Author: LauraAllenMT

Massage therapist, author, educator, blogger
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You Say To-may-to, I Say To-mah-to

Actually, I’m from the south, where we often say “mater.” A ‘mater sandwich should be on white bread, slathered with an artery-clogging amount of Duke’s mayonnaise, and eaten standing over the kitchen sink so it can run down your chin and drip appropriately.

Everybody has their opinions…I’m out here regularly expressing mine, and not everybody agrees with them. That’s fine by me. The world would be a boring place if we all thought the same thing, and the world of massage is no different. This morning, as is my habit when I’m drinking my coffee, I looked at the comments on my blog, hung out on FB, checked out the massageprofessionals.com website to see what kind of arguments were brewing, all a part of my usual routine.

There are so many wonderful and dedicated people in our profession.

Some of them think the standards for entry-level education should be raised, and some of them don’t.

Some of them think massage therapy should be regulated to the nth degree, and some think it shouldn’t be regulated at all.

Some think continuing education requirements are nothing but a burden on their time and finances, and some look forward to taking it.

Some think teacher standards need to be raised, and some don’t.

Some think they have good representation from their professional association, and some don’t . Some don’t belong to one at all, nor do they care to.

Some massage therapists think of themselves as health care providers, and some don’t.

Some think evidence-based practice is the only way to fly, while others immerse themselves in energy work and all manner of woo-woo that can’t be proven.

Some get involved in politics, pay attention to what’s going on in regulation and legislation, and some don’t.

Some step up to the plate and volunteer, and some just want to be left alone to practice massage.

People have their own opinions on what constitutes dressing appropriately for massage, whether or not they should discount services, whether or not it’s okay to give away free massage, whether or not it’s okay to massage friends and family, whether or not it’s ethical to retail products, whether or not it’s okay to give undraped massage.

Every morning, during my routine, I am always noticing the differences of opinion. As I just posted on FB this Easter morning, my friends include Christians, Pagans, Buddhists, Muslims, Hindus, Jews, atheists, agnostics, and pretty much every other religion or lack thereof on the planet. It’s the same with my massage colleagues. The fact that you don’t share my opinions doesn’t make me like you any less, anymore that the fact that you have different religious beliefs would make me like you any less.

We’re all here for the same reason: we know the awesome power of touch. We know massage restores and heals. As for the rest of it, take what you like, and leave the rest. I’m going to go have a ‘mater sandwich.

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My Organization is Better Than Your Organization

The massage profession has a plethora of organizations these days.

AMTA (American Massage Therapy Association) is a non-profit organization that has some executive staff at the top, a board elected by the members, and a hearty band of tireless volunteers that keep the wheels turning. AMTA has about 57,000 members.

ABMP (Associated Massage & Bodywork Professionals) is a for-profit concern, and frankly I’m just sick and tired of hearing that fact stated as a criticism. What is inherently wrong with making a profit? I want to make one in my massage therapy practice, don’t you? ABMP has around 77,000 members.

The NCBTMB (National Certification Board for Therapeutic Massage & Bodywork) , for 17 years, was virtually the exclusive provider of certification exams that were used for licensing in many states, and the approval body for continuing education providers. A few states had/have their own exam. About 90,000 massage therapists are nationally certified. The NCBTMB also has a board elected by their certificants.

Then along came the FSMTB (Federation of State Massage Therapy Boards) with the MBLEx test as a route to licensure, which many of the 40 or so member states have adopted. The Federation also recently announced plans to get into the business of approving continuing education, and they are creating a model practice act. They also have a board, which their state delegates elect.

The new kid on the block is the AFMTE (Alliance for Massage Therapy Education), which aims to advance the quality of education and develop a model of teacher standards. The Alliance has announced that they would be collaborating with the FSMTB on the continuing education project. They still have their first board seated; that’s how new they are.

We’ve also got COMTA (Commission on Massage Therapy Accreditation) in the business of giving accreditation to schools and programs who meet their standards of excellence. Getting COMTA approval is voluntary, expensive and time-consuming. There are only 100 or so that have earned it.

The majority of states now regulate massage, some by their own self-supporting massage board, some lumped in with nursing boards or other health boards. I am often asked by therapists what their state board does for them. Other than issuing their license and in some states licensing schools, the answer is not much. A public board serves the purpose of public protection. Some do a better job than others. State board members are appointed by politicians. The average board is usually composed of a few dedicated people, often includes one or two clueless slackers, and a rebel redneck like me. I’m sure my board is glad I’m at the end of my service. My blog makes them nervous.

I’m a member of both AMTA and ABMP. I’m a member of FSMTB by virtue of my seat on the North Carolina Board, which I will be vacating later this month after five years. I have been a past delegate to the Federation. I am a founding member of the AFMTE. I’ve been nationally certified for over ten years, and an approved CE provider under the NCBTMB as well. I am soon to go on my first site visit for COMTA. I attended their reviewer training after I wrote a few derogatory blogs about them and they invited me to attend. Positive change usually happens from within, doesn’t it?

I have a stake in all these organizations so I’ll pat them on the back when I think they deserve it, and I don’t mind calling them out when I think they deserve it. I have the same attitude with them that I have with other massage therapists who act competitive instead of collegial. This isn’t a contest. If one organization has to fail in order for another to succeed, that’s just a big shame as far as I’m concerned. When one organization slams another and presents half-truths and posturing, it starts to look like a playground fight–better call that a turf war, I guess–and it’s not attractive in the least.

None of these organizations would exist without their constituents–the massage therapists. And none of them can represent all of the people all of the time. They’ve all made moves that didn’t suit me at one time or another, and what ticked me off may have made other MTs perfectly happy, or vice versa. And the therapist who isn’t represented by any of them probably couldn’t care less what they do or how they act. In fact, many of their own members couldn’t care less what they do or how they act. When it comes to the professional associations, many therapists just join for the insurance and have no interest in the political fray at all–until something detrimental happens that affects their license or access to education.

If you don’t like a piece of proposed legislation, contact your legislators to tell them. And if you don’t like the direction your professional organization is taking, contact them to tell them. Get yourself in there as a board member or volunteer and change it from within. Cancel your membership, or switch organizations.  Money still talks. It’s akin to voting…if you don’t exercise that right, then don’t gripe about the outcome. Go to your state board’s meeting and sign up for public comment. You have a voice. It’s only effective if you use it.

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More Myths of Massage

Last week I wrote a post on Facebook about some of the myths of massage. My statement on this issue was and continues to be that I am not accusing anyone of telling a deliberate lie, nor am I attacking the character of any teacher who has helped to perpetuate these myths. I choose to believe that everyone has good intentions.

Before I became interested in the evidence-based practice of massage, I’ve been just as guilty as sharing some of them myself. There seem to be so many of them, and in my opinion  people tend to blindly accept what they learn in massage school. We view teachers as authority figures, but the fact is, teachers have a tendency to repeat what they were taught in massage school…so they pass that on to their students, who in turn share that false information with their clients, with the best of intentions. Some of those same students go on to become the next generation of teachers, and those same myths just keep being perpetuated.

Yesterday I heard from Lee Kalpin of Ontario, who shared a few more of these massage myths with me. I am presenting them here, and if anyone has any valid research references that will back these up as fact, please feel free to post it for our enlightenment.

– Massage removes toxins from the muscles.

– Lactic acid is responsible for DOMS (Delayed Onset Muscle Soreness).

– Massage can get rid of cellulite.

– It is contraindicated to massage a person who has cancer (or had cancer).

– If you massage a person who has consumed alcohol, it will increase the effects and make them more intoxicated.

– You can strengthen muscles by performing tapotement.

– You can straighten a scoliosis by doing tapotement on the weak side and stretching on the tight side.

– Manual Lymph Drainage causes the lymphatic channels to collapse for 20 minutes so you cannot do any other manipulations after MLD.

– You should never do more than 3 trigger point releases in a treatment (no reason stated for this one – it was just stated as a fact).

– Ischemic compression for trigger point release should be done as deep as possible.

– Only deep massage is therapeutically effective – as deep as possible. Lighter massage is just for relaxation.

– You should not massage pregnant women during the first trimester.

– You should not massage the feet and ankles of a pregnant woman as it may cause her to miscarry.

– Drinking lots of water flushes toxins out of the system – encourage the client to drink water after a massage.

– You cannot massage a person who has “high blood pressure” – definition needed about how high is high, and cause of hypertension.

– You must massage toward the heart or you could damage the heart valves.

– It is contraindicated to massage pitted edema.

I must say that I have heard all of these at one time or another. Where did they come from? I don’t know. As one FB friend said “I heard it from some reputable teachers.” And they probably heard it from their reputable teachers.  So let’s just let the buck stop with us. If the words “research shows” are going to come out of your mouth, then back that up with the actual research reference, and if you can’t produce any, don’t say it–to your students or to your clients. If all the evidence you need is that massage helps people feel better, then let that stand for itself and don’t make wild claims. And please, as I said above, if you have the research to prove any of these statements, share that with the rest of us.

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Local Legislation Often A Disgrace to Massage Therapy

I usually report on state legislation, but the fact of the matter is, educating legislators about massage therapy has to begin in your own backyard. In many places, whether there is state regulation of massage or not, local laws are so archaic and penalizing to massage therapists, it is just disgusting.

The latest thing to hit my radar is from the city of Indianapolis. The application required to practice massage in the city is entitled “Application for Massage Therapist/Escort/Body Painting/Nude Model License.” Update 09/20/2025: Thankfully, this is no longer on their website. 

I am shocked and appalled that this still exists. Where are the massage therapists who should be up in arms about this? Is everyone so complacent they just fill it out and don’t complain? Has anyone ever brought it up to the city government? Have any of our professional associations seized this opportunity to protect the rights of massage therapists?

A few years ago in the small town of Canton, NC, one of my former students excitedly opened her massage therapy practice, and within two days was cited for “massaging a member of the opposite sex.” She had no idea her hometown was a throwback to the Dark Ages, and she wasn’t going to take it lying down. She printed off copies of our Practice Act for every member of the town council, and got herself put on the agenda for the meeting, where she proceeded to enlighten them about the realities of being a professional therapist. The end result was the repeal of an ordinance that was enacted back in the 50’s in an effort to thwart illegal “massage parlors.”

I hope that the massage therapists in Indianapolis will take a lesson and rise up to do something about this. Unfortunately, it isn’t the only place where idiocy like this is perpetuated. After I posted this on my FB page, therapists started coming out of the woodwork with their own stories of unfair local laws. …locales requiring massage therapists to take tests for sexually transmitted diseases, applications that still say “Massage Parlor” and all manner of derogatory and unfair laws aimed at us.  All I can say is what I’ve been saying for the past few years: Don’t wait for someone else to do something about it. Take the initiative and get the ball rolling. Call your colleagues and ask them to appear with you at a town council meeting. Write letters and call your local legislators. Don’t sit on your hands. If we don’t educate legislators, nobody will.

 

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Texas Hold ‘Em

Update 09/20/2025: If there is no blue link, the referenced legislation no longer exists and the representatives email address no longer exists. 

Texas has a few pieces of massage legislation in the offing. And while I don’t think most of it is as detrimental to the profession on the whole as the recent amendments to Utah’s regulations, I can’t say I’m crazy about it. I have a fundamental problem with regulations that are not clearly defined, and this seems to be one of those cases. Their language just plain ticks me off, as well.

HB 722 starts out with “relating to the regulation of massage therapists, massage schools, massage establishments, and sexually oriented businesses, providing penalties.” Do we see any legislation that starts out “relating to the regulation of bowling alleys, physician’s offices, funeral homes” etc that has to include “sexually oriented businesses?” No, we do not. Texas is far from the only state who refers to us in this manner.

As we read further, we come to an amended section (there are several amended parts) stating that it shall be against the law to provide or offer to provide massage “while nude or in clothing designed to arouse or gratify the sexual desire of an individual.”

Update 09/20/2025: Thankfully, the link to this bill no longer exists. 

Now here is where the language is offensive, to me. Of course, I am glad to know it’s against the law to massage in the nude. However, I think the second half of that sentence is extremely ambiguous, and is going to be open to the interpretation of whichever board members or judge in a civil or criminal court hears the first test case. While it’s obvious that lingerie from Victoria’s Secret might fit the bill, what about a v-neck top or a tank top? What about a pair of tight jeans, leggings, or yoga pants? A form-hugging sweater if you have large breasts? What about a pair of shorts, who is going to say how many inches from the knee they can be before they look “sexually arousing?”  There are some people who could manage to look sexy in a flour sack, and others who couldn’t look sexy no matter what they are wearing. In my opinion, that is a bad piece of legislation because it isn’t clearly defined. Furthermore, a couple of lines later it goes on to say that while you are in a massage establishment you may not “possess” clothing designed to arouse or gratify the sexual desire of an individual.  If you have a date after work, you’d better not hang your little black dress in the office so you can change, lest you be accused of something.

This bill also includes reflexology as a method of massage subject to their practice act. HB 722 is sponsored by Rep. Garza, (512) 463-0269,  or e-mail him here.

HB 556 seeks to exclude Muscle Activation Techniques from being covered under massage licensing. Muscle activation techniques include the detection and correction of muscle imbalances through the use of palpation and isometric exercises. HB 556 is sponsored by Rep. Howard, (512) 463-0631 or e-mail her here.

HB 1716 will exclude from licensure a lot of techniques that are commonly used by massage therapists–mostly energy work techniques including Healing Touch, polarity, craniosacral, body/mind techniques, Ayurveda, and a host of others. Strangely, the bill also includes the admonition to the public that people performing these techniques are not licensed and that they are free to seek a diagnosis from a licensed physician, chiropractor, dentist, nurse, etc and actually includes massage therapists and personal trainers in that group. Really? Diagnosing is out of our scope of practice as massage therapists and while I am usually concerned about our rights being taken away, I really don’t think it’s a good thing to say we can give a diagnosis just because we have a massage license. What’s to prevent some newbie fresh out of school from diagnosing someone?  It doesn’t matter if you’ve been practicing 25 years, you still shouldn’t be diagnosing people. We aren’t trained for that.

HB 1716 is sponsored by Rep. Harless, (512) 463-0496or e-mail her here.

I urge you to contact theses legislators to say Texas, hold ’em. None of these bills look like a good thing for massage therapists.

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If You’re Not Moving Forward, You’re Backing Up

 

There have been several developments in the regulation of massage in the past few weeks that I personally find distressing. Earlier this week, Florida Senate Bill 584 moved a step closer to passage. This piece of special-interest legislation would amend Florida’s massage therapy law to allow graduates of certain board-approved schools to obtain a temporary permit and practice for six months without a license, until such time as they fail the exam or become licensed, whichever comes first. Although the bill states that they must work under the supervision of a licensed therapist, the terms of that are not spelled out. Does that mean the supervising therapist is on the premises, in the treatment room, or giving an occasional phone call? This is where boards frequently get into trouble and spend a lot of time with something bogged down in a policy committee—when something has not been clearly defined—and in this case, “supervision” isn’t clearly defined. Update: This bill did not pass. You must be licensed to work in Florida.

New Hampshire is trying to abolish massage licensing altogether, as a cost-cutting, government-reducing move. That would of course mean back to square one, where anyone who knows absolutely nothing about contraindications for massage, endangerment sites, or professional ethics can feel free to call themselves a massage therapist. Update: This failed. You must be licensed to work in NH. 

Utah just amended their practice act to remove the key word “therapeutic” from the scope of practice definition and added in the word “recreational”, in what is in my opinion a misguided attempt to thwart sexual activity being conducted in the name of massage. Other than the fact that I think House Bill 243 is a big step back for our profession, I was just as shocked that the government relations folks in the Utah chapter of AMTA supported it to start with. I’m an active member of the North Carolina chapter, and I cannot imagine the leadership of our chapter supporting that. Update: as of 09/20/2025, the word “recreational” does not appear in Utah’s Practice Act. 

I was gratified a few days ago to see Les Sweeney, President of ABMP, and a few days later Bob Benson, the Chairman of ABMP, weigh in with the same attitude I have about this legislation. Rick Rosen, who is a former Chair of the North Carolina Board of Massage & Bodywork Therapy, former Executive Director for FSMTB, and currently the Executive Director of AFMTE, made a comment on Bob’s blog (Update: no longer available) that I think nailed the important points of this issue:

The most critical component of the state law for any regulated profession is what’s known as its Scope of Practice definition. The list of prohibited acts in a law is important, but less so than the scope definition. If what you want to do in your massage therapy practice is not listed in the scope, you can’t legally do it.

The Utah action that removed the term “therapeutic” from the scope definition, and added the term “recreational massage” may have the effect of narrowing the scope of practice for massage therapists. At the very least, it takes massage therapy out of the realm of health care and into the murky world of “other business activities”, which includes adult entertainment.

Considerations around enforcement of a Practice Act should not take precedence over the scope itself, and it is not a sound justification for downgrading the law. That’s what has occurred in Utah, and the Licensed Massage Therapists of that state will have to deal with it.

Every single word in statues and rules that regulate the practice of massage therapy is important. What you think it says is not always what it means — or what it will produce in the daily administration of a regulatory program. That’s why we need experienced and competent government relations professionals representing our interests.

I report on the legislation of massage, and I have future aspirations of working in government relations. I’ve spent a lot of time in the past few years doing research on boards and practice acts, and while I’m certainly not as experienced or learned as Rosen, I think I’m at the point of recognizing a piece of bad legislation when I see it. The way I see it, if you’re not moving forward, you’re backing up.

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The Utah Brouhaha

A couple of the officers of the Utah Chapter of AMTA are upset with me for a video I put out yesterday about H.B. 243 that is in the works in their state. You may read the bill here.

This bill removes the term “therapeutic” from the description of massage. It also modifies the language in their Practice Act to include “recreational massage.” Is there anyone among us who would like to be known as a recreational massage therapist? Please weigh in on that. I am personally not acquainted with anyone who would like to be known that way.

I read the bill in its entirety, when it was brought to my attention, and then, AMTA member that I am, went to the Utah Chapter’s website to see what they were doing about this. I was shocked to see no mention of it anywhere, so during the course of the video I encouraged AMTA members to get in touch with their board members and mobilize them to take action on this, and I urged all Utah therapists to contact their legislators to protest what in my opinion is a detrimental change in their language. I posted it on the Utah Chapter’s FB page, as well as my own.

Imagine my disbelief when I received a communication from one of their officers on my YouTube channel telling me that I should have contacted them before making my video and telling me to take it down asap. They are of course free to remove it from their own page. They are not free to tell me to remove it from mine. It has had over 700 hits in the last 24 hours and been shared by over 400 therapists. One therapist had made a positive comment about H.B. 243 on FB, the last time I checked. Too many others to count were all as distressed about it as I was.

I also received a lengthy and polite response from one of their officers, that stated  “There is no mention of this on the Utah Chapter website. This matter has purposely not been published on our website at AMTA Utah Chapter precisely for the purposes of NOT bringing attention to the fact that the Massage Therapy Practice Act was being “opened for changes” in this legislative session,” and ended with the request that I remove the video without comment, and to check with them in the future before I make any reference to Utah again.

Sorry, but that will not be happening. Perhaps you have heard of the First Amendment.

Perhaps you have also heard that all legislation is an open book–or it is supposed to be. It is the public’s right to know. If something is affecting massage therapists, it is the massage therapist’s right to know. And it is the mandate of any public board and any non-profit organization to operate in a transparent manner. Anything less than that is unacceptable. Nothing is, nor should it be private, about changes in a Practice Act.

The two AMTA representatives, one of whom emailed me and the other who left a comment on my YouTube page,  obviously feel differently than I do about this, and that’s their right. We can agree to disagree. But as much as I am personally mortified by this bill, I am even more mortified that someone would think that massage therapists shouldn’t be informed of what is going on in their own state, given the opportunity to weigh in on it, and to openly hear their professional organization’s stance on it, until after the fact. That doesn’t work for me, and it shouldn’t work for you. I have preached this sermon many times about knowing what is going on in your state, and this is a prime example of that.

Any state’s Practice Act may be up for changes at any time.  And when a precedent is set in one state, it’s that much easier to get it passed in another. Practice acts are always “open” to changes, assuming any interested party can manage to get it on the legislative calendar. Here in NC, we had a detrimental change that our Board had no knowledge of  at all until it was a done deal. That’s not a good thing–and keeping secrets from the massage therapists who are affected by proposed changes in legislation is not a good thing, either. I refuse to apologize for spreading the word, or for expressing my opinion on it.

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10 Questions for Alexa Zaledonis, New Chair of the NCBTMB

Alexa Zaledonis, LMT, CPT, NCTMB, is the new Chair of the National Certification Board for Therapeutic Massage & Bodywork. She is the owner/operator of Even Keel Wellness Spa, a therapeutic massage and skin care center in Annapolis, Maryland. Even Keel employs seven full-time and several part-time employees who specialize in Thai, sports and rehabilitative massage.

A graduate of the Baltimore School of Massage, she passed the NCE in 2002 and has spent the past seven years building her practice in the community. Zaledonis is a certified Lotus Palm Thai Yoga Massage practitioner and a Certified Personal Trainer through the National Strength Professionals Association. Zaledonis currently is completing her Yoga Teacher Training (RYT200). She also teaches Thai Massage at Even Keel Institute for Continuing Education and is an NCBTMB-approved provider.

A former Certified Public Accountant, Zaledonis specialized in healthcare and nonprofit organizations for more than 15 years. She received her bachelor’s degree from Albertus Magnus College in New Haven, Connecticut.

I am NCTMB myself since 2000, and I’ve seen the good, the bad, and the ugly at the NCBTMB. They had a few rocky years and have been the target of my pen on numerous occasions…and in the past year or so, have received my accolades as well, as I feel they’ve made a big effort to right themselves. I don’t expect perfection from any person or organization, but I do expect effort, and I’m glad to report it when I see it happening. I’m glad to see Zaledonis take over the helm of the 9-member Board of Directors, and recently took the opportunity to find out more about her and her future plans for the organization. I recently seized the opportunity to ask her a few questions. My interview follows, and her answers are printed verbatim:

1. How long have you been involved with the NCB, and what previous roles have you been in there, if any?

By definition, I am not your “normal” volunteer. I joined NCB as a Board member in 2007, became Chair Elect in 2009. I had no prior volunteer experience with NCB before joining the board, outside of being a proud certificant. Volunteering prior to 2007 was not a possibility. I moved to Annapolis in 2003 and began my practice while still working part time as a CPA—there was no time for sleep, much less time to be a valuable volunteer. I believe if you can’t commit then don’t raise your hand.

2. What first led you to volunteer?

I raised my hand. I had figured out how to be a competent therapist, teach the community the value of quality massage and help other therapists to succeed in a viable career. Then, one morning, I asked myself, “What is the future for my employees, for myself, for the industry?”  I was one person helping a village. I knew that I needed to belong to a bigger village, and because national certification was always the backbone of my career as a CPA, becoming a volunteer at NCB was a natural next step for me.

3. What do you feel are the biggest challenges facing the NCBTMB today?

While massage therapy may be an ancient art, the industry in this country is young and will continue to evolve. There are incredible opportunities for our profession, but that can be a double-edged sword. What I mean is, it’s easy to lose focus without input and guidance from stakeholders. That’s why we always base what we test for and what we do programmatically on what the profession tells us is important. So the challenge is really to listen—and to always make sure that the individual therapist is heard, has a say and stays involved.

Ralph Waldo Emerson said, “Do not go where the path may lead, go instead where there is no path and leave a trail.” At NCB we are trying every day to listen, and then help lead our industry to grow in new ways. Sometimes, that requires forging new paths—like the advanced practice credential for example.

4. What are your priorities for your term as the Chair?

We have so many great things going on, but my top priorities surround the execution of the National Certification for Advanced Practice, or the NCAP, and future specialty credentials. Also, addressing the issues of continuing education and nurturing and enhancing our school compliance program. I look forward to seeing all of our programs work hand in hand, each one helping the next one to add value to and take the industry to new heights.

5. In your From the Top letter on the website and the one that was recently mailed out to the associations and regulatory boards, you talk about revamping the Continuing Ed/Approved Provider program and vetting individual courses. One of the most serious problems at the NCB in years gone by was overwhelming inefficiency, which was the main reason for switching to the present system of audits instead of requiring each class to be vetted. How do you plan to keep that from happening again? Are you going to hire new staff?

Yes, NCB is developing a new National Approved Provider and Continuing Education program, but at this point, nothing is written in stone. We have invited thought leaders, subject matter experts, state board representatives, peer organizations, approved providers and certificants to engage in high-level discussions and participate in the Massage Approved Provider Panel. The response has been impressive.

I think people in the profession are ready to take the next logical step for Continuing Education. And that is to define, differentiate and identify the educational level of the wide variety of modalities and subjects offered. We are looking to design a user-friendly review and approval process, but the panel will help inform the best way to go about accomplishing that.

The magnitude of continuing education has grown far beyond the conventional methods of administering and maintaining a program. We have to think outside of the box. Forge a new path. We have a rough framework of ideas and have are asking subject matter experts to share their best thinking. This truly involves the entire profession.

Imagine this: what if it were possible that in its final form, the national program could consist of an array of industry-wide workgroups comprised of key stakeholders as part of the “engine” that vets CE for the entire profession. All-inclusive involvement. Now that would be groundbreaking! And at the end of the day, it’s everyone together working to move the profession forward while protecting the safety of the public. Blazing new trails.

6. The NCBTMB has taken a substantial financial hit in the past year or two, but as I reported in my annual financial series, there’s been a great job done in cutting expenses. Do you think the NCB can remain financially viable?

Laura, there is no doubt we have had to make some important strategic decisions. But we are proud of our accomplishments, and in fact, independent auditors have said that NCB has exhibited a textbook turnaround during the last two years.

The NCB Board, along with senior leadership, have worked hard to ensure that our current programs, personnel and operational concerns are sound, support one another and offer real benefits for our certificants and the profession. This is how we are building value. With Paul Lindamood as CEO and my love of financial statements, you can bet we will keep close watch on the fundamentals…and the finances!

7. There are now a couple of other organizations looking at getting into the approval of continuing education. Do you think the NCB can stay competitive in the marketplace if that happens?

Thus far, everyone seems to be showing great interest in being part of our Massage Approved Provider Panel. I don’t see this as competition. I see this as the industry putting forth their best effort on something, and that is a beautiful thing.

8. How is the NCAP progressing? I need to know since I plan to be the first one to take it!
And Laura we want test number one to have your name on it! NCB has spent more than a decade polling the profession and has witnessed the growing demand for an advanced credential. Not only that, but the medical industry is showing exceptional interest in it as well. We have spoken to numerous doctors who all support an advanced credential. This is incredibly exciting for the profession—and we are only scratching the surface.

Regarding our progress on the NCAP, a Job Task Analysis survey was sent out the latter part of 2010 and we have just received the preliminary report. NCB would like to thank all of our partners in the field from professional organizations to schools and students as well as industry media for spreading the word about the survey. We had a tremendous response.

Our next steps involve the development of test specifications, which will be sent out for public comment in March. After that, item writing will begin in earnest. It is a very comprehensive and rigorous process.

9. Your term is for a period of two years. Do you think you can accomplish all the things you want to accomplish?

Two years is not a long time. However, as I quoted Emerson earlier, I will be happy with my accomplishments if I can help to blaze a path to advance this profession, and most importantly leave trail markers clear enough for the next person to follow.

10. What’s your fondest hope for the organization going into the future?

I hope that the organization can help to bring this scenario to life:

Therapist calls prospective employer:

Ring Ring

Employer: “Hello, Human Resources at Community General Hospital”

Therapist: “Hello I am a Massage Therapist and was wondering if you are hiring?”

Employer: “Well your timing couldn’t be better. We are always looking for qualified  people. Tell me about yourself.”

Therapist: “I am a Licensed and Certified Massage Therapist. I hold a National   Certification in Advanced Practice, am working toward a specialty in                      Medical Massage and have a list of qualified continuing education I can                  share with you.”

Employer: “Your credentials sound great. We only hire Licensed and Nationally Certified Therapists. Why don’t you send over a resume and we can set up a time to talk.”

You gotta think big, Laura. Thanks for giving me the chance to be a part of your blog.

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Competency vs. Hours

I have long desired to see the standards for massage therapy education raised in my state and across the nation. Here in North Carolina, the requirement is only 500 hours. That varies in the US, from the unregulated states that have no requirements at all, to the 1000 hours required by New York, Nebraska, and Puerto Rico. The rest fall somewhere in between.

Our neighbors to the north in Canada have a few provinces that are unregulated, but those that are regulated have a much higher hour requirement than the norm here in the US. However, in looking over their documents pertaining to their regulations, I see that it is not really about the number of hours; it is about the basic competencies that they have set forth for an entry-level massage therapist, and I must say that I find it quite impressive.

I imagine that the higher number of hours is merely a by-product of the competencies that are required. It would take a lot more than 500 hours to pack all those competencies in. And I couldn’t find any fault with any of them. It actually bears a lot of similarities to our recent document, the Massage Therapy Body of Knowledge. That’s not a perfect document; it’s just a start on defining what an entry-level therapist should know here. I’ve heard a good many complaints about it. In fairness to the dedicated volunteers who gave of their time and expertise to work on it, they offered a long period for comments from the profession, and I was personally appalled at how few they got. I think they got about 600 or so, and about 50 of them were mine. Textbook author and school owner Sandy Fritz wrote twice that many. It was also very telling to me that when our Board sent out a survey to the approximately 40  school owners and program directors recently about raising the standards, only 7 of them bothered to reply. There is a big lack of interest in raising the bar.

The complacency here is staggering, and people just tend to complain after the fact instead of offering input on the front end. It’s the same thing I’ve seen over and over again when it comes to detrimental legislation in our profession; a few dedicated people will contact their legislators before something awful gets passed into law, and the rest will just gripe about it after it happens. That’s another blog, and one that I’ve written several times.

I’ve actually been pushing for our Board to raise educational standards, which like anything a public board is considering gets passed along to a committee for study. It is unfortunate that we could not find any concrete evidence that requiring more hours leads to better test scores. Then again, is that what it’s all about? The ability to pass a test? In our paradigm, yes, it is. We are lacking here in measuring competency in any other way.

I am the author of a popular book on how to pass the exams that are required here, and for over ten years I’ve been teaching a test-prep class as well as tutoring students privately. Let me tell you what I’ve observed. There are some people who can’t pass a test. Does it mean they can’t give a good massage? Not at all. They might be perfectly capable of putting me to sleep on the table or helping my aching back. And on the other hand, we’ve got the people who happen to be good test-takers and who are good at regurgitating information, who couldn’t give a decent massage if their life depended on it. They just don’t have what it takes. The ability to pass a test doesn’t make you competent, in my humble opinion. It just demonstrates that you know a certain amount of information.

When I was reading the Canadian document, I was more than a little envious of it. I kept comparing it to what I learned in massage school, and thinking, “Wow, I wish I had been taught that at the beginning.” In the dozen years since I went to massage school, I have managed to learn most of it through continuing education, self-study, and on-the-job experience. I’m the resourceful type and a go-getter, and I’ve had a modicum of success in spite of not knowing these competencies right out of the gate. I’ve learned a lot of them through the school of hard knocks. There’s no doubt I could have avoided some of those hard knocks if I had known these things at the outset of my career.

As a provider of continuing education, I’ve often been distressed and appalled when people call me up and say something like, “I need 6 hours, do you have any classes that long?” They don’t give a rip if the subject matter interests them or not. I’ve also been informed that “I don’t know why I have to get continuing education, I already know everything I need to know.”  They are clueless.

One of my North Carolina colleagues stated on a forum this week that his poll showed that people were very satisfied with the 500 hours, and of course, a lot of people are. Going beyond that requires money and effort, and many people don’t want to spend any more money or effort than they can get by with. I’m personally not interested in just getting by.

Education is never wasted, and hopefully, I still learn something new every day. That’s my goal, anyway.  My education didn’t end at 500 hours. It hasn’t reached 3000 yet, but I intend for it to, and I still won’t know everything there is to know.

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Pay in Massage Therapy: What’s for Real?

Note: Some information was updated on 09/20/2025.

I just finished reading AMTA‘s 2011 Massage Profession Research Report. It’s 66 pages of information that was created from several surveys conducted by AMTA and supplemented by government statistics.

The report covers many topics, including consumer demographics, information about massage schools and their students, where massage is fitting into the general scheme of health care in the US, and statistics on the practitioners themselves.

According to AMTA’s report, during 2010 the average massage therapist worked slightly less than 20 hours per week and made $41.00 per hour including gratuities. That was down from 2009, when the average therapist reportedly worked 20.4 hours per week and made 44.90.

In looking around for verification and figures to compare these to, I checked out the stats from ABMP (Updated  2023) and also referred to the AMA Health Care Careers Directory and the Bureau of Labor Statistics (BLS) (Updated 09/20/2025). The BLS has faulty statistics as far as I’m concerned, because they are based on a therapist working 40-hour weeks year round, which is usually not the case. Their formula shows the median pay in 2025 to be $26.59 an hour, up from $16.78 per hour in 2011. Many therapists only work part-time, sometimes keeping other jobs that provide them with needed benefits. The AMA publication cites therapists who do more like 15 hours of massage per week and make between $15,000-30,000.

I also conducted an informal survey recently of the 1200+ massage therapists who are on my Facebook page. I asked how much money self-employed therapists charge for massage, and asked for their location, and was not surprised to see how much variance there is from place to place. I got everything from $35 in rural areas to $120 in some of the bigger cities. However, you have to remember that’s the gross, and doesn’t take into account that the self-employed have overhead that can really cut into that. By the time one pays for space, advertising, telephone, utilities, laundry, and supplies, actual take-home income is probably half that, if not less.

As far as those who work for someone else, I personally know of a licensed massage therapist who makes less than $9.00 an hour working for a chiropractor. Another acquaintance who works in a ritzy day spa in Cape Cod during the summer makes as much as $2000 a week in take-home pay, but when she’s in North Carolina in the wintertime, has worked in day spas here for as little as $12 an hour plus tips. My own staff members are paid between $30-45 an hour depending on the work they do and how long they’ve been here, and I constantly hear from therapists who work elsewhere that I am the best-paying employer in our small town.

I believe all the above organizations did the best they could in compiling these reports. I also think they are all somewhat skewed (and in fairness, AMTA does quote a 3% + or – confidence level) by several things. No survey can possibly take in every massage therapist in the US. There are still unregulated states, and any therapist who isn’t a member of a professional organization or unrecognized by a licensing or certification board isn’t going to be included in any surveys. And people tend not to answer surveys; according to www.quora.com, a statistics site, a 3% return is about average on e-mail market studies. 10% is magnanimous. According to the laws of statistics, you can get an accurate sample from a little as a 1% response rate, but I think most of us have a hard time thinking that what happens with 1% applies to the rest of us.

When it comes to pay in massage therapy, what’s for real? It’s hard to say.

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