Every massage therapy student should have to read at least one textbook.

I was required to take a minimum of 750 hours of schooling to become a licensed massage therapist in the state of Arizona. Roughly translated, that’s nine months of school four full days a week. Most of the curricula focused on anatomy, pathology, practical application, and ethical considerations. In order to maintain my license,  I need to take 25 hours of continuing education classes every two years.

If I had still been living in San Francisco when I decided to get a license, I could have been granted a “General Practitioner Permit” with 100 hours of training, or an “Advanced Practitioner Permit” with 200 hours of training.  In other words, if I go back to California and prove that I meet those minimum requirements, I would basically be a   General+Advanced-Advanced-Advanced Practitioner.

Somehow, I don’t think I qualify to be considered a massage therapy superhero. I also don’t think that each California school hour is twice as educational as an Arizona school hour.

What’s even more confusing: California, like some other states, doesn’t have set of statewide regulations. Even worse is that some states do have a set of regulations, but they allow their cities to impose separate regulations that therapists must adhere to. If a massage therapist wants to move over to a neighboring city, she might have to change her policy or even take an extra exam. (Of course, if that therapist moves to a different state, she might have to take an extra 900 hours’ worth of classes.)

Certain cities’ regulations are downright offensive. While I was sitting in a Scottsdale, Arizona cadaver lab to learn the ins-and-outs of human anatomy, some California would-be massage therapists were submitting to STD tests in order to become certified. Massage licensing regulations are all over the place (or for some states, nonexistent.)

The American Massage Therapy Association (AMTA) estimated in 2008 that there were between 265,000 and 300,000 massage therapists and massage therapy students in just the United States. The U.S. Department of Labor estimated that the massage therapy field would see a rapid 20 percent increase in employment from 2006-2016.

I think it’s laughable, yet also sad, that such a booming industry hasn’t yet found a way to establish a cohesive set of strict regulations. I don’t necessarily think that massage therapy should be formally standardized across the United States, but I do think that all states should establish their own regulations. I also think that all states should set similar standards.

It just doesn’t seem right to me that, while I provide injury treatments and while therapists in New York are working to obtain 1,000+ hours of training, massage therapists in some parts of the country are still called “masseuses” in the way that strippers are called “exotic dancers.”

Regulating massage therapy will:

1. Help ensure that all clients are safer because all therapists will have been background checked.
2. Ensure that all therapists have met a minimum set of educational requirements so that clients will be able trust who is treating them.
3. Set ethical standards and allow the law to apply appropriate punishments to those who break those standards.
4. Increase the amount of clinical studies performed in regard to massage therapy and encourage insurance companies to cover massage as a result of proven results.
5. Encourage massage therapists across the country to feel more united as a team.

It’s time to get the ball rolling.

If you’re interested in finding out more about regulations in your state or city, check out the following links:
Massage Therapy State Boards and Licensure
Massage Laws and Legislation in the United States and Canada

Legitimate massage therapy businesses shouldn't display this sign.

“You do massage therapy? Do you like being a masseuse?”

Well, I wouldn’t really know what it’s like to be a masseuse because I’m a licensed massage therapist (L.M.T.) in the state of Arizona. Unfortunately, that statement almost makes me sound like I add the fancy acronym to all of my magazine subscriptions as if I were a doctor. I’m not really that uptight, but I do have a legitimate reason to squirm away from the “masseuse” title.

The word “masseuse” originated in French to describe a female who gives massages and “masseur” describes a male who gives massages. “Masseuse” describes me, right?

Yes and no.

A licensed massage therapist can always be considered a masseuse/masseur but a masseuse/masseur isn’t always a licensed massage therapist. Now that massage therapy has started to become regulated in this country, most states won’t allow unlicensed individuals to charge for massage. People who aren’t licensed, certified, registered, etc. in their states do give massages on the sly, but they can’t profess that they meet state or city requirements.

Some masseuses/masseurs may be self-taught experts of anatomy and physiology. They may be better at my job than I am. (I suppose they can call themselves massage therapists as long as they don’t purport to be licensed.) Others just hand out business cards that say, “I’ll rub you the right way,” and, “Feeling knotty?” They will give you a back rub. Some masseuses/masseurs may work out of their homes, others may do outcalls, but many of them work at massage parlors, where the clientele expect a little more than a massage.

The terms “masseuse” and “masseur” were used on a regular basis in the United States for so long that it is still normal for anyone to use them interchangeably with “certified massage therapist,” “licensed massage therapist,” or “registered massage therapist.” But, as one who went through the 750 hours of schooling to obtain a license, I’d prefer not to be linked to a name which indicates that I may wear stilettos and a tube top on the job.

So, if someone ever calls me a masseuse, I don’t get huffy and say, “I can’t believe you just called me that!” I might, however, offer a gentle nudge in a more affirmative direction by nodding and saying, “Yes, I am a licensed massage therapist.”

Your abdomen is your friend.

The abdomen isn’t merely a container for most of the body’s internal organs; it is also contains emotions. Have you ever received terrible news and had the feeling that your heart has plummeted into the pit of your stomach? I have.

Some of us experience tension mostly as headaches while others of us deal with stomach problems connected with daily stress. Body stress actually begins in infancy. Many babies experience abdominal distress on a regular basis (often linked to colic,) and children get tummyaches when they are stressed out about school or friends. As we get older, we usually fall into one of two categories: headache people and stomachache people.

Sure, we might all get both every once in a while, but one type of discomfort is definitely prevalent. While I feel fortunate to be able to say I’ve never had a migraine headache, I can’t say the same about excruciating stomach pain. Most of my stomach troubles came at a time when I was being treated for Generalized Anxiety Disorder (GAD). Not surprisingly, a study published in “Alimentary Pharmacology & Therapeutics” found a direct association between GAD and Irritable Bowel Syndrome (IBS).

Emotions are indeed very physical. It’s the reason why getting a massage doesn’t just feel good physically, but also allows us to leave the table feeling like life is completely worthwhile. The best part is that, while massage does help reduce physical ailments, its benefits are multiplied because a healed mind contributes to a healed body.

I’m disappointed that massage therapists don’t spend much time working in the abdominal region. I currently have one client on whom I perform regular weekly abdominal massage, and the treatment is truly a mind-body experience for both of us.

If you get a lot of stomachaches, I encourage you to ask your massage therapist to focus on your abdomen for at least a few minutes every session. Because the abdomen can be so closely connected with emotional reservations, receiving a massage in that area can feel a little more intimate or even invasive in the beginning. Over time, however, you will get used to having someone else apply healing touch in that area, which I believe will allow you to release some of what is causing the discomfort.

I also encourage you try some basic abdominal massage techniques on yourself:

1. Lie flat on your back with a thick pillow just below your knees.

2. Rub your palms together until you feel heat radiating from your hands.

3. Let your hands rest side by side and palm-down just below your navel. Feel the steady rise and fall of your abdomen as you take slow, deep breaths. Focus on every breath, allowing your body to relax under the warm weight of your hands.

4. Using the full surface of both palms, massage your abdomen in clockwise circles to follow the natural digestive pathway in your colon. Start with small circles directly around the navel, gradually working your way out toward the edges of your torso. Let your hands work in a flowing motion by alternately stroking with one as you lift the other.

5. Let your massage last as long as your body is receptive to it, but try to work for at least 10 minutes to start with.

Tips:

• You can massage your abdomen through thin clothing, but working directly on your skin with a warming massage oil is a more effective way to induce physical and emotional relaxation.
• Check out this video if you want to see some advanced techniques.

Warning:

Abdominal massage is contraindicated for anyone:

• In the first trimester of pregnancy
• Actively undergoing chemotherapy
• Experiencing a flare-up of IBS or Crohn’s Disease
• Recently recovering from abdominal surgery
• With an abdominal aneurysm
• With cirrhosis of the liver
• With angina pectoris
• With an active infection or cancer in the abdominal region

Caution: After you get your first massage, you may be addicted for life.

Caution: After you get your first massage, you may be addicted for life.

So you’ve never gotten a massage.

Well, there has to be a first time for everything! Many clients come to me for their first massage, not exactly sure what to expect. They have an idea of what a professional massage should be like based upon some combination of what their friends tell them and what they see in the movies.

Trust your friends more than you trust the silver screen. I’ve got to say that movies provide an interesting depiction of massage therapy. While some representations are accurate, others are wildly different from the real experience. For example, most of my clients don’t look like supermodels. Secondly, not every client chooses to dress down to nothing. Finally—and most importantly—my massages are always purely platonic.

The truth is: the massage experience is different for everybody, but you should never feel uncomfortable when you are on the table. Every good massage therapist should know that and make sure that you feel at ease throughout the whole experience. However, I have to add that most massage therapists aren’t mind readers; you need to be able to feel comfortable asking questions and voicing your concerns whenever they come up.

Just to ease your mind a little in advance, I’ll lay out some common questions/concerns about a first massage and briefly respond to each.

1. I have a medical condition. Is it OK for me to get a massage? Many people with medical conditions find relief from their symptoms when they receive massage regularly. However, certain conditions are contraindicated. Some conditions, like rashes, may only be contraindicated locally (or directly on the site of the condition,) while others are more serious. Talk to your doctor before you get a massage. Once your doctor gives you the thumbs up, make sure your massage therapist knows about your condition.

2. When should I show up for my first massage? Most therapists prefer that regular clients show up at least 10 minutes early, but you should show up at least 20 minutes early for your first massage. You will need to fill out an intake form and have plenty of time to use the restroom, etc. Not all clients are aware that their massage time usually starts when they are left alone in the room to get on the table. If you show up early and are on the table by your slated start time, you generally will get a longer massage.

3. Do I have to take off all of my clothes? (Even my underwear?) You don’t have to take off all your clothes if you feel uncomfortable removing all of your clothes. In fact, some massage modalities don’t require you to take off any clothes. However, if you are experiencing low back or hip pain and you are going to receive anything like a Swedish or Deep Tissue massage, your therapist will be able to access more muscles if you remove all of your clothes. Know that even if you are fully unclothed, your therapist will only remove the sheet from one small area at a time as he or she works on it.

4. How often should I talk during the massage? Some massage clients find that they are able to unwind more if they get to know their therapist a little bit in advance. Others find talking completely unnecessary. Massage therapists are used to having talkers and non-talkers. However, your therapist should check in with you periodically to make sure you are comfortable and to inform you if/when you need to change your position on the table.

5. Is massage painful? It shouldn’t be painful for you. Your therapist will work to your pressure tolerance and ask you how you feel: don’t lie if you’re not enjoying the massage. The only person you’re hurting is yourself. If you’ve decided to get a massage in order to relieve some pain, you may experience some discomfort when your therapist does condition-specific work. Even then, your therapist should check in with you to make sure he or she is working within your threshold.

6. What happens if I accidentally get aroused? Sometimes things like that happen even when you don’t have sexual thoughts running through your head. All good therapists should know that and not think anything of it. However, if you begin to act based on any of those sensations (e.g. you touch your therapist or make insinuating comments,) your massage therapist reserves the right to—and very well should—end the massage right there and refuse to give you massages in the future.

7. What if I feel so relaxed that I end up falling asleep? Great! I encourage my clients to fall asleep. I especially find that clients who don’t get much sleep at home are able to fall quickly asleep during a massage. Most sleeping clients’ bodies are so relaxed that I am able to make more progress than I would be able to if they were tensing their muscles the whole time. Also, don’t worry about snoring. Therapists hear that all the time.

8. What should I do after my massage? Stay relaxed! Take deep breaths and be mindful of your body for the rest of the day. After the post-massage sleepy, trance-like state wears off, you should feel well-rested and maybe even have a heightened sense of clarity for the rest of the day. Also, don’t forget to drink lots of water. Water is a great natural way to flush toxins (natural metabolic byproducts that come to the surface during a massage) out of your system. I once didn’t hydrate properly after I got a massage and I didn’t feel so great a few hours later.

9. Should I leave a tip? Just as you would tip a hairdresser or server, leave your therapist gratuity if you think she deserves one. Since I work in a chiropractic office where not all clients realize they’re even allowed to tip, I’m very grateful for any tips I receive. Be aware that therapists who work at spas only earn a small fraction (~20-30%) of what the massage cost, and therapists who work for other therapists or chiropractors typically only receive about 40% to half of what the massage cost.

Do you have any other questions? Send me a note on my contact page and I’ll get back to you as soon as I can.

Massage therapy students are sometimes required to give out free chair massages.

Do you want a massage therapy license? Here are some steps you need to take to get one, whether the idea of becoming a massage therapist is just a passing thought or it is your lifelong passion.

1. Find massage therapy license regulations for the state you live in. If you live within the United States, massage therapy license requirements vary state-to-state. In some states (Arizona, for example) they have been regulated across the entire state. However, if you live in a state like California, massage therapy license requirements vary by city. Go here to find a list of requirements by state. To gather more up-to-date information on your state, use a search engine and enter a term such as “massage therapy license Texas” (or replace ‘Texas’ with the state you actually live in.) Sites created by your state government are the most accurate. Decide right now if you can truly commit to the hours, cost, and work necessary to complete a full program.

2. Visit a website  like this one to find nearby schools that will cater to your needs as a potential student massage therapist. You may also want to type “massage therapy schools” and the name of your city into your favorite search engine to make sure you’ve located all of your possible options. What you find will vary greatly depending on where you live. If you live in a more rural area, you will probably have to travel a bit to find the school you’re looking for. If you live in a bustling, modern metropolis such as Seattle or New York City, your main predicament will be sifting through all the available massage schools in order to find the one that suits you best.

3. Call the massage therapy school(s) you’re interested in attending to schedule an interview. Most schools will have an admissions counselor/specialist whose job it is to show you around the school and answer any questions you may have. Be aware that this person isn’t necessarily a massage therapist.  Her job is to recruit new students.

4. Ask a lot of questions at your interview, including:
-Is the school accredited?
-What types of classes will you take?
-What are the qualifications of its instructors?
-Does the school help students obtain their massage therapy licenses by providing the necessary paperwork, etc.?
-What kind of job placement assistance does the school offer?
-What is the school’s reputation?
-Do classes prepare students to take any massage therapy license-required state and/or national exams?
-What is the cost of tuition and who do you talk to regarding financial aid?

5. Choose a school and get ready to sweat. Because massage therapy is being looked at as a legitimate form of complementary and alternative health care, more and more rules are regulating it and making a massage therapy license more difficult to obtain. Expect to take in-depth anatomy courses and ethics classes. Also expect to give away a lot of free massages before you obtain your massage therapy license. Extra work is a good thing because it means that massage therapists are increasingly being respected as legitimate practitioners rather than as “masseuses” and “back rubbers”.

My About section already offers a little bit of insight about why I started this blog, but I don’t think that a formal overview entirely portrays who I am.

Who am I and what makes me a reliable guide?

Well, to fully cover the most significant aspects of my life I’d need to make myself a large cup of strongly caffeinated tea and have a few hundred extra hours on my hands. I don’t have a few hundred hours at my immediate disposal, but I do have a blog, an indefinite future, and a few spare hours here and there. I’m excited that, in time, I’ll have the chance to let my personality and some credibility shine through these virtual pages.

For now, let me make it clear that I don’t think of myself as a massage therapy guru of any sort. I’m still very new to the field, but massage therapy as it is currently known is also somewhat new. I’m proud to be a licensed massage therapist in a time when more and more research is being dedicated to understanding therapeutic massage therapy as a medicine in its own right. (Did you know that massage therapy is the most commonly used form of complementary and alternative medicine in U.S. hospitals?)

I’m excited and honored that you’ve chosen to join me as I also educate myself about the endless healing potential of human touch.