, but the massages are given in special chairs. Clients are fully clothed, and the typical on-site chair massage takes about fifteen minutes.
Rolfing: The goal of Rolfing is to align the body along a vertical axis. The therapist (called a rolfer) uses thumbs, hands, and arms to deeply realign, reeducate, and alter the length and tone of muscles. The therapy can be slightly painful, but this structural integration is believed to increase the health and effectiveness of body functioning.
Trager: The Trager method is a fluid, moving, therapy that uses bouncing and light rocking movements to loosen joints, increase flexibility, and release physical and psychological tension.
Craniosacral Therapy: Craniosacral therapy is the massage of the bones in the face, neck, head, and skull. Bones and membranes are subtly manipulated to reduce tension and to treat headaches, ear infections, migraines, and jaw pain.
Shiatsu: This is a Japanese method of massage that uses deep pressure on meridian points along the body to increase the flow of chi or life energy. The therapist uses hands, elbows, arms, knees, and feet to apply rhythmic, deep pressure. Typically the client remains clothed.
Pregnancy and Infant Massage: Massage therapists specialize in pregnancy massage to help women with muscle pain, fluid retention, and other discomforts of pregnancy. Upon birth, infant massage therapists teach mothers massage techniques to increase newborn motor skills and bonding of mother and child.
The average length of a massage is one hour, although sessions vary from half an hour to two hours in length. In some settings it can be as short as fifteen minutes, such as chair massages offered in the workplace. The number of massage sessions depends on the therapist's method and the client's health goal. People who use it for relaxation may only get a massage when they are stressed. Others with certain health conditions need massages weekly or daily, as in the case with athletes. There is no typical length of treatment because massage is often used as a supplement to medical treatment. It should be noted, however, that the therapeutic benefits of massage are cumulative-the more often a person gets a massage, a deeper level of relaxation is reached and the better he or she will feel.
Employment Settings and Working Conditions
"A lot of massage therapists just starting out like to work in established practices so they don't have to worry about insurance, health codes, zoning laws, and getting an establishment licensed. Or they can go out on their own. Where I work, another person owns it and I pay a percentage of what I make. For me it is the perfect thing, working part-time and being a wife and mother."
-Petra Jennings, Massage Therapist, NCMT
Massage therapists work individually in private practice or in group practices with other massage therapists and health practitioners. They can be found working with doctors, nurses, physical therapists, psychologists, chiropractors, and acupuncturists. Massage therapists can be found in hospitals, nursing homes, health clubs, hotels, fitness centers, spas, beauty salons, vacation resorts, and on cruise ships. Some work as private therapists for the rich and famous. Increasingly, massage therapists are being hired by corporations to provide massage in the workplace in the attempt to reduce stress on the job and keep employees healthy. A small number of massage therapists teach at schools of massage.
Massage therapists have the flexibility to choose their own work settings and levels of responsibility. If they choose private practice, they have the added responsibility of running their own businesses. They are responsible for advertising and marketing their services, billing clients, keeping records, scheduling appointments, filing taxes, obtaining insurance coverage, and managing the office. Most massage therapists in private practice do everything themselves, where group practices may hire office employees, adding the responsibility of staff supervision, payroll, and employee benefits. Massage therapists in private practice can design their work environments and schedules and control the number of clients they see each week. Many massage therapists offer evening hours to be more accessible to working clients. Massage therapists in private practice work in offices that are relaxed, comfortable, and clean. Some work in their homes or go to clients' homes. Self-employed massage therapists typically earn more than do those who are not.
Besides self-employment, there are many other employment settings available. The conditions vary as working in a corporation is very different from working on a cruise ship. Corporations, health clubs, spas, cruise ships, and resorts often have massage therapists working on staff as salaried employees. Another avenue is contracting. Spas, health clubs, and corporations may contract a massage therapist on a part-time basis. In this case, therapists may work one day at spa, a few days at a health club, and one day at a corporation. In these situations massage therapists are still considered self-employed, but they have different responsibilities from those in private practice. A benefit of this profession is the various work scenarios available, and massage therapists can design their work life to meet their individual interests and needs.
As with work settings, the number of hours worked varies. Working full-time as a massage therapist doesn't mean doing eight hours of massage a day, for five days a week. Massage is hard work and can be physically and emotionally draining. It is difficult to stay mentally focused, and physically it is hard on muscles, hands, and back. Again, it is up to the massage therapist how much work he or she can handle, but according to massage therapist Petra Jennings, three to five massages a day, five days a week is feasible.
"It's really an enriching experience. The effect massage has on people is really wonderful. And they keep coming back and coming back!"
-Petra Jennings, Massage Therapist, NCMT
The Profession
Estimates vary, but according to the American Massage Therapy Association there are between 120,000 and 150,000 massage therapists working as full and part-time practitioners. Massage therapists practice in every state in the United States, and twenty-five states and the District of Columbia license them.
Training and Qualifications
Most massage therapists enter the profession because they want to help people in a personal and meaningful way. Success as a massage therapist requires academic knowledge, technical and clinical skills, manual dexterity, sensitivity, interpersonal skills, communication skills, and a strong commitment to helping others. Knowledge of massage techniques combined with empathy and caring are important qualities for this career.
In 1992 a certification exam called the National Certification in Therapeutic Massage and Bodywork (NCTMB) was created as the first nationwide method for credentialing massage therapists. This certification enhances a therapist's professional credentials. The approximately 15,000 therapists today holding this certification are required to participate in continuing education and professional development activity to stay current in the field.
Although there are more than sixty accredited schools of massage in the United States, many others are not accredited by the American Massage Therapy Association. All programs accredited by the American Massage Therapy Association require at least 500 hours of classroom instruction, with a minimum of 300 hours of massage therapy techniques, 100 hours of anatomy and physiology, and 100 hours of additional required courses including first aid and CPR. Outside of these minimum requirements, programs vary in terms of philosophy, techniques, character, number of hours, and curriculum. States have requirements for practice, and schools often reflect these requirements.
Each school of massage has its own admission requirements, but typically applicants must have a minimum of a high school diploma or GED. Schools look for mature candidates who are physically, emotionally, and academically able to practice massage therapy and are in good health. Applicants must have a clear desire to help people and a motivation for massage therapy.
The length of time to complete massage therapy training can be from six months to one and a half years of full-time study. Many schools offer part-time evening or accelerated programs to make it available to working adults who are making a career change. The number of hours required for training varies between 500 and 1,000 hours.
All programs include classroom instruction, lectures, demonstrations, paired practice, and clinical internships. Upon completion, therapists can continue their education to develop a specialty or to deepen their knowledge of the body and massage. Typical specialty areas include sports massage, infant massage, reflexology, Shiatsu, structural bodywork, and mind/ body massage.
In states not listed, no state agency administers massage credentialing. This does not mean massage therapists can't practice in those states. Massage therapists practice in all fifty states in the United States. In states without state licensing, local or county governments regulate massage practice. Even in licensing states, local laws may still apply. Contact the city attorney, mayor, or county commissioner's office for information on regulations.
"I can't imagine anything better than what I am doing now. But it's not for everybody. You have to be caring and take into consideration that there are going to be overweight people, extremely thin people, and people with skin conditions and disease. You need to be able to see beyond the physical-ness of it."
-Petra Jennings, Massage Therapist, NCMT
Job Outlook and Salary
Massage therapy is a growing field driven by consumer demand. In a study published in the New England Journal of Medicine, massage therapy was found to be the third most prevalent type of alternative medicine used by adults in 1990. According to American Massage Therapy Association, consumers visit a massage therapist seventy-five million times each year. Legislative activity and increasing licensing laws also indicate the growth of this profession. With the increasing interest in preventive health by the public and an awareness of the negative effects of stress, massage therapy as a profession will continue to grow.
Salaries can be influenced by the qualifications of the therapist, client satisfaction, number of years in practice (if self-employed), employment setting, and geographic location. In most cases, massage therapists receive payment from clients. Massage therapists charge between $35 and $75 per hour. According to a 1994 American Massage Therapy Association survey, the median income for members was between $20,000 and $29,000 a year, with 30 percent earning in excess of $30,000 a year. Some insurance companies will pay for massage if it has been prescribed by a physician.
