The massage industry is a meat grinder, it is fed hopeful souls and it spits out shredded husks. The outside appears magical and majestic, it shimmers with a radiant glow and exudes hope. So how could it be so brutal?
Massage therapists often drift into a lonely sea after graduation. The comradery experienced during school fades as they enter the workforce and feel alone. I remember looking forward to working in an industry saturated with purposeful men and women with the same zeal and passion as I. Unfortunately, I found a collection of passionless, disenfranchised therapists.
What are the most important problems that define the meat grinder of massage? The schools, the massage chains, and our culture.
The Massage Industry
The schools have the responsibility of creating a safe, ethical, and effective workforce. The state boards exist to help protect the public by investigating allegations of misconduct and pursuing disciplinary measures when appropriate. They are also responsible for license approval, renewal, and revocation. The associations are supposed to represent the professional interests of its members and achieve this with lobbyists, insurance coverage, and professional guidance.
The machine was designed well. The people who trail blazed its design accomplished a great achievement with its creation. Unfortunately, like anything it wasn’t designed perfectly. The loving souls who built our industry did they best they could with what they were working with. In Missouri during the 1990’s massage was under attack and a lot of livelihoods were on the line. They did what they needed to ensure they could provide for their families. Due to their sacrifices we are able to practice massage today, but now it is our responsibility to accept the torch and foster a future for the next generation of massage therapists. Click here to dive into a fascinating massage article about our industry.
The Meat Grinder of Massage: The Schools
How many massage therapists know how the industry is organized, its power structure, their own state’s regulatory policies, the role of the massage board, or the function of the professional associations? In my experience few know the answers to those questions. Truth be told I did not know the answers until I crossed paths with the USOLMT in 2021.
The schools are responsible for providing us with the minimum education to practice massage. Would you consider the above-mentioned information an essential aspect of practicing massage professionally? It may not sound important, but how can we achieve meaningful and positive influence as LMTs if we are unaware of how our industry functions?
Much of this information is not taught to us because it would never be found on the MBLEX. I think this is a problem. Going to massage school should be about learning how to serve as a professional massage therapist, its focus shouldn’t be to pass a test.
Sure the test serves some value, but it does not reflect a student’s practical knowledge of their trade. It cannot serve as an indicator to determine if we are using proper body mechanics, or whether our massages feel good. All of these skills are from hands-on training, mentorship, role-playing, and practice. If we want to be an amazing massage therapist we have to actually perform, experience and observe massage in action.
I think the core of our profession’s major problem exist within the entry point of our industry. The doorway to our dreams is education. If students were taught the knowledge they needed to know to have a successful massage career most of our issues would disappear.
Unfortunately new massage therapists are being taught just enough to jump into the pool, splash around a bit, and drown. This is unacceptable. A school should prepare each student for their career. Every facility needs to be teaching their students to excel, so they may swim like an Olympian and emerge a champion of their dreams.
My Journey through massage school
My journey through massage school was unbelievably bad. I entered the Meat Grinder of Massage when I started massage school in 2015. Three out of my four instructors were completely uninvested. My first instructor insulted students, refused to answer questions, arrived to class late, used inappropriate and vulgar language, and threatened me while I was in school. My second instructor refused to teach any hands-on skills, often slept during class, created opportunities for his students to cheat on tests, and coached students toward a specific massage chain. The third instructor spent more time writing a curriculum to create his own massage school than he taught the people he was supposed to lead. He refused to help his students improve their draping and hands-on skills, fostered a hostile, chaotic, and disrespectful clinical environment and transformed the clinicals section of the school into a series of lonely study sessions. The fourth instructor was the only invested teacher in the program, unfortunately he only taught anatomy of physiology. The administration did not care about their students, and this was most evident in the unqualified instructors they employed, and their cold approach when engaging with students.
They used a disjointed modular curriculum that made learning incredibly difficult for most students. The school employed the absolute minimum number of instructors necessary. The program was broken into two major sections: the classroom environment, and clinicals. Each was designed to be taught by two separate instructors. After my instructor threatened me and subsequently resigned after I reported the event to the administration and pressed them to act. After his resignation the classroom was taught by two instructors.
Throughout the program very little time was invested into the development of the student’s interpersonal skills, their physical ability to perform massage, or taught how to effectively navigate their career as a massage therapist.
Students were allowed to remain enrolled in the program even when their attendance fell below the minimum according to the program’s requirements. When students failed at test, they were allowed to retake it with an open book, then when they failed it again the instructor would place the answer key within sight as they took the test a final time.
Massage Schools of 2012
Have the massage schools improved since 2012? How many of the same problems are we still facing as an industry in 2022?
When addressing the Real Problems of the massage industry Ralph Stephens states:
“We have a real problem with substandard, inconsistent entry-level education causing poor quality massage to be delivered to the public. The problem with this low-quality massage training and its resulting low quality of massage practice is the unintended consequence of AMTA’s policy of working to get 50 state licensure — no matter what the laws look like, with no attention paid to maintaining, much less expanding, our scope of practice or the regulation of entry-level training programs.
Over the past 15 years (as of 2012), the number of institutions offering entry-level massage training programs has expanded in recently licensed states. Most of these new programs were not traditional start-ups by long-time massage therapists who embodied the lineage of the field. For the first time, we saw the unfettered entry of for-profit career colleges and taxpayer-funded community colleges into our sector. It’s simply supply and demand. The passage of new massage laws created new demand for the training required for licensure. These entities were in place with both classrooms and the Federal Student Aid eligibility to quickly add programs. The fact that there was not a population of trained massage therapy educators to teach these programs was not an issue, because the regulations for massage schools and instructors were lax or non-existent.
These institutions are opportunistic: they observe what’s happening in the workplace and create or remove training programs according to what’s hot and what’s not. They have no long-term investment in the profession of massage therapy, as it’s just another program to provide revenue. It’s solely about the money and not about the lineage of massage therapy or who is being put out onto the street to practice it.
These developments have changed the landscape in ways we could not have imagined. In the rush to “elevate” massage to the status of a profession, AMTA (lately working with ABMP) has actually created a serious decline in the quality of massage services provided to the public (the unintended consequence). This problem is hard to get recognized, because most massage consumers don’t know what a decent-quality massage treatment is like.”
In 2012 Ralph Stephens, BS, LMT, NCBTMB wrote an article named The ELAP Project vs. The Seven Deadly Sins of Massage Education. This article was published by Massage Today. In this article he discussed the ELAP and the education and training issues facing the massage industry.
He moves on to discuss the seven deadly sins of massage education. As you read them, ask yourself how many are still a problem in the massage schools as of 2022?
•Employ unqualified instructors.
•Deliver the curriculum in a disjointed “modular” system that prevents sequential learning and integration.
•Have just one (or maybe two) instructors teach the entire curriculum.
•Use stock courses off the shelf that serve a variety of career programs, instead of courses designed specifically for a massage therapy program.
•Enroll students who lack the interpersonal skills or the cognitive, physical, and emotional resources to be competent and ethical practitioners.
•Keep students in a program whose performance is marginal, just to get their Federal Student Aid disbursements (tuition).
•Allow students to graduate who cannot perform a competent massage, or create a secure therapist/client relationship.
In 2012 Ralph Stephens, BS, LMT, NCBTMB wrote an article named The ELAP Project vs. The Seven Deadly Sins of Massage Education. This article was published by Massage Today. In this article he discussed the ELAP and the education and training issues facing the massage industry.
The Meat Grinder of Massage: The Massage Chains
LMT Owned Massage Businesses Need the Schools
Massage businesses need schools, they cannot operate without them. They must have employees to generate revenue. Right now, every clinic needs providers, their customers want massage, but the businesses cannot meet the demand. This aspect of the Meat Grinder is relatively difficult to unpack. It may sound weird, but LMT owned massage businesses need recent graduates more than the chains do. The membership model of the chains allows them to breakeven even if their facility is not performing the minimum number of massage hours to pay the electric bill. As long as they have members paying their monthly subscription they are fine. Smaller facilities must have service providers to keep the lights on. Even if they have a membership system in place it does not afford them the same protection as it would for a chain facility. Customers will tolerate waiting to receive their massage at a chain for two months, they wont for you. The reason is because the chains are bigger, they have greater brand recognition, and they are capable of manipulating their members with the sunk cost fallacy.
Yet The Massage Schools favor the Chains
The chains still need students and because of their size and purchasing power they often get priority with the schools. I have personally witnessed special privileges offered to the chains that no other massage business is granted. An example of this phenomena is when a contact from a franchise is allowed to visit with the students in class when no other business is granted the same opportunity. This early access to a student can have a profound impact on their decision making. I have spoken to many massage therapists who said they chose their employer because it was the first person who showed interest in them. In these situations these massage therapists accepted a substantially lower wage as a consequence.
In addition to early access the teachers and administration often advise their students to work for the chains to “gain experience”. This creates an unfair bias toward the chains that LMT owned facilities cannot compete with. Graduates will often follow the advice of their own instructors even when it may be a determent to their career.
I have even witnessed instructors accepting compensation from the chains for steering their students toward their company. When I went to school I was hounded by one of my instructors when I told him I did not want to work for a specific chain. Later I learned he was being paid nearly a thousand dollars per graduate he referred to the chain.
The Hands-off Approach of Sexual Solicitation
Our community is packed with horror stories. The formula is the same nearly every time, a client touches or solicits a massage therapist for sex, the therapist reports it, and nothing is done. Sometimes management promises to move the client to someone else, but it happens again and the cycle repeats.
We can longer allow employers to ignore the issue by hiding their head in the sand. This stuff breaks massage therapists and it is destroying our industry. We need to protect the sanctity of our profession from the creeps who want to sneak into our soul, and the managers who allow them to slither around freely.
The Industry Must Protect Its Therapists
Facing these situations in the treatment room is unnerving and scary; and is impossible to escape unscathed. Every time it happens it sears our soul with a terrible burn and leaves a scar behind that will always remind us of what happened. We need to prevent these situations from ever happening by setting the professional stage and shaping reality to meet our needs.
Once we allow a serpent into our home it is hard to find where they snuck off to. Instead of allowing them to slide on in and get comfortable we need to close the door so the pests cannot enter. Creeps are like cockroaches, where one is, others will soon be found. Likeminded people congregate and share, we don’t want to be their topic of discussion at the water cooler. To prevent this, we must safely guard our palace by presenting our place in a way that makes them feel unwelcome.
Exploring the Meat Grinder of Massage
In 2019 the ABMP reported that 334,219 LMTs were in the industry. The research suggests the number of active massage therapists may be 20% fewer.
Do these numbers accurately estimate the number of massage therapists actively practicing in the massage industry? Do they reflect the number of massage school graduates? The simple answer is no. There are far more graduates than there are massage therapists who have a license, and the statistics often provided by our professional organizations do not provide an estimate of the number of practicing massage therapists.
According to the ABMP 507,806 people have graduated from massage school from 1998 – 2018.
What happened to the 173,587 graduates who didn’t get a massage license?
All we know is they are not licensed massage therapists. Maybe it has something to do with the 67% pass rate for the MBLEX reported by the FSMTB. That is a lot of people paying a quantifiable amount of money for an education they cannot use. If the average estimated tuition for massage school is $12,500, the total cost of lost dreams comes to $2,169,839,500.
How many licensed massage therapists are still practicing in the United States? Why does it matter?
Knowledge removes the blinders from our eyes and allows us to see our professional landscape. If we want meaningful change to occur within our industry, we must have a map to help us navigate our way. Ultimately, I do not have a concrete answer, but I estimate we have about 100,000 to 150,000 licensed massage therapists actively practicing.
Research Tools
Bureau of Labor Statistic
The Bureau of Labor Statistics states there were 107,240 LMTs in 2019, and 81,030 in 2021. These stats do not include self-employed LMTs.
AMTA Massage Therapy Professional Report
According to the 2021 AMTA Massage Therapy Massage Profession Report it claims “Massage Envy is the largest employer of massage therapists in the country, with more than 35,000 massage therapists and estheticians employed by the company.”
After some additional research this information appears to be inaccurate. According to the Massage Envy website it states they have “35,000 Massage therapists, estheticians, and other associates employed in nationwide franchised locations”.
Calculating the numbers from other sources
If we use Zippia’s estimate for the number of practicing massage therapists, it brings our workforce to a total of 105,687 LMTs.
Zippia uses the following calculation to determine how LMTs remain in the workforce according to the number of years they have been in the industry.
Less than 1 year 23%
https://www.zippia.com/massage-therapist-jobs/demographics/
1-2 years 30%
3-4 years 13%
5-7 years 16%
8-10 years 6%
11+ years 12%
According to Franchisechatter, the estimated number of locations among the top 9 massage franchises is 2,261. Massage Envy owns an estimated 1,112 locations (49% of the top 9 franchise facilities) in the United States.
If we were to only calculate the number of massage therapists working at these facilities the total estimated LMTs working for the chains would come to 33,915. This calculation assumes each facility has an average of 15 therapists per location.
If these franchises had an average of 15 LMTs per facility the total estimated LMTs would come to 33,915. This would indicate these 9 chains employ about 10% of the massage workforce.
If we use Zippia’s 105,687 estimate for the number of practicing massage therapists, the total number of LMTs employed by the chains would be 32%,
New Students Must be Shown How to Succeed
The sum of a student’s success is determined by the passion, professionalism, and skill infused into them throughout their education. New massage therapists are being taught just enough to jump into the pool, splash around a bit, and drown. This is unacceptable. A school should prepare each student for their career. Every facility needs to be teaching their students to excel, so they may swim like an Olympian and emerge a champion of their dreams.
Instead, massage therapists often drift into a lonely sea after graduation. The comradery experienced during school fades as they enter the workforce and feel alone. I remember looking forward to working in an industry saturated with purposeful men and women with the same zeal and passion as I. Unfortunately, I found a collection of passionless, disenfranchised people.
The massage industry is a meat grinder, it is fed hopeful souls and it spits out shredded husks. The outside appears magical and majestic, it shimmers with a radiant glow and exudes hope. So how could it be so brutal?
Right now, every clinic needs providers, their customers want massage, but the businesses cannot meet the demand. Watching revenue slip between your fingers is maddening and over time the desperation has reached titanic proportions. The frenzied hunger of the mega chains has ravaged our occupational landscape and built a bubble that is about to pop.
The mega chains have a valuable place in the history of massage by helping it gain acceptance across America. I am thankful for their contributions to our beautiful profession, but they have also destroyed our culture. As the demand for massage increased, the necessity for more massage therapists followed.
If our industry could maintain our workforce this would be great. Effectively everyone would win. Unfortunately, our industry is a meat grinder. As the demand for massage increases, so does the need for therapists, right now the clinics do not have the ability to meet the demand, so they stop focusing on quality and instead focus on quantity. This reduces the benefit the public receives from our services. As more therapists drop from the industry the clinics require more providers, guaranteeing job placement for all therapists. This lowers the quality of massage and the public’s perception of the benefit it provides.
When the demand outweighs the supply service rates increase. This results in a price increase even though the quality of said services are decreasing. Once the price is higher than the perceived benefit of massage the bubble pops.
What happens when the bubble pops? History repeats itself; our industry collapses and massage will return to its darkest era of all time.
We are heading in this direction
According to the ABMP the number of massage therapists currently working dramatically fell in Missouri from 2019 to 2020. In 2019 Missouri had an estimated 6,126 massage therapists actively working in the field, while in pre-covid 2020 this fell to 4,451. This was a loss of 1,675 jobs or 27.3% of the employment pool. In addition to this the FSMTB reports a 67% pass rate for the MBLEX which is the minimum state licensing exam required for all therapists to legally practice in the state of Missouri.
The demand for massage therapy has grown over the years and is projected to increase over the next ten years. The United States Bureau of Labor Statistics projects the demand for massage therapy positions will raise by 21 percent from 2019 to 2029. This is a significant jump, as of 2019 the industry had 166,700 available jobs for massage therapy, and in 2029 this number is expected to be 201,100. [https://www.bls.gov/ooh/healthcare/massage-therapists.htm#tab-6] Will there be enough new massage therapists to meet the demand? It is doubtful, as of May 2020 there were only 85,040 massage therapists in the United States according to The United States Bureau of Labor Statistics. [https://www.bls.gov/oes/current/oes319011.htm]
Research statistics have shown that the schools are dying, which could be another reason why the mega chains and local massage businesses do not have enough massage therapists.
The ABMP conducts a census of all state-approved massage programs documenting their results every two years and published the results in 2019. In this pre-covid analysis it showed that the total number of massage schools were at an all-time high in 2008 with 1,600 schools. As of 2018 it had dropped to the third lowest it had been in 20 years, with only 965 schools. [https://www.abmp.com/updates/blog-posts/number-massage-program-graduates-continues-decline]
Why have the total number of massage schools been on a steady decline? I believe Covid played a huge part in 2020, but that doesn’t explain their gradual decline for the last twenty years. In a recent survey the number of schools dropped from 965 to 919.
The number of students graduating has also been on a steady decline. In the same study the highest number of graduates to enter the industry was 71,272 in 2004 and has continued a dramatic decline. As of 2020 only 20,598 massage therapists entered the workforce. [https://www.abmp.com/updates/blog-posts/massage-schools-stay-resilient-during-covid-19-pandemic]
Why have fewer students graduated? I Don’t know. Maybe word of mouth has spread in local communities about the poor satisfaction working in the industry? Maybe the same word of mouth has convinced prospective students to choose another career. Maybe it is because there were never meant to be as many massage therapists as there are. Our profession is a calling, you either have the natural aptitude to do it or you don’t. You must be the kind of person who loves helping people and derives a deep satisfaction from the joy of others.
As our industry continues down this path the mega chains will accept more unqualified service providers into their ranks. Right now, anyone legally able to practice massage is employable, effectively making quality completely irrelevant. This is because they must do whatever it takes to survive. They need to eat, and when resources become scarce, they will eat whatever they can, the hungrier they get the more desperate they grow and the more damage they will do.
Why must the mega chains have new massage therapists? The simple answer is due to the Membership Domino.
