Massage Profession Research Report - SpaFinder

massage profession
research report
2013

Table of Contents
Introduction ............................................................................................................... 2-3
Executive Summary .................................................................................................. 4-6
Section 1. Consumers of Massage Therapy .................................................................. 7
1A. What changes are taking place in the U.S. Population? .................................................................... 8-9
1B. What drives consumer use of massage therapy? ............................................................................ .9-10
1C. Who gets massage? ..................................................................................................................... 11-13
1D. Why do consumers get massage? ................................................................................................. 14-16
1E. Where are consumers getting massage? ........................................................................................ 16-18
1F. What did AMTA hear from consumers on its outreach in 2012? ........................................................ 19
Section 2. The Massage Therapy Profession .............................................................. 20
2A. Who is practicing massage therapy? ............................................................................................ 21-24
2B. How much are massage therapists compensated for their work? ................................................... 25-29
2C. What are some of the biggest challenges facing massage therapists? .................................................. 30
2D. Where are massage therapists practicing? .................................................................................... 31-34
2E. What’s the latest on the spa industry and massage therapy? .......................................................... 35-37
2F. What impact are massage chains having on the profession? .......................................................... 37-38
Section 3. A Special Look at Health Care and the Massage Profession .................... 39
3A. Continued growth in the health care industry .................................................................................... 40
3B. Growth in the integration of Complementary and Alternative Medicine (CAM) treatments into
hospitals ..................................................................................................................................... 40-42
3C. Consumer use of massage as part of an integrated approach to health care .................................... 42-45
3D. Massage and insurance ................................................................................................................ 45-47
Section 4. Training and Education of Massage Therapists ........................................ 48
4A. Hours and types of training ......................................................................................................... 49-52
4B. School trends and demographics. ................................................................................................. 53-55
4C. School challenges ........................................................................................................................ 56-58
4D. School accreditation ......................................................................................................................... 59
4E. Teachers. ..................................................................................................................................... 60-63
4F. Graduates ......................................................................................................................................... 64
4G. Students ...................................................................................................................................... 65-66
Section 5. Massage Therapists’ Use of Technology .................................................... 67
5A. Massage therapists’ performance on basic online tasks ..................................................................... 68
5B. Massage therapists’ overall use of technology ................................................................................... 69
5C. Social media and massage therapists ............................................................................................ 70-71
5D. Massage therapists’ use of websites for their practices ...................................................................... 71
5E. Massage therapists’ smart phone use ................................................................................................. 72
Appendix—List of Sources .................................................................................... 73-75
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American Massage Therapy Association 1

Introduction
Dynamics of the massage therapy profession
The 2013 Massage Profession Research Report
Welcome to the 6th annual Massage Profession Research Report, AMTA's collection and
analysis of current market data and trends that impact the massage therapy profession.
AMTA develops this report to provide massage therapy schools with up-to-date
information and research to help them determine their curricula and make knowledgeable
business decisions. This report is a key AMTA School Member benefit that helps you
scan the current market (including consumers, therapists and schools) without a large
investment of resources and/or manpower.
Four Annual Research Studies
In the pages that follow, you’ll find results of four benchmark surveys that track the state
of the profession through 2012:
· The AMTA Consumer Survey (16 th annual) was commissioned by AMTA to
poll American adults on their use of massage therapy. (Confidence level of plus
or minus three percent.)
· The AMTA Industry Survey (8th annual) provided feedback from massage
therapists on everything from compensation, to hours, to longevity in the
industry. (Confidence level of plus or minus two percent.)
· The AMTA Massage School Survey (6th annual) acquired feedback from
schools with 500-plus hour programs. (Confidence level of plus or minus eight
percent.)
· The AMTA Technology Survey (4th annual) obtained input from massage
therapists about their use of digital technology for individual and professional
purposes. (Confidence level of plus or minus five percent.)
This report provides timely and relevant data on the state of the massage profession,
compiled from the results of these surveys and supplemented by U.S. government
statistics and information found in industry and/or business publications. (For
methodology, see the Appendix.)
Periodic Updates
As new data becomes available, you’ll receive periodic updates to this report as well
as targeted fact sheets. You can use these resources to:
Ready students to enter the profession – In this dynamic and challenging
economy, students can benefit from understanding and responding to consumer
trends and demand for massage therapy.
American Massage Therapy Association 2

Support business class instructors – Therapists frequently tell AMTA they
would like to receive more business training in massage school. The information
in this report can help students build and market successful practices.
Direct and grow your school wisely – Employ this information to market your
school to those seeking to become massage therapists.
American Massage Therapy Association 3

Executive Summary
The massage therapy marketplace continues to be affected by the challenging economic
environment. Although consumers continue to strongly believe in the efficacy of
massage therapy, fewer of them received massage in the last year. Practicing massage
therapists reported working, on average, more hours this past year, however. This
indicates that fewer therapists were providing massage this past year.
Here is a summary of key findings for each section of this report.
Consumers of Massage Therapy
The percentage of adult American consumers who received a massage declined to 16
percent in 2012 from 18 percent in 2011 and the average number of massages obtained
went from 4.5 in 2011 to 4.2 in 2012. Approximately 34.5 million people had a total of
145 million massages in 2012, a 15 percent decline from the 170.5 million massages
consumed in the U.S. by 37.9 million people in 2011. Smaller percentages of all age
groups received massage in 2012 except for Gen-Xers, those 35 to 44 years old. Twentythree
percent of this group received massage in 2012, more than any other age category,
versus 18 percent in 2011.
Consumers continue to believe in the efficacy of massage as 89 percent consider massage
to be effective in reducing pain and 87 percent believe massage can be beneficial to
health and wellness. The primary reason consumers obtained massage continues to be for
medical purposes – pain relief, soreness/stiffness and recovery from injury - with 43
percent of massage consumers getting massage for these reasons.
As part of a major multi-year commitment to public education on the benefits of massage
therapy, AMTA launched it Consumer Awareness Program by visiting five major
metropolitan areas in the summer of 2012, providing free chair massages and information
about the benefits of massage at each stop. Data collected from consumers after
receiving massage at these tour stops showed 89 percent were more likely to recommend
massage to their family or friends and 78 percent reported they would be more likely to
look for an AMTA massage therapist.
The Massage Therapy Profession
On average, massage therapists worked 21.6 hours per week in 2012, up significantly
from 19.6 hours per week in 2011. Massage therapists saw an average of 41 clients each
month in 2012, up from 38.9 clients per month in 2011. Including tips, the average
therapist earned $30.76 per hour in 2012, about the same as in 2011, $31.11 per hour.*
Between 2011 and 2012, the estimated number of massage therapists grew less than one
percent to 307,104. The number of massage therapists has increased 41 percent over the
past ten years but the number has increased only 9 percent in the past five years
indicating a slowing of growth in the number of therapists. Most massage therapists
continue to be female (85 percent), had a different profession prior to becoming a
therapist (81 percent), have formal education beyond a high school diploma (90 percent)
American Massage Therapy Association 4

and are sole practitioners (69 percent). Massage therapists practice an average of seven
modalities with 89 percent providing Swedish massage.
The biggest professional challenges reported by massage therapists continue to be
industry perception (being recognized / respected as health care professionals and public
awareness of massage therapy profession), and business / economy issues (poor economy
and maintaining steady business / finding new clients).
*2011 hourly income data is not consistent with that previously reported due to corrections made to calculations of this
data.
Health Care and the Massage Industry
The health care industry continues to offer employment opportunities for massage
therapists in a variety of settings. Health care industry employment grew 2 percent higher
in 2012 over that for 2011 to 17 million. The category of “Outpatient care centers,”
which includes massage therapists, as defined by the Bureau of Labor Statistics,
experienced a 5.8 percent growth in the past year.
Twenty-seven percent of massage therapists reported working in a health care setting in
2012 (19 percent in a chiropractic office / integrated health care clinic and 8 percent in a
hospital / medical office or clinic) slightly less than the 29 percent of therapists working
in health care settings in 2011. In addition, health care is second only to other forms of
bodywork as a source of additional income for massage therapists that have other, nonmassage
related, employment.
More massage therapists received referrals from health care professionals in 2012 than
2011 with particular increases from hospitals and medical offices (51 percent in 2012
versus 46 percent in 2011) and chiropractors and integrated health clinics (67 percent in
2012 versus 63 percent in 2011).
The growing number of referrals from health care professionals indicates increased
integration of massage therapy in health care environments.
Training and Education of Massage Therapists
Massage therapy schools reported their top challenges as difficulty in attracting students
and in marketing their programs. Seventy-five percent of schools reported in 2012 being
accredited by nationally-recognized accrediting organizations.
The average number of graduates per school dropped from 48.5 in 2011 to 37 in 2012.
Individually owned schools experienced the largest decrease from 53.6 graduates on
average in 2011 to 41.7 graduates in 2012.
Seventy-five percent of schools offered financial aid to their students in 2012, up from 71
percent a year ago. To address the difficulty that some graduates may have in obtaining
employment after graduation, 91 percent of schools offered some form of job placement
services to students in 2012.
American Massage Therapy Association 5

Seventy-six percent of massage therapists rated the quality of their initial massage
training as excellent or very good. Ninety percent of massage therapists reported taking
continuing education classes in 2012. On average, massage therapists took 24 hours of
continuing education in 2012, more than the 19 hours reported in 2011.
Massage Therapists’ Use of Technology
Massage therapists are increasingly using digital technology in their professional and
personal lives. On a daily basis, 82 percent of massage therapists used the Internet in
2012, the same percent as in 2011, and 48 percent used social media, an increase from 41
percent last year. Thirty-six percent of therapists used social media to stay in touch with
clients in 2012, a 3 percentage point increase over 2011.
Close to half of all massage therapists (47 percent) reported having their own business
websites in 2012 compared to 40 percent in 2011. Practically two-thirds (65 percent)
now own a smart phone such as iPhone or Android compared to 51 percent in 2011.
In the report to follow, these issues are explored in more detail, along with other issues
important to the massage profession.
Note: Data for 2012 referenced in this report are based on research that occurred at
various times during that year and thus may not represent information for that entire
calendar year, e.g. some data was compiled in July and August of 2012.
We’d love to hear from you.
Let’s work together to educate the next generation of massage therapists. If you have
suggestions, or identify additional information you need, please contact us anytime at
research@amtamassage.org.
American Massage Therapy Association 6

Section 1 — Consumers of Massage Therapy 1
Consumer use of massage therapy affects the speed and dynamics of growth
of the entire massage industry. How frequently, for what purpose, and at
what type of locations consumers get massage affects the number of
massage therapists needed as well as the types and settings for massage.
This section provides information on the latest data and trends in the U.S. population and
massage consumer use.
Key Concerns:
How will shifting population demographics impact massage therapists and
massage therapy schools?
How can we help our students connect with the populations most likely to
seek massage therapy?
How can we gear our massage programs towards the markets most likely to
grow?
How do massage franchise chains fit in?
How can this information help us make our massage therapy program more
attractive to students?
Key Findings:
· Sixteen percent of adult American consumers received a massage in 2012, compared
to 18 percent in 2011.
· U.S. population growth is slowing and becoming more diverse.
· Consumers continue to believe in the efficacy of massage.
· People living in metropolitan areas and women are the greatest consumers of
massage.
· Consumers continue to use massage for pain relief, pain management and to control
headaches.
· Gen Xers, those between 35 and 44 years old, are becoming more frequent consumers
of massage.
These questions will be answered:
1A. What changes are taking place in the overall U.S. population?
1B. What drives consumer use of massage therapy?
1C. Who gets massage?
1D. Why do consumers get massage?
1E. Where are consumers getting massage?
1F. What did AMTA hear from consumers on its outreach in 2012?
American Massage Therapy Association 7

1A. What changes are taking place in the overall U.S. population? 2
Consumers are the engine of growth in the profession. The greatest growth
of the U.S. population is taking place in the oldest segment. In addition, the
population is becoming more diverse, driven by the significant growth of
Hispanics in the country.
According to the U.S. Census Bureau, the U.S. population is growing, but at a
relatively slow rate
The U.S. population has grown to 314.9 million from approximately 312.6 million a year
ago. That’s a population growth of 0.74 percent, the lowest since the mid 1940’s. The
population is projected to grow even more slowly over the next several decades as the
number of births and international migrations are expected to be lower.
The U.S. population continues to age
The median age of the U.S. population increased to a new high of 36.8 years in 2011, up
from 35.3 years in 2000. The increase in median age is driven by the aging baby boomer
population, those born between 1946 and 1964. As shown in the table below, the median
age is expected to steadily increase over the next several decades.
Year
Median age of U.S.
population
2000 35.3
2010 36.7
2020 39.6
2040 40.8
2060 42.2
Figure 1. Average current and projected age of U.S. population
The oldest part of the population is growing the fastest
According to the U.S. Census Bureau, the population 65 years of age and older is
expected to more than double from 43.1 million in 2012 to 92.0 million by 2060. The
number of those 85 and older is expected to more than triple from 5.9 million in 2012 to
18.2 million in 2060. It is estimated that 20 percent of the U.S. population will be 65 or
older by 2060.
The U.S. population continues to become more diverse
In 2012, the U.S. Census Bureau reported that the racial minority population in the
United States reached an estimated 116.2 million, or 37 percent of the nation’s total
population, as compared to 31 percent of the total population reported in 2000. By 2060,
minorities are projected to comprise 57 percent of the U.S. population at 241.3 million
people.
The Hispanic population will continue to grow
More than half of the growth in the total population of the U.S. between 2000 and 2010
was due to the increasing Hispanic population.
American Massage Therapy Association 8

· The Hispanic population grew by 43 percent between 2000 and 2010, from 35.3
million to 50.5 million.
· As of 2012, there are 53.3 million Hispanics comprising 16.6 percent of the total
U.S. population.
· By 2020, the Hispanic population is projected to be 63.8 million, making up 19
percent of the U.S. population.
· By 2060, the Hispanic population is expected to more than double to 128.8
million, comprising 33 percent of the U.S. population.
For more information on U.S. population trends, refer to the U.S. Census Bureau data at
http://www.census.gov.
Applying the Research:
1. Census projections and estimates have remained steady since last year. Talk with
your students about the increasing age of the population, and the increasing diversity
of the population. Discuss why this is occurring with baby boomers growing older,
and the growth in the Hispanic population.
2. Have your students consider what the marketplace will look like in 5, 10, or 20 years
from now based on population estimates. Then ask them to think about how they
might respond to these changes in their practices.
1B. What drives consumer use of massage therapy?
As the economy continues to struggle, the percentage of Americans getting
massage declined in the past year as did the total number of massages.
The 2012 AMTA Consumer Survey results show that:
· Sixteen percent of all adult Americans had at least one massage in 2012 compared
to eighteen percent in 2011.
· Of those consumers that received massage in the past year, the mean number of
massages decreased to 4.2 in 2012, down from 4.5 in 2011.
· In 2012, 25 percent of all adult Americans reported receiving a massage in the last
five years down from 31 percent who reported receiving a massage in the past
five years in 2011.
· Roughly 34.5 million people had a total of 145 million massages in 2012,
compared to 37.9 million people having a total of 170.5 million massages in the
U.S. in 2011. 3
· The decline in the total number of massages in the past year, from 170.5 million
to 145 million, represents a 15 percent decline.
· While the economy continues to slowly recover from the recession, we expect the
use of massage to remain steady.
American Massage Therapy Association 9

During the past ten years, consumer usage has moved from 21 percent in 2003 to a high
of 24 percent in 2007 and then to 16 percent in 2012 (See figure 2 below).
Figure 2. Total use of massage among adult U.S. population
Consumers continue to believe in the efficacy of massage:
· Eighty-nine percent of consumers agree that “Massage can be effective in
reducing pain.”
· Eighty-seven percent of consumers agree that “Massage can be beneficial to your
health and wellness.”
· Sixty-eight percent of all consumers said they have or would recommend massage
to a relative or to someone they knew in 2012.
· Twenty-eight percent of the adult population expects to get a massage in the next
12 months, an increase of 5 percentage points from 2011.
American Massage Therapy Association 10

1C. Who gets massage?
Gender, generation, education and income all affect the likelihood of
consumers using massage. The greatest consumers of massage are women
and those living in metropolitan areas.
Of those consumers that received massage in 2012:
· Seventy-nine percent live in a metropolitan area.
· Sixty-nine percent are women.
· Sixty-six percent are white.
· Sixty percent reside in the West (30 percent) or South (30 percent).
· Fifty-seven percent don’t have a child under 18 living in their household.
· Fifty-seven percent earn more than $50,000 per year.
· Fifty percent are 44 years of age or younger.
· Thirty-eight percent are college graduates.
Metropolitan residents - Seventy-nine percent of massage consumers resided in a
metropolitan area.
· Of all adult residents of a metropolitan area, 16 percent got a massage in 2012,
compared to 20 percent in 2011. Additionally, metropolitan dwellers received 4.3
massages on average in a year, down from 4.8 massages in 2011.
Women – Sixty-nine percent of all massages in 2012 were received by women, up from
66 percent in 2011.
· Twenty-two percent of adult women got at least one massage in 2012, slightly
less than 2011, when 24 percent of women got at least one massage.
· The mean number of massages women received in 2012 increased to an average
of 4.3 massages. This is still considerably less than the 7.6 massages women
received in 2009, but higher than the 2011 average of 3.9 massages.
· Men received fewer massages on average than women, 4.1 massages compared to
4.3 massages for women.
· Ten percent of men had a massage in 2012, down from 13 percent in 2011.
Figure 3. Total use of massage among U.S. population by gender
American Massage Therapy Association 11

Race – Sixty-six percent of massage consumers were white.
· Sixteen percent of whites received a massage in 2012, compared to 17 percent in
2011.
Households without children - Fifty-seven percent of all massage consumers did not
have a child under 18 years old in their home in 2012.
· Usage among households with no children was 14 percent in 2012 down from 18
percent in 2011.
Household Income – Twenty-three percent of all massage consumers had a household
income of $100,000 or more.
· Thirty percent of those that have household income between $75,000 and
$100,000 received a massage in 2012, down from 37 percent of those with
household income between $75,000 and $100,000 in 2011.
· Eighteen percent of those that have household income between $35,000 and
$50,000 got a massage in 2012. Twelve percent of this household income group
received a massage in 2011.
College graduates – Thirty-eight percent of massage consumers were college graduates.
· Twenty-two percent of college graduates received a massage in 2012 compared to
30 percent in 2011. College graduates on average received 4.9 massages in 2012
compared to 5.4 massages in 2011.
Level of consumer
education
Massage
use in 2009
Massage
use in 2010
Massage use
2011
Massage use
2012
Completed college 35% 29% 30% 22%
Figure 4. Total use of massage among college graduates
Those 18 to 34 years old – Twenty-six percent of massage consumers were between 18
and 34 years old.
· Fourteen percent* of this group received a massage in 2012 compared to 16
percent in 2011.
· On average, this group received the fewest number of massages in 2012, 2.3
massages. That’s down from the 4.8 massages they received on average in 2011.
Gen-Xers – Twenty-four percent* of massage consumers were between 35 and 44 years
old.
· Twenty-three percent of those between 35 and 44 years old received a massage in
2012, a higher percentage than any other age group. Last year 18 percent of this
age group received a massage.
· This age group also got more massages than any other age group, receiving an
average of 5.4 massages in 2012, compared to 4.5 massages on average in 2011.
American Massage Therapy Association 12

Baby boomers - Thirty-six percent* of massage consumers were baby boomers, between
45 and 64 years old.
· Fewer baby boomers received massage in 2012, 17 percent compared to 22
percent in 2011, at the same frequency as last year, 4.7 massages on average.
· Nineteen percent of those 45 to 54 years old received massage in 2012 compared
to 23 percent in 2011. However, those 45 to 54 years old received more massages
in 2012, 4.2 on average, than in 2011 when they received 3.9 massages on
average.
· Fifteen percent of those 55 to 64 years old received massage in 2012,
considerably less than in 2011 when 20 percent said they received massage in the
past year. This group also received fewer massages on average in 2012, 5.2
massages compared to 5.8 massages in 2011.
Seniors – Eleven percent* of massage consumers were 65 years or older.
· Ten percent of seniors received a massage in 2012 compared to 12 percent last
year.
· On average, senior consumers received more massage in 2012 than in 2011.
Seniors received 5.1 massages in 2012 compared to 3.7 massages in 2011.
*The difference between the total of all above age groups and 100 percent is due to three percent of respondents not
providing their age.
West and South – Thirty percent of massage consumers reside in the West and 30
percent reside in the South.
· In both the West and the South, the number of consumers receiving a massage
declined from 34 percent in 2011 to 30 percent in 2012.
· Furthermore, consumers in the West received fewer massages on average in 2012,
4.4 massages compared to 5.9 massages in 2011.
Applying the Research:
1. Discuss the changing usage of massage across demographic groups and how this
might affect the selection of their practice location and their marketing.
2. Remind your students that women receive 69 percent of all massages but that almost
all consumers believe in the efficacy of massage
3. Fewer men received massage in 2012 and the mean number of massages they
received decreased. Let students know they may need to educate male clients in
particular about the benefits of massage.
American Massage Therapy Association 13

1D. Why do consumers get massage?
The primary reason consumers get massage continues to be for medical
reasons – pain relief, soreness/stiffness and recovery from injury.
Figure 5. Primary reasons for receiving last massage in 2012
Medical Reasons – About the same percentage of massage consumers got a massage
for medical reasons in 2012 as in 2011 – 43 percent in 2012 and 44 percent in 2011.*
· Fifty-five percent of men who received a massage in 2012 did so for medical
reasons compared to 48 percent in 2011.
· Fifty-seven percent of massage consumers who had a high school degree or less
got a massage for a medical reason in 2012.
· Fifty-six percent of massage consumers who earn $100,000 per year or more got a
massage for a medical reason in 2012.
· Fifty-one percent of massage consumers 45 or older got a massage for a medical
reason in 2012.
· Thirty-eight percent of women who got a massage in 2012 did so for medical
reasons, down from 42 percent in 2011.
The top medical reasons for getting a massage in 2012 were:
· Pain relief/pain management - Nineteen percent of massage consumers received
a massage in 2012 for pain relief/pain management, the same as in 2011.
· Seniors, those 65 years of age and older, are increasingly getting massage for
pain relief. Twenty-eight percent of massage consumers over 65 years of age
got a massage for pain relief in 2012, up from 13 percent in 2011.
· Of women getting a massage in 2012, 20 percent received a massage for pain
relief/pain management, about the same as the 19 percent in 2011.
American Massage Therapy Association 14

· The number of Americans that ever used massage therapy for pain relief
was 29 percent in 2012 down slightly from 31 percent in 2011.
· For soreness/stiffness/spasms - Thirteen percent of massage consumers got a
massage for soreness/stiffness/spasms in 2012, compared to 12 percent in 2011.
o Eighteen percent of male massage consumers received a massage for
soreness/stiffness/spasms in 2012, up from 14 percent in 2011.
o Only thirteen percent of seniors (65+) who received a massage in 2012
got a massage for soreness/stiffness/spasms, down from 24 percent in
2011.
· Injury recovery/rehabilitation - 9 percent of massage consumers got a massage
for injury recovery/rehabilitation in 2012, the same percentage as in 2011 and
2010.
Americans’ beliefs about medical applications of massage 2010 2011 2012
Massage can be effective in reducing pain. 86% 90% 89%
Massage can be beneficial to health and wellness. 84% 86% 87%
Figure 6. American’s belief about massage in 2012
Relaxation/stress reduction – Thirty-two percent of massage consumers got a massage
for relaxation/stress reduction in 2012, up from 30 percent in 2011.*
· Forty-three percent of massage consumers who are college graduates got a
massage for relaxation/stress in 2012, up from 40 percent a year ago.
· Forty-two percent of massage consumers that earn between $75,000 and $100,000
per year got a massage for relaxation/stress reduction in 2012, up from 36 percent
in 2011.
· Thirty-five percent of women massage consumers got a massage for
relaxation/stress in 2012, up from 30 percent in 2011.
*For purposes of this report, relaxation and stress relief were not included under medical reasons for massage.
Pampering/just to feel good/special indulgence - Twelve percent of massage
consumers received a massage for pampering/just to feel good/special indulgence in
2012, the same percent as reported in 2011.
· Fifteen percent of women who received a massage did so for pampering reasons
in 2012, up from 11 percent in 2011.
· Seven percent of men who received a massage did so for pampering reasons in
2012, down from 16 percent in 2011.
· Twenty percent of Gen Xers, those between 35 and 44 years old who received a
massage, did so for pampering related reasons in 2012, up from 8 percent in 2011.
American Massage Therapy Association 15

Applying the Research:
1. Consumers continue to use massage therapy for medical reasons. Have your students
identify the skills they’ve obtained to meet this consumer demand.
2. More women got a massage for relaxation/stress reduction reasons in 2012 than in
2011. Discuss year to year consumer preferences and how students can best manage
changing consumer demands.
3. Gen-Xers, those between 35 and 44 years old, are increasingly getting massage.
Brainstorm with your students on how they might market to this demographic.
1E. Where are consumers getting massage?
The most popular place to receive a massage continues to be at a Spa.
Nineteen percent of consumers reported in 2012 receiving their last massage at a spa. The
next most popular locations to receive massage were massage therapist’s office/location,
client’s home or home of someone they know, massage chain and beauty salon. (See
Figure 7.)
Figure 7. Where did you get your last massage in 2012?
American Massage Therapy Association 16

Spas – Nineteen percent of all massage consumers received massage at a spa in 2012,
down from 23 percent in 2011.
· Twenty-seven percent of female massage consumers got a massage at a spa in
2012 compared to 28 percent in 2011.
· Only two percent of male massage consumers got a massage at a spa in 2012,
down from 12 percent in 2011.
Massage Therapist’s office/location - Fourteen percent of massage consumers received
a massage at a massage therapist’s office/location in 2011 versus 16 percent of
consumers in 2011.
· Twenty-seven percent of those 45 to 54 years old who received a massage in 2012
received a massage at a massage therapist’s office location, up from 7 percent in
2011.
· Twenty-six percent of massage therapy consumers that earn $100,000 or more
received a massage at massage therapist’s office/location in 2012, up from 21
percent in 2011.
· Twenty-five percent of men who got a massage in 2012 did so at a massage
therapist’s office/location, the same as last year. Only 9 percent of women
massage recipients in 2012 received a massage at a massage therapist’s office,
down from 12 percent last year.
Your home or at the home of someone you know - Eleven percent of massage
consumers received a massage at their home or at the home of someone they knew in
2012, compared to 13 percent in 2011.
· Twenty-three percent of senior massage consumers (age 65 years old or older) got
a massage in 2012 at their home or the home of someone they knew, up from 13
percent in 2011.
· Eighteen percent of massage therapy consumers that earn less than $35,000 got a
massage at their home or the home of someone they knew in 2012, down from 29
percent in 2011.
Massage Chains - The percentage of massage consumers that received a massage at a
massage franchise chain was 10 percent in 2012, up from 3 percent in 2011. Note that
some consumers may not distinguish between a massage chain and a spa.
· Fifteen percent of white massage consumers got a massage at a franchise chain in
2012, up from 3 percent in 2011.
· Fifteen percent of those between 35 and 44 years old got a massage at a massage
chain in 2012, up from 5 percent in 2011.
Beauty Salons – Ten percent of consumers got a massage at a beauty salon in 2012, up
from 6 percent in 2011.
· Thirty percent of massage consumers with a household income between $75,000
and $100,000 got a massage at a beauty salon in 2012, up from 6 percent in 2011.
· Twelve percent of female massage consumers received a massage at a beauty
salon in 2012, up from 8 percent in 2011.
American Massage Therapy Association 17

Hotel/Resorts/Cruises - The percentage of massage consumers that received a massage
at a Hotel/Resort/Cruise in 2012 was 6 percent, the same as in 2011.
Chiropractor’s office - The number of massage consumers getting massage at a
chiropractor’s office decreased to 5 percent in 2012, down from 7 percent in 2011.
Applying the Research:
1. Help your students identify where consumers are most likely to get a massage and
what are the demographics of customers most likely to get massage in various
settings.
2. Spas continue to be a top venue for receiving massage. Encourage your students to
think about how they can incorporate spa elements into their chosen work setting
and/or marketing to attract clients.
3. Massage consumers are increasingly getting massage at massage chains such as
Massage Envy, Elements and Massage Heights. Have your students discuss the pros
and cons of working at a massage franchise.
American Massage Therapy Association 18

1F. What did AMTA hear from consumers in its outreach in 2012? 4
As part of a major multi-year commitment to public education on the
benefits of massage therapy, AMTA launched its Consumer Awareness
Program by visiting five major metropolitan areas in July and August of
2012. The tour included stops in Chicago, Columbus, Boston, Philadelphia
and New York City.
At each stop, AMTA’s branded van transformed into a massage therapy pop-up zone
where consumers received free chair massages and information about the benefits of
massage from AMTA member volunteers.
The following data highlights were collected from consumers on computer tablets during
the tour*:
· Sixty-three percent of consumers that received a massage at a tour location were
female.
· Forty-two percent were between 18 and 34 years old.
· Seventy percent of consumers that received a massage at a tour stop said they receive
at least one massage per year.
· Thirty-two percent chose their last therapist based on referral recommendation while
fourteen percent said they found their therapist by walking or driving by their
location.
· Forty-five percent cited a medical condition as the primary reason for their last
massage.
· Forty-four percent said the primary reason for their last massage was for relaxation,
while 11 percent said pampering.
· When asked to name what contributed to their getting their last massage, 36 percent
of respondents said location and 27 percent said referral.
· Eighty-nine percent of those receiving massage at a tour stop said they were more
likely to recommend massage to their family or friends.
· Seventy-eight percent of consumers that received a massage at a tour stop said they
would be more likely to look for an AMTA massage therapist.
* Data collected during the tour may differ from the data found on the 2012 AMTA Consumer Survey due to
differences in questions and sample groups and is not to be used for comparison purposes or in place of the
data on the 2012 AMTA consumer survey.
Let’s work together on educating the next generation of massage therapists. If you have
questions regarding information included in this report or can think of additional data that
you would like to have available in the future, please contact us anytime at
research@amtamassage.org.
We are here to serve your needs.
American Massage Therapy Association 19

Section 2 — The Massage Therapy Profession 5
Staying current about the latest trends in the massage profession helps
schools give students the best information on which to make decisions
regarding their massage therapy careers.
This section covers information regarding the massage therapy industry including
employment, income and work settings.
Key Concerns:
How do you help your students be prepared to respond to changes occurring in the
massage profession due to economic and demographic shifts affecting those who
receive massage?
Are your students informed about compensation, hours and requirements of various
work settings, etc.?
In what ways are the demographics of your school consistent with those of the
profession?
Do your students understand the various aspects of managing a massage therapy
practice?
Key Findings:
· Most massage therapists are women, previously worked in another profession and
they practice a wide array of modalities.
· On average, massage therapists earned $30.76 per hour in 2012. Therapists working
in their clients’ homes earned the most at $65 per hour.
· Massage therapists view industry perceptions and the economy as their top
challenges.
· More clients are finding massage therapists through social media.
· Most massage therapists describe themselves as sole practitioners.
· Massage Envy is the largest employer of massage therapists with over 800 locations
in 45 states.
These questions will be answered:
1A. Who is practicing massage therapy?
1B. How much are massage therapists compensated for their work?
1C. What are some of the biggest challenges facing massage therapists?
1D. Where are massage therapists practicing?
1E. What’s the latest on the spa industry and massage therapy?
1F. What impact are massage chains having on the profession?
American Massage Therapy Association 20

2A. Who is practicing massage therapy?
Over the last decade, the number of practicing massage therapists increased
by 41 percent. 3
According to the 2012 AMTA Industry Survey, massage therapists in the U.S. are:
· Mostly female — Eighty-five percent of massage therapists are women, a fact
that hasn’t changed substantially over the last few years.
· Trending younger than previous years— More massage therapists were under
the age of 35 this year (41 percent) than last year (25 percent), and fewer were
between the ages of 35 and 44 (20 percent in 2012 versus 26 percent in 2011), as
well as between 45 and 54 (24 percent in 2012 versus 29 percent in 2011).
· Educated — Thirty-six percent of massage therapists have a Bachelor’s Degree
or higher and 90 percent have achieved formal education levels above a high
school diploma or GED. This is consistent with previous data. (See Figure 8
below.)
2006 2007 2008 2009 2010 2011 2012
Education (Non-Massage)
High school grad or less 11% 14% 13% 12% 15% 12% 10%
Some college 27 28 27 28 23 27 22
Associate’s Degree 15 14 14 12 13 16 19
Technical/vocational 10 9 11 10 8 8 14
certificate
Bachelor’s degree 27 25 26 25 29 27 29
Master’s degree 9 8 8 11 10 9 6
Doctorate 1 2 2 2 1 2 1
Gender
Male 15% 15% 12% 15% 13% 12% 15%
Female 85 85 88 85 87 88 85
Figure 8. Massage therapist’s profile
Most massage therapists are coming from another profession
· Sole practitioners are most likely to have had a different occupation prior to
becoming a massage therapist. (See Figure 9 for more information). This has not
changed from 2011 data.
· Therapists working as employees or contractors are comparatively more likely to
enter massage therapy as their first profession. (These types of work settings may
attract younger candidates with less prior work experience.)
American Massage Therapy Association 21

Figure 9. Was massage therapy your first career choice?
Massage therapists practice a wide array of modalities
The average number of modalities practiced remained constant at seven from 2011 to
2012.
· Top modalities practiced include Swedish massage, deep tissue, chair, trigger point,
and hot stone. (Similar to 2011 data.)
· More than 8 out of 10 therapists are practicing Swedish and deep tissue massage.
American Massage Therapy Association 22

2006 2007 2008 2009 2010 2011 2012
Swedish 76% 82% 89% 84% 88% 87% 89%
Deep Tissue 66 70 82 77 84 85 85
Trigger Point 35 43 52 49 55 54 56
Sports Massage 32 40 49 45 53 52 53
Neuromuscular 29 28 31 33 38 32 32
Myofascial 28 29 41 46 52 46 47
Reflexology 28 31 46 45 47 47 46
Chair 32 37 58 52 62 62 63
Hot Stone 39 40 55 47 53 57 54
Prenatal/
Pregnancy
28 30 49 44 53 51 52
Figure 10. Top modality specialties of massage therapists
Highlights from Figure 10:
Among massage modalities, Swedish (89 percent) and deep tissue (85 percent) still
rank as those most frequently practiced.
The number of massage therapists in the U.S. remained constant from last year but has
grown over the last decade 3
Over the past ten years, the estimated number of massage therapists has increased 41
percent.
Between 2011 and 2012, the number of massage therapists grew less than one percent to
307,104. Pennsylvania passed state licensing requirements and began enacting them in
2011, accounting for an increase in massage therapists in licensed states. Over the last
five years, there has been a 9 percent increase in the number of massage therapists. This
is lower than in previous years, indicating slower growth in the industry.
The following chart illustrates the growth of the total estimated number of massage
therapists over time.
American Massage Therapy Association 23

350,000
300,000
250,000
% Change in Total MTs
% Change in LMTs
Estimated MTs
Licensed MTs
15%
3%
Total MTs By Year
(LMT and EMT Combined)
3%
4%
3%
85,166
1%
85,811
5%
88,868
0%
69,915
200,000
4%
2%
109,948
97,928
100,244
94,053
9%
150,000
100,000
99,105
100,929
20%
13%
163,002
4%
169,099
11%
186,916
9%
203,380
1%
205,919
5%
217,090
237,189
6%
2%
144,009
50,000
118,281
120,458
0
2003
(217,386)
2004
(221,387)
2005
(253,957)
2006
(260,930)
2007
(269,343)
2008
(280,969)
2009
(288,546)
2010
(291,730)
2011
(305,958)
2012
(307,104)
Highlights from Figure 11:
In 2012 there were approximately 307,104 massage therapists in the United States,
which is slightly up from 305,958 therapists in 2011.
*LMT: licensed massage therapists, MT: massage therapists from non-licensing states
Applying the Research:
1. Discuss the various work options available to your students and the similarities
and differences between them so they can make informed decisions about where to
work after graduation.
2. Consider the implications of slowed growth in the number of massage therapists with
your students as they enter the job market and workplace. How can they use this
information to their advantage?
American Massage Therapy Association 24

2B. How much are massage therapists compensated for their work?
Massage therapists’ compensation per hour changed minimally from last
year.
How much are clients paying for massage?
· In 2012, clients paid an average of $61.60 for one hour of massage, an increase of
$2.60 from 2011.
· Hotels, resorts and cruises charged clients the most, an average of $96.49 per hour.
· Hospitals and medical offices charged the least, an average of $49.69 per hour.
Average hourly earnings of massage therapists stayed about the same as last year
Massage therapists were paid an average of $30.76 per hour (including tips) across all
work settings in 2012. That’s about the same as in 2011, $31.11 per hour*.
Therapists working in their client’s homes made the most, an average of $65.47 per hour.
Those working in massage only franchises and chains made the least, an average of
$18.12 per hour.
Massage therapists earned tips more frequently in 2012 than in 2011. Thirty-six percent
of therapists reported receiving tips 80-100% of the time in 2012 versus 30 percent in
2011.
Figure 12. Average 2012 hourly pay and tips for massage therapists by work setting.
*An audit of 2011hourly income data uncovered discrepancies in calculations that led to misreporting of data in last
year’s report. The 2012 data reported is accurate and corrections have been made to the 2011 data in this year’s report.
American Massage Therapy Association 25

Massage therapists are working more hours than last year
On average, massage therapists worked 21.6 hours per week in 2012, a significant
increase from 19.6 hours per week reported in 2011. Fifty-two percent of massage
therapists would like to work more hours in massage therapy. This is down markedly
from sixty percent wanting to work more hours in 2011. On average, therapists who want
to work more hours would like to add an average of 12 hours to their work week.
Massage therapists were paid for 17.1 of the 21.6 average hours they worked per week
in 2012, or 79 percent of the time they spent at work.
Health benefits stayed the same in 2012
Massage therapists were about as likely to receive health benefits from their employers in
2012 (34 percent) as they were in 2011 (36 percent).
Massage therapists continued to depend heavily on repeat clients
In 2012 massage therapists saw an average of 41 clients each month, returning to 2010
levels after a decrease to 38.9 clients per month in 2011.
Repeat clients made up 71 percent of massage therapists’ appointments in 2012 with new
clients comprising the remaining 29 percent, essentially the same as last year.
Total Clients (#) % New Clients % Repeat Clients
Total 41 29% 71%
Sole Practitioner 41 24% 76%
Contractor 44 36% 64%
Full time employee 63 39% 61%
Part time employee 38 36% 64%
Highlights from Figure 13:
The majority of clients that massage therapists see in a month are repeat clients (71
percent).
Full time employees see the most clients of all work settings over the course of a
month (63 clients per month).
Massage therapists continued to barter or trade their services, but less than in previous
years
Seventy-three percent of massage therapists bartered or traded their services. That’s down
from 83 percent in 2011. The number of therapists who said they never barter their
services increased from 2011, and the number of therapists who said they barter every
couple of weeks or more often decreased from 2011.
The average dollar value of services bartered decreased to $580 in 2012 from $627 in
2011. Sole practitioners had the highest value of bartered services, at $669.
American Massage Therapy Association 26

Figure 14. Percentage of massage therapists bartering services
Highlights from Figure 14: Seventy three percent of massage therapists reported
bartering massage services in 2012, fewer than in 2011.
Where consumers find massage therapists and therapists find clients.
Massage therapists obtain clients from many sources. In 2012, both massage therapists
and their clients cite referrals as the primary method they used to locate each other. See
Figure 15 below.
% of consumers find
therapists via this medium
% of therapists who
promote via this medium
Referrals by clients 74% 72%
Internet/websites 37 49
Community/local events 26 43
Social media 20 40
Locator service 8 15
Figure 15: Where consumers found therapists and where therapists promoted their services.
As shown in Figure 16, referrals from other massage therapists decreased slightly from
2011 to 2012, down 1 percent.
American Massage Therapy Association 27

Figure 16. Frequency of receiving referrals from other massage therapists
Massage therapists employed various advertising methods but reduced their use of
advertising overall
Massage therapists advertised their services in a variety of ways in 2012, as shown in
Figure 17 below. This year, therapists reported advertising their services less frequently
than last year with more indicating they did not advertise their services at all.
Medium 2007 2008 2009 2010 2011 2012
Advertise Services 72% 72% 68% 77% 94% 90%
Internet/website --- 24 28 50 58 49
Social media --- --- 52 55 45 40
Referrals 37 40 30 30 89 72
Community/Local
Events
38 38 33 35 56 43
Radio 5 5 4 1 4 3
Figure 17. Media massage therapists use to advertise their services
More massage therapists used social media in their practices for purposes beyond
advertising 6
Massage therapists continued to increase their use of social media to stay in touch with
clients. In 2012, 36 percent of massage therapists used a social network to stay in touch
with clients, a significant increase over the 23 percent of massage therapists reporting
they used an online social network for this purpose in 2011. Facebook use increased
again in 2012, with 81 percent of massage therapists reporting that they used the site,
compared to 78 percent in 2011 and 63 percent in 2010. Given this increase, the reported
American Massage Therapy Association 28

decline in use of social media for advertising implies that massage therapists could be
using social media for personal reasons as well as professional purposes.
More massage therapists have their own websites 6
The last year, 2012, saw major growth in the number of massage therapists with their
own website, with 46.5 percent indicating they have a website for their practice, up from
39.8 percent in 2011 and 38 percent in 2010.
Massage business continued to improve for sole practitioners and independent
contractors
Fifty-three percent of sole practitioners and independent contractors indicated that their
business improved in 2012, continuing an upward trend since 2010. Only 14 percent
reported their business had declined over the past year.
Applying the Research:
1. The latest information about compensation, tips, and hours for each setting can help
students negotiate their starting pay in the industry.
2. Make sure that your students understand that average hourly pay and annual salary
information for massage therapists cannot be compared to a standard forty-hour work
week.
3. Massage therapists practice an average of 7 modalities. Discuss the importance of
knowing different massage techniques with your students, and how to find training in
new modalities that may interest them.
4. Seventy-one percent of appointments in 2012 came from repeat clients, and this is a
figure which has not changed much since 2008. Discuss the importance of
maintaining current clients while recruiting new clients to a massage practice with
your students.
5. Consumers are finding massage therapists online more and more. Make sure your
students create a robust online presence to give consumers the best opportunity to
locate them.
American Massage Therapy Association 29

2C. What are some of the biggest challenges facing massage therapists?
In 2012, massage therapists cited industry perception and business/economy
issues equally as their biggest professional challenges.
Massage therapists are affected by the perception of their industry
· Massage therapists continued to want to be recognized and respected as health care
professionals and to seek more public awareness of the massage therapy profession to
improve the industry’s reputation.
· The struggling economy continued to affect massage therapists as well.
· Figure 18 below lists the top challenges reported by massage therapists overall and by
work setting.
Total
Sole
Practitioner
Contractor
Full Time
Employee
Part
Time
Employee
71% 70% 70% 69% 68%
Industry Perceptions
- Being recognized /
respected as health
care professionals,
public awareness
Business/Economy
Issues - Poor
economy, maintaining
steady business /
finding new clients,
licensing
Job Factors -
Avoiding personal
injury, low income,
finding/maintaining
employment
Education Issues -
Workshop
costs/finding CE
classes, standards of
education/training
inequalities
Figure 18. Largest challenges facing massage therapists
70% 69% 72% 67% 68%
34% 27% 30% 29% 37%
31% 31% 35% 37% 38%
Applying the Research:
1. How do business and economy issues affect practicing massage therapists in your
area? Invite a local massage therapist to discuss the reality of these issues with your
students.
2. Considering the increased use of massage therapy in major medical and health care
institutions, discuss the importance to the careers of new massage therapists of
networking with health care professionals.
American Massage Therapy Association 30

2D. Where are massage therapists practicing?
Massage therapists tend to work in multiple settings and most describe
themselves as sole practitioners.
AMTA’s research on the massage industry in 2012 shows that massage therapists:
· Continued to travel to their clients’ homes to provide massage. Massage provided in
the client’s home increased to 48 percent in 2012, the second year this setting topped
the list.
· Provided massage in their offices as well. This number increased to 39 percent in
2012, as compared with 36 percent in 2011.
· Did not provide massage out of their homes as frequently. Massages provided in
therapists’ homes decreased to 36 percent in 2012, down from 41 percent in 2011.
· Results of the 2012 AMTA Industry Survey and information from other sources
indicated 5 percent (+ or – a few percent) of massage therapists work in massagetherapy
only franchises or chains.
See Figure 19 for the visual representation of this data.
Figure 19. Massage therapists’ work settings in 2012
American Massage Therapy Association 31

Highlights of Figure 20: Nearly 70 percent of massage therapists describe
themselves as sole practitioners. Full-time employees comprise the smallest group of
massage therapists.
Massage therapists worked more hours in 2012
The average work week of massage therapists increased significantly to 21.6 hours in
2012 from 19.6 hours in 2011. Fifteen of those hours, or 70 percent, were spent
performing massage. The other 6.5 hours were spent on marketing, performing general
business tasks and other tasks. Massage therapists said their ideal work week would be 34
hours, an increase of 12 hours from their current work week. See Figure 21 for more
detail on this.
American Massage Therapy Association 32

Figure 21. An average work week of a massage therapist
Massage Therapists’ Annual Income
Massage therapists made an average of $20,879 per year from the profession. Sole
practitioners, contractors and full-time employees all earned a higher than average
income from massage therapy. Part-time employees were the only group who made less
than the average.
Massage therapy comprised 73 percent of the typical therapist’s household income for
2012.
Fifty percent of therapists earned all of their income for the year from massage therapy.
See Figure 22 for the breakdown of other sources of income for massage therapists.
American Massage Therapy Association 33

Figure 22. Sources of secondary income for massage therapists
Applying the Research:
1. Help your students develop a plan on how they will support themselves until their
massage practice brings in enough revenue to live on.
2. More massage sessions are occurring at consumers’ homes or work places than in the
massage therapist’s home. What are some strategies you can give your students to
manage several different work environments over which they limited control?
American Massage Therapy Association 34

2E. What’s the latest on the spa industry and massage therapy? 7
According to the ISPA 2012 U.S. Industry Study covering 2011activity, spa visits
and revenue increased over 2010, showing a continued rebound in the spa industry
that started in 2009.
Spa visits increased in 2011
· Spa visits increased 4 percent from 2010 to 2011.
· Spa industry revenue surpassed 2008 levels in 2011, increasing to $13.4 billion, the
highest revenue in the last five years.
· Revenue per spa establishment increased 4.8 percent from 2010 to 2011 but is still 34
percent below 2001 numbers, when the revenue was $1.024 million per
establishment.
Year Estimated spa visits Estimated spa
industry revenue
Spa revenue per
establishment
2007 138 million 10.9 billion $ 607,000
2008 160 million 12.8 billion $ 601,000
2009 143 million 12.3 billion $ 594,000
2010 150 million 12.8 billion $ 642,000
2011 156 million 13.4 billion $ 673,000
Figure 23. Information on spa revenue and visits
The number of spa locations declined for the third straight year in 2011
The number of spa locations continued to decline, from 19,900 locations in 2010 to
19,850 locations in 2011 (See Figure 24).
American Massage Therapy Association 35

Figure 24. Growth in Spa Locations (US)
Other findings regarding the spa industry:
· Average visits per spa establishment continued to increase, to 7,859 in 2011 from
7,522 in 2010. This is a 4.5 percent increase.
· The average number of employees per spa increased from 16 to 17 from 2010 to
2011, a rise of 5.6 percent. Jobs in the spa industry as a whole increased 2 percent to
338600 in May 2011, from 332,000 in May 2010. There was an increase in hiring of
full-time employees and a decrease in hiring of part-time employees and contractors.
· The average price of spa services rose only 0.6 percent between 2010 and 2011, even
as revenue and spa visits increased substantially more.
· Ninety-two percent of spas offered massage services in 2011.
· Spa clientele was 77 percent female and 23 percent male in 2011.
Massage therapists’ employment in spas dipped slightly in 2012 5
· Twenty-five percent of massage therapists worked in spas or salons in 2012, down
from 29 percent in 2011.
Note that the 2012 AMTA Industry Survey references 2012 data while the ISPA 2012 U.S.
Spa Industry Study references 2011 data.
American Massage Therapy Association 36

Applying the Research:
1. The spa industry is returning slowly to its earlier size, but consumers are not returning
in high numbers. How can massage therapists employed in spas help increase the
number of massage customers?
2. Provide information to your students about working in spas including work
requirements and environments. AMTA’s Career Success Series and online Career
Assessment Quiz help your students determine the best work setting for them.
2F. What impact are national massage chains having on the profession?
Results of the 2012 AMTA Industry Survey indicate national chains
continued to expand and provide steady employment and work experience
for many massage therapists.
National massage chains continued to expand and diversify their services
National massage chains have been growing for the past several years. In 2012, this
growth continued, with most major massage chains opening new locations.
Consumer use of massage chains increased in 2012, with 10 percent of consumers
indicating a chain as the location of their last massage. In contrast, only 3 percent of
consumers got their last massage at a chain in 2011. Note that some consumers may not
realize the difference between a spa and a national massage chain. 1
Five percent of massage therapists worked at a national massage chain in 2012, down
from 7 percent in 2011. Here again, some therapists may report that they work in a spa as
opposed to a franchise or chain.
The main players in the massage chain market include:
Massage Envy was established in Arizona in 2002, and has grown to over 800 locations
in 45 states, opening its 800 th location in September of 2012. The company reports it will
open an additional 250 locations by the end of 2015. In 2011, Massage Envy had 742
locations in 44 states and was the largest employer of massage therapists, with a staff of
roughly 21,000 across all franchises. These therapists provide over 324,000 massages
every week. Massage Envy offers an annual membership for $59 per month which
includes a 50-minute massage. Massage Envy Spa locations also offer therapeutic facials
for just $10 more than a massage session.
Elements Therapeutic Massage has over 130 locations in 32 states, with an additional
53 locations scheduled to open soon. Elements’ Wellness program carries a monthly fee
of $59, which includes one hour-long massage, and members receive discounts of at least
$20 on each additional massage. Other Wellness program benefits include the ability to
roll-over unused massage sessions, the ability to pass on monthly massages to a family
American Massage Therapy Association 37

member or significant other, and online members-only specials. Non-member pricing for
a one-hour massage is approximately $89. Elements announced a partnership with
Everest College in November 2011, where Elements will recruit Everest graduates in
exchange for input into the massage therapy training program at Everest.
Massage Heights originated in San Antonio, Texas in 2004. The company’s goal is to
open over 1,600 US locations by 2015. Massage Heights had 87 locations in 18 states,
and 4 locations in Canada, an increase of 13 locations over 2011. The company has a
similar membership model to Massage Envy as members pay a rate of $49.99 per month
for one 50-minute massage. Additional massages can be purchased for $39.99, which is
half off the non-member rate. Massage Heights offers half-hour, one and a half-hour and
two-hour massages as well. The company recently announced a partnership with the
American Cancer Society’s DetermiNation training program, and has also partnered with
the Rock ‘N Roll Marathon series.
XPresSpa and Massage Bar continues to operate in many domestic airports. XPresSpa
was in 28 terminals in 14 U.S. airports in 2012, and has 3 locations in an international
airport. Thirteen additional locations are listed as coming soon. XpresSpa has a
membership card which is free and gives a $5 reward for every $100 spent on services
and products. Massage Bar, which has been in business since 1994, has 14 locations in 9
U.S. airports, a slight increase over 2011.
Zen Massage Centers is based out of North Carolina, and currently has 14 locations in 7
states. The chain has no membership fees and markets itself as having affordable
massage therapy available on the client’s terms. Massages are offered in hour, one-anda-half
and two hour increments, and Reiki, Reflexology and Aromatherapy can be added
on to any massage for an additional charge. The company offers 11 different massage
modalities for clients to utilize. Pricing is specific to each location, but most list a 50-
minute Swedish massage for $39.95 or $49.95.
Other companies still in the market include LaVida Massage, MassageLuxe, The Great
American Backrub and several other regional chains.
Applying the Research:
1. Massage chains are being used more commonly by consumers, and offer a consistent
experience and increased access to massage with affordable rates. How does this
change the landscape of the profession?
2. New services are being offered at many of the major chains, including facials and
various modalities of massage. Consider offering at least introductory training in
many of these services and modalities to give your students the best possible
advantage in the job market. Contact a franchise in your area to find out what they are
offering, and partner with them if possible.
If you have suggestions or identify additional information you need, please contact us at
research@amtamassage.org.
American Massage Therapy Association 38

Section 3 — Health Care and the Massage Profession 5
Consumers continue to increase their use of massage for medical reasons.
As the health care industry continues to grow, health care providers are
more commonly viewing massage therapy as a legitimate option to address
health concerns.
This section discusses dynamics of the health care industry and the participation of
massage therapists in the industry.
Key Concerns:
How is massage therapy being affected by the growth of the health care industry?
How much are insurance companies reimbursing massage therapists?
In what ways is massage therapy being integrated into various health care
environments?
In the section, you’ll…
· Obtain an update regarding employment in the health care industry and how this
affects massage therapists.
· Learn about examples of major health institutions incorporating alternative medicine
treatments, including massage therapy.
· See how consumers are using massage for their health.
· Read about various insurance reimbursement opportunities for massage therapists.
As you examine these timely topics:
3A. Continued growth in the health care industry
3B. Growth in the integration of Complementary and Alternative Medicine (CAM)
treatments into hospitals
3C. Consumer use of massage as part of an integrated approach to health care
3D. Massage and insurance
American Massage Therapy Association 39

3A. Continued growth in the health care industry
Between October 2011 and October 2012, health care employment
increased 5.8 percent in the industry category that includes massage
therapists. 8
· Overall, employment in the health care industry increased 2 percent from
November 2011 to November 2012 to 17 million. The health care category of
“Outpatient care centers,” which includes massage therapists, as defined by the
Bureau of Labor Statistics, experienced an employment increase of 5.8 percent
over this period.
· The Bureau of Labor Statistics projects that the health care and social assistance
sectors of the economy will add the most jobs of any economic sectors by 2020.
· Continued increases in both the overall size of the healthcare industry and in
consumer spending on health care demonstrate increased demand for health care
related products and services. These trends are expected to continue as the US
population ages.
3B. Growth in the integration of Complementary and Alternative
Medicine (CAM) treatments in hospitals.
Major health systems throughout the United States are incorporating CAM
therapies, including massage therapy, into treatment plans for patients.
· Duke Integrative Medicine in Durham, North Carolina offers acupuncture,
behavioral health, movement/fitness, nutrition counseling, as well as massage and
bodywork. This provider also allows the public to utilize its services without a
doctor’s referral, increasing accessibility and knowledge of CAM therapies. Duke
will also be conducting clinical research on massage therapy.
· Mayo Clinic’s Complementary and Integrative Medicine Program offers patients
access to massage therapy, meditation and other CAM therapies by recommendation
of the physicians at Mayo Clinic. This program has been in place since 2001 and
treats more than 5,000 patients each year.
· Northwestern Memorial Hospital in Chicago, Illinois offers integrative care as part
of treatment plans, and employs massage therapists, acupuncturists, naturopaths, and
other CAM practitioners. Their physicians are trained in both traditional and
integrative medicine to ensure that they suggest the best course of treatment for each
patient.
· Major healthcare networks are offering greater access to massage and other CAM
therapies to their patients as part of holistic care plans. Patients receive these therapies
with the recommendation of physicians. Insurance coverage varies by clinic and
American Massage Therapy Association 40

patients’ insurance plans. As insurance is regulated by the state, coverage also varies
from state to state. AMTA expects such integrations of massage therapy into hospital
and major medical facilities to continue to grow in the future.
Massage therapists support the integration of massage in health care. As such
integration continues to grow, more scientific research is being conducted on the
efficacy of massage.
Massage therapists continue to support integration of massage therapy into health care
The number of massage therapists who think that massage therapy should be considered
part of the health care field has remained constant at 97 percent since 2010. Therapists
indicated the following as the most important ways to accomplish this integration
(percentages are of respondents listing item as their top choice):
· Massage prescribed/referred by health care provider (44 percent)
· Massage therapists working as part of a health care team alongside other
complementary practitioners (23 percent)
· Massage therapists working as part of a health care team within a hospital or
clinic (14 percent)
· Making massage available in hospitals and clinics (11 percent)
· Making massage available in integrated clinics (5 percent)
· Massage supervised by a health care provider (4 percent)
Clinical studies on the efficacy of massage are ongoing
AMTA continues to leverage its existing relationships within the healthcare industry to
forge new partnerships with major organizations to conduct research studies on the
efficacy of massage. The results of these studies will provide more evidence based
research about massage therapy. Increasing the base of clinical knowledge and research
about massage therapy will further enhance the integration of massage therapy into
healthcare and will increase its use by patients. In recent years, there has been a shift
towards comparative effective research, a methodology designed to yield evidence on
effectiveness, benefits and harms of different treatment options. This type of research
compares massage therapy to other interventions.
The Massage Therapy Foundation promotes research literacy and capacity in the
profession by granting funds for research and educational initiatives related to massage
therapy, by providing direct consultation to the medical and research communities, and
by educating massage therapists about the world of research.
There are many resources you can use to access current and past studies on the efficacy
of massage:
www.spaevidence.com
www.pubmed.gov
www.massagetherapyfoundation.org
www.nccam.nih.gov
www.biomedcentral.com
American Massage Therapy Association 41

Applying the Research:
1. Discuss with your students different ways that massage therapists can increase public
awareness of and access to massage therapy, regardless of work setting.
2. As massage therapy becomes more integrated into health care, massage therapists
need to know the latest research about the efficacy of massage therapy. Share the
information in this report with your students and encourage them to explore
information regarding clinical research at www.massagetherapyfoundation.org.
3. Refer students to AMTA Position Statements
www.amtamassage.org/positionintro.html regarding how a growing body of research
indicates the value of massage for specific health issues.
4. Another valuable resource for scientific research on massage therapy is
www.PubMed.gov. Have your students choose a study and present the findings to
their class in a relevant and creative way.
3C. Consumer use of massage as part of an integrated approach to
health care 1
Consumers used massage for medical reasons more in 2012 than they did in
2011. Physicians increased their encouragement of patients to receive
massage.
Consumer use of massage for medical and health reasons continues to rise
Forty-three percent of American massage consumers got a massage for medical and
health reasons in 2012 per the 2012 AMTA Consumer Survey. That’s up from 44 percent
in 2011 and 29 percent in 2010.
· Overall, 89 percent of Americans believe that massage can be effective in
reducing pain and 87 percent believe that massage can be beneficial to health and
wellness.
· Men continued to use massage for medical and health reasons (55 percent) more
than women (38 percent) in 2012. Men increased their use of massage for medical
and health reasons over 2011 (55 percent in 2012 versus 48 percent in 2011), while
women decreased their use of massage for medical and health reasons (38 percent in
2012 versus 42 percent in 2011).
· In 2012, there were no significant differences in use of massage for medical and
health benefits across age groups of consumers; however, all age groups have
increased their use of massage for these reasons. In prior years, consumers over the
age of 65 were more likely than younger consumers to use massage for medical
reasons. In 2012, younger consumers increased their use of massage for these reasons
and began to close the gap with their older counterparts.
American Massage Therapy Association 42

· Consumers of all ages are using massage for injury recovery and rehabilitation.
In 2012, 9 percent of all massage consumers received massage for injury recovery
and rehabilitation, the same percentage as in 2011. Nine percent of those aged 55-64
received massage for injury recovery and rehabilitation, 10 percent of consumers ages
65 and older used massage for these reasons and seven percent of massage consumers
aged 18-34 used massage for injury recovery and rehabilitation.
· Sixteen percent of consumers discussed massage therapy with their doctor or
healthcare provider in 2012. This is essentially unchanged from 2011 data.
· Women are more likely than men to discuss massage therapy with their doctor, a
fact that has not changed over the past three years. (See figure 26 for more
information).
Figure 26. Consumers who discussed massage therapy with their health care providers
Per AMTA’s consumer research, the number of consumer referrals to massage therapy
by physicians increased from 2011 to 2012
Of consumers who discussed massage therapy with their doctor or healthcare provider,
more received referrals from physicians (61 percent in 2012 versus 52 percent in 2011),
but referrals from all other categories of health care professionals remained constant from
2011 to 2012. Figure 27 shows the percentage of consumers, who discussed massage
therapy with their health care provider, that received recommendations for massage by
the type of health care professional.
American Massage Therapy Association 43

Figure 27. Health care professionals who recommended massage to consumers.
*Consumers received referrals from multiple types of health care professionals.
Massage therapists received more referrals from health care professionals
Massage therapists received more referrals from hospitals and medical offices as well as
chiropractors and integrated health clinics in 2012 than in 2011.
Type of Health care
Professional
2011 2012
Hospitals and Medical Offices 46% 51%
Chiropractors and Integrated
Health Clinics
63% 67%
Other Health care Professionals 68% 69%
Other Massage Therapists 76% 75%
Figure 28. Percentage of massage therapists who received referral at least once every 6 months by
category of referring health care professional (2011 data changed from that previously reported due
to corrections)
American Massage Therapy Association 44

Applying the Research:
1. Massage therapy is becoming a more commonly used treatment as part of an
integrated health care plan for patients. Discuss with your students the implications of
this for therapists in various work settings, not just health care.
2. As more consumers increase their use of massage as part of their health regimen,
massage therapists can support this growth by being able to discuss the efficacy of
massage for pain management, injury recovery, and other conditions. Encourage your
students to explore various ways to answer the question “Why should I get a
massage?”
3. More hospitals are offering CAM therapies to patients. Discuss the related potential
employment opportunities with your students.
3D. Massage and insurance
Insurance reimbursement for massage therapy decreased slightly in 2012
Twenty percent of massage therapists were reimbursed by insurance for massage, a 2
percent decline since 2011. Note that “insurance reimbursement” encompasses many
different types of insurance, not just health insurance.
Of massage therapists receiving insurance reimbursement, 14 percent were reimbursed by
medical insurance and 6 percent by auto insurance. Less than 1 percent received
reimbursement through worker’s compensation.
Americans would like their health care plans to cover massage
According to AMTA’s 2012 Consumer Survey, 61 percent of adult Americans would like
to have their health insurance plan cover massage, which is consistent with last year’s
results. At 38 percent, the 65 and older age bracket was significantly less likely than all
other age brackets to want their health insurance to cover massage.
Twelve percent of consumers surveyed indicated that the payment for their last massage
was covered by a mix of health, auto or worker’s compensation insurance, a 4 percent
increase over 2011.
Massage therapists who use insurance reimbursement find it worthwhile for their
business
The 2012 AMTA Industry Survey provides information on insurance reimbursement for
auto, medical, worker’s compensation and other insurance.
· Most massage therapists who received insurance reimbursement in 2012 found it to
be worthwhile for their businesses.
· Depending on the type of insurance, the average amount of reimbursement received
varied widely.
American Massage Therapy Association 45

The table below shows that the average reimbursement for one hour of massage increased
or remained the same as in 2011 across all types of insurance. Note that insurance
reimbursement is determined by each state and not all states permit insurance
reimbursement.
Average Reimbursement Worthwhile for Business
for One Hour of Massage
2011 2012 2011 2012
Auto Insurance $73 $93 83% 79%
Medical Insurance $51 $75 72% 74%
Worker's Compensation
$ 63 $84 74% 70%
Insurance
Other Insurance $ 50 $61 72% 68%
Figure 28. Insurance reimbursement by type of insurance
Studies show that patients are paying out of pocket for massage in health care settings
and insurance companies are covering a comparatively small portion of massage.
Consumers, however, reported an increase in insurance company coverage of massage
over last year.
AMTA’s 2012 Industry Study shows that:
· Massage therapists working in a hospital, medical office or clinic were paid by
patients 44 percent of the time, by insurance 11 percent of the time and by the
facility 45 percent of the time.
· Therapists employed in a chiropractic office or integrated health care clinic were
paid by patients 38 percent of the time, by insurance 9 percent of the time and by
the facility 52 percent of the time.
AMTA’s 2012 Consumer Survey shows that:
· Eight percent of consumers indicated that health insurance paid for their last
massage, a 5 percentage point increase from 2011.
· One percent of consumers had their massage paid for by their employer, or paid a
co-pay with the balance covered by insurance.
The Future of Health Care and Health Insurance
With the US Supreme Court upholding the constitutionality of the Affordable Care Act,
state and federal officials have been moving towards meeting various implementation
deadlines. Several state governments have begun the implementation process for state
operated health insurance exchanges and the development of rules pertaining to the
expansion of Medicaid programs. In late November 2012, the US Department of Health
and Human Services (HHS) released the long anticipated rules pertaining to the essential
health benefits (EHB) requirements for insurance plans offered through federally
operated exchanges. HHS summarized the rules on the website Healthcare.gov.
The Affordable Care Act sets forth that EHB be equal in scope to benefits offered
by a “typical employer plan.” To meet this requirement in every state, the
American Massage Therapy Association 46

proposed rule defines EHB based on a state-specific benchmark plan, including
the largest small group health plan in the state. The rule proposes that states
select a benchmark plan from among several options identified in the proposed
rule, and that all plans that cover EHB must offer benefits that are substantially
equal to the benefits offered by the benchmark plan. This approach balances
consumers’ desires for an affordable and comprehensive benefit package, our
legal requirement to reflect the current marketplace, and issuer flexibility to offer
innovative benefit designs and a choice of health plans. 9
As such, it seems the impact on the massage therapy profession will be determined
separately in each state. It is important to note that this is a snapshot of a highly fluid
environment. Much is still to be determined in the implementation of the Affordable
Care Act, including the role of the provider nondiscrimination provisions. AMTA
understands some members find value in working with health insurance companies while
others prefer to not participate in reimbursement. Through activities with a variety of
health care organizations, AMTA continues to monitor and engage national and state
agencies on behalf of its members and the profession. AMTA continues to stay
committed to keeping its membership up-to-date on the latest developments.
Applying the Research:
1. Health care professionals are increasingly referring their patients to massage
therapists. Discuss with your students how this could affect the massage therapy
profession and students’ future practices.
2. Research and discuss your state’s insurance reimbursement policies with your
students to make sure they have the most up-to-date information.
3. Although the number of massage therapists reimbursed by insurance for massage has
not increased recently, the average reimbursement by insurance for massage did
increase in the past year. What does your school do to teach insurance billing and
educate students about referrals from health care professionals?
If you have suggestions or identify additional information you need, please contact us at
research@amtamassage.org.
American Massage Therapy Association 47

Section 4 — Training and Education of Massage Therapists 10
The vast majority of massage therapists rate their education as excellent or
very good but schools continue to be challenged by marketing their
programs and hiring qualified teachers.
This section takes an in-depth look at demographics, challenges and opportunities that
affect massage therapy schools, teachers, graduates and students.
Key Questions:
How can we attract more students?
What kinds of financial aid are schools offering to students?
How can we support new teachers?
What benefits do schools provide to teachers?
How can we help a younger student body? What special concerns should we address?
What business skills are most helpful to graduating therapists?
Key Findings:
· Seventy-six percent of massage therapists rated the quality of their education as
excellent or very good.
· The average number of graduates reported per school in 2012 dropped to 37.0 per
year from 48.5 reported in 2011.
· As reported by schools in 2012, the average number of hours to complete an entry
level program rose to 706 hours from 689 hours from the previous year.
· Forty-seven percent of schools continue to have difficulty attracting students.
· Schools are employing fewer full-time instructors, 2.6, on average.
· Seventy-five percent of schools offer financial aid to students.
We will cover these facets of massage education:
4A. Hours and types of training
4B. School trends and demographics
4C. School challenges
4D. School accreditation
4E. Teachers
4F. Graduates
4G. Students
American Massage Therapy Association 48

4A. Hours and types of training
In 2012, the average massage therapist reported having received a few more
hours of initial training than was reported in 2011, and the vast majority of
therapists rated the quality of their massage training as excellent or very
good.
Although most massage therapists graduated from an individually owned, private, for
profit massage therapy school, these schools’ trained a smaller share of therapists in
the past year
Sixty-six percent of massage therapists reported in 2012 having graduated from an
individually owned, private, for profit massage therapy school compared to 70 percent
the prior year. 5
In 2012, seventeen percent of therapists reported graduating from a corporate school
compared to 16 percent the previous year and 17 percent reported graduating from a
public institution (community college, city college, state college/university) compared to
14 percent the prior year. 5
Quality of massage training
Seventy-six percent of massage therapists said that their initial massage training was
excellent or very good. Eighty-six percent of massage therapists who are employed fulltime
said there initial training was excellent or very good.
The total hours of massage therapists’ initial training increased slightly in 2012
The average amount of initial training reported by massage therapists on the 2012 AMTA
Industry Survey was 632 hours in 2012, an increase of 13 hours from 2011. The reported
average of training hours has not changed significantly over the past several years. (See
Figure 29 below.)
Hours of Initial Percentage of Massage Therapists
Training
2008 2009 2010 2011 2012
Less than 500 16% 16% 13% 20% 20%
500-600 33 38 32 32 30
601-700 16 15 16 14 12
701-900 20 15 23 21 24
901-1,000 7 8 8 8 7
More than 1,000 6 4 6 6 7
Average Number
of Hours
633 624 660 619 632
Figure 29. Hours of initial training.
American Massage Therapy Association 49

The number of initial training hours, on average, across all work settings increased from
2011 to 2012 with health care workers receiving the most initial hours of training (703).
Overall, the number of initial training hours has remained steady over the past several
years. (See Figure 30.)
Setting
Initial
training
hours (2009)
Initial
training
hours (2010)
Initial
training
hours (2011)
Health care 597 712 562 703
Spa/salon 661 678 603 647
Health club 628 673 648 655
Sole
practitioners
609 664 623 631
Contractors 690 640 595 648
Initial
training
hours (2012)
Figure 30. Hours of initial training by therapists working in different work settings.
Schools are diverse in the type of massage therapy program they offer
· Eighty-eight percent of surveyed schools offer a basic certificate/diploma in massage
therapy.
· Twenty-six percent offer an associate degree in massage therapy, same as last year.
(For more information refer to Figure 31 below.)
Figure 31. Type of massage therapy program(s) or education schools offer
Courses geared to work settings
Ninety-five percent of schools offer at least one course that is specific to a massage
therapy work setting.
American Massage Therapy Association 50

· Eighty-seven percent of schools offered a class regarding offering massage therapy as
a sole practitioner.
· Eighty-three percent of schools offered a course regarding providing massage therapy
in medical locations.
· Seventy percent of schools offered a course regarding massage therapy provided in
spas.
Business courses
Schools are increasing their business course offerings. In 2012, schools offered the
following business courses:
· Marketing - 85 percent of schools offered marketing courses compared to 82 percent
last year.
· Management - 69 percent offered management courses compared to 61 percent last
year.
· Accounting - 43 percent offered accounting courses compared to 38 percent last year.
· Digital technology - 32 percent offered a course in digital technology, i.e. website
development, PowerPoint presentation or social media compared to 25 percent of
schools last year.
Multilingual programs
Fewer schools reported offering massage courses in a second language this year.
· Only 2 percent of schools currently offer massage courses in a second language
compared to 5 percent of schools last year.
Distance learning
According to the 2012 AMTA School Survey, 9 percent of schools offer distance learning
courses for their entry level program versus 13 percent last year. Of those schools that
offer distance learning for their entry level program:
· Forty-five percent of schools with distance learning said they offered 1 to 2 distance
learning classes as part of their entry level massage therapy program.
· Eighty-eight percent of schools prefer face to face classroom discussion for
instructing students.
· Twelve percent of schools say they used blended (face to face learning and online)
learning to deliver instructional material.
· No schools are solely using online learning in their entry level programs.
American Massage Therapy Association 51

Continuing Education
Fewer schools reported offering continuing education courses in 2012; however, massage
therapists are taking more hours of continuing education.
· Thirty-nine percent of schools reported in 2012 offering continuing education classes
in massage therapy compared to 49 percent of schools a year ago. However, 39
percent is consistent with the percentage of schools that offered continuing education
in 2010.
· Ninety percent of massage therapists who responded to the 2012 AMTA Industry
Survey took continuing education classes in 2012, compared to 91 percent of massage
therapists in 2011.
· On average, massage therapists reported taking 24 hours of continuing education in
2012, more than the 19 hours reported in 2011. Full time employees and
hospital/health care workers reported taking 30 hours of continuing education in
2012.
Applying the Research:
1. As more consumers are finding massage therapists via the internet, consider
offering a business course at your school in digital technology, i.e. website
development, PowerPoint and social media applications.
2. Is your school offering continuing education courses? It’s a great way to add
value to your school, generate revenue and stay in touch with recent graduates and
alumni.
American Massage Therapy Association 52

4B. School trends and demographics
In 2012, schools overall had fewer locations and fewer graduates than in
2011, and required more in-class hours.
There is a wide variety of massage schools in the United States.
The results of the 2012 AMTA School Survey show variations across schools in massage
therapy training. These include:
· Number of locations
· Graduates per year
· Program hours
· Cost
· Year established
School Type
Age of School
Total
Individually
Owned
Part of
Larger
Corporation
Public
Institution
2001 or
Newer
2000 or
Older
Average number of locations 2.6 2.1 5.6 1.4 2.8 2.4
Average number of graduates per
year 37.0 41.7 52.9 19.7 30.8 42.2
Average in-class supervised hours
required (entry-level program) 706 671 744 738 693 717
Average clinical hours required
(entry-level program) 79 78 83 79 75 82
Average cost-per-hour of entry level
program before financial aid $13.0 $12.8 $16.3 $11.4 13.1 $13.0
Length of Operation
2001 or newer 45% 37% 26% 37% 100% 0%
2000 or older 55% 59% 14% 27% 0% 100%
Figure 32. School profile information from 2012 AMTA School Survey
Highlights of Figure 32 This chart gives insights into some of the main differences in
schools of massage therapy. Keep reading for more information.
Number of Locations
On average, massage schools have 2.6 locations, compared to the 3.0 locations schools
reported a year ago.
· Individually owned schools have an average of 2.1 locations compared to 2.5
locations last year.
· Schools that are part of larger corporations averaged 5.6 locations, down from 6.4
locations in 2011.
· The average number of public institution locations remained steady at 1.4 locations,
compared to 1.3 locations last year.
American Massage Therapy Association 53

· Newer schools (started in 2001 or after) averaged 2.8 locations, down slightly from
2.9 locations last year, while older schools (founded before 2001) saw their average
number of locations dip to 2.4 locations from 3.0 locations in 2011.
Graduates per year
In 2012, there were 37.0 graduates per school compared to 48.5 graduates in 2011.
· Schools that are part of a corporation saw their average number of graduates per year
decrease by 16 percent from 62.9 in 2011 to 52.9 in 2012.
· The number of graduates at individually owned schools decreased to 41.7 graduates
in 2012 from 53.6 graduates in 2011, a decline of 22 percent.
· The average number of graduates at public institutions in 2012 fell slightly to 19.7
versus 22.7 graduates a year ago.
Program hours
On average, schools required 706 in-class, supervised hours in 2012, an increase of 27
hours over the 689 hours reported for 2011. Note, however, that initial training hours
reported in 2012 by individual therapists was 632 hours on average.
· The average school required 78 clinical hours in their entry programs, the same as in
2011.
· Massage programs at corporate-owned schools required the highest number of hours
at 744, while schools that are individually owned continued to require the least
number of hours at 671.
· The average number of required school hours for older schools (founded before 2001)
on average was 717 hours while newer schools (started in 2001 or after) was 693
hours in 2012. This is a reversal from last year when newer schools had a higher
average of required school hours, 715 hours, compared to older schools which only
averaged 675 required hours.
Cost
The average cost per hour for entry-level massage programs was $13.00 in 2012,
comparable to the average cost per hour of $13.10 last year.
Average cost per hour before financial aid
2009 2010 2011 2012
$10.20 $12.60 $13.10 $13.00
Figure 33. School profile information by survey year
· Schools that are part of larger corporations typically charged the most ($16.30) and
public institutions charged the least ($11.40) for an average hour of entry-level study.
American Massage Therapy Association 54

· Average fees from corporate schools increased by $1.00 in 2012 to $16.30 while
individually owned schools rates declined by thirty cents to $12.80. Public schools
fees remained steady at $11.40.
· Newer schools (2001 and newer) saw an increase of twenty cents per credit hour to
$13.10 in 2012 while older schools (2000 and older) lowered their class fees twenty
cents to $13.00 per hour.
Year Established
Fifty-five percent of the schools participating in the 2012 AMTA School Survey were
established in the year 2000 or before, compared to 65 percent last year. Of those
schools:
· Fifty-nine percent are individually owned schools, down from 69 percent in 2011.
· Twenty-seven percent are massage schools within public institutions/community
colleges, up from 14 percent in 2011.
· Fourteen percent are part of a larger corporation, down from 15 percent in 2011.
Applying the Research:
1. How has the economic recession of the recent past impacted your school?
2. Think about changes your school made to weather the economic recession and
what your school can do to benefit from the gradually improving economy.
American Massage Therapy Association 55

4C. School challenges
Difficulty attracting students and marketing their school/programs remain
the biggest challenges for schools.
Individually-owned massage schools
The biggest challenges for these schools remain attracting students and marketing
their school/programs. However, the percentage of schools citing these challenges
declined in the past year. Thirty-six percent of schools said they had difficulty in
attracting students compared to 46 percent of schools last year. Twenty-six percent of
schools said they had difficulty in marketing their school/programs compared to 32
percent of individually-owned school in 2011. (See Figure 34.)
Massage schools as part of larger corporations
Their biggest challenge remains attracting students. Sixty-eight percent of corporate
schools said they have difficulty attracting students compared to 46 percent of schools
last year. Their next biggest challenges were finding qualified teachers and difficulty in
teaching students with diverse needs. (See Figure 34.)
Public institutions with separate massage programs
Fifty-eight percent of public schools said marketing their program was challenging in
2012, compared to 60 percent in 2011. They also had increased difficulty attracting
students, 53 percent in 2012 versus 48 percent last year. (See Figure 34.)
American Massage Therapy Association 56

Figure 34. Top challenges affecting massage schools
Interpreting Figure 34
Schools mentioned many other challenges beyond those listed on this chart. The majority
of the responses to the open-ended questions related to issues of recruiting qualified
students and time/cost of accreditation.
American Massage Therapy Association 57

How schools are marketing their programs
School websites are the most commonly reported medium used by schools to promote
their organizations with ninety-two percent of schools saying they use their websites for
marketing purposes. Eighty-six percent said they market their school through word of
mouth and 64 percent used social media. (See Figure 35 below).
Figure 35. How do you market your school?
Of those schools that answered “other,” the most prevalent responses were school visits
and career fairs.
Applying the Research:
1. Talk with your staff about the challenges inherent in your type of massage school.
How can you turn these challenges into opportunities?
2. One of the biggest challenges for all massage schools is attracting students.
Schools need a concrete plan for how they’ll distinguish themselves.
3. Consider how your AMTA School Member benefits might help your school
address these challenges. For instance:
o School Profile Page — marketing your school.
o AMTA Job Bank — finding qualified faculty.
o AMTA Store — saving on purchases of supplies/materials.
If you’re unsure how to use these benefits to your greatest advantage, contact AMTA
Member Services for ideas and inspiration at 877.905.2700.
American Massage Therapy Association 58

4D. School accreditation
According to the 2012 AMTA School Survey, 75 percent of schools report
being accredited.
Between 2009 and 2012, the total number of massage schools accredited by nationallyrecognized
accrediting organizations 12 increased 10 percent while the number of
campuses in these accredited institutions increased 40 percent. (See Figure 36.)
Accrediting
Organizatio
n
2009 Numbers 2010 Numbers 2011 Numbers 2012 Numbers
Institutions
Campuses
(Including
Main) Institutions
Campuses
(Including
Main) Institutions
Campuses
(Including
Main) Institutions
Campuses
(Including
Main)
ABHES 69 84 57 71 65 74 68 68
ACICS - - - - 67 234 65 240
ACCET 29 77 41 113 23 77 25 75
ACCSC 105 192 97 185 86 181 85 170
COMTA 72 97 58 89 59 91 57 87
NACCAS 54 75 61 89 65 98 62 99
Total 329 525 314 547 365 755 362 739
Figure 36. Accreditation numbers
Applying the Research:
1. Is your massage school accredited? Accreditation can maximize your school’s
credibility, giving you an advantage in advertising to prospective students. Learn
more at www.comta.org or at any of the other accrediting organization websites.
American Massage Therapy Association 59

4E. Teachers
Schools are employing fewer full-time massage therapy teachers and more
schools are having difficulty finding qualified instructors. However, teacher
pay has increased.
Most massage instructors are part-time employees.
Massage schools employ fewer full-time instructors on average than part-time instructors
or independent contractors.
5.1 Number of part-time instructors currently employed (down from
6.2 in 2011).
2.7 Number of independent contractors currently employed (down
from 3.1 in 2011).
2.6 Full-time instructors currently employed (down from to 3.6 in
2011).
76% Have part-time instructors (down from 84% in 2011).
66% Have full-time instructors (down from 69% in 2011).
36% Have independent contractors (down from 47% in 2011).
Figure 37. Number of instructors in massage therapy schools
Instructor teaching experience
The average instructor in a massage therapy program has 6.7 years of experience
teaching.
American Massage Therapy Association 60

Figure 38. Experience of massage therapy instructors related to massage therapy
Teaching experience unrelated to massage is 3.5 years on average. Schools may want to
consider providing massage therapy teacher training for new instructors without
experience in massage therapy instruction.
What qualifications do massage schools look for in instructors?
In their instructor hiring requirements, massage schools focus on massage therapy
experience first. Figure 39 below provides more detail regarding hiring requirements for
instructors.
General Hiring Requirements by School Type
Total
Individually
Owned
Part of
Larger
Corporation
Public
Institution
Experience as a practicing
massage therapist 93% 95% 92% 90%
Current status as a practicing
massage therapist 67% 66% 80% 60%
Teaching experience 51% 52% 32% 60%
Experience in specific modalities 50% 57% 40% 48%
Require massage instructor
training 28% 40% 16% 18%
Bachelors degree 21% 13% 0% 45%
Associate degree 19% 5% 20% 40%
Figure 39. General hiring requirements by school type
American Massage Therapy Association 61

Hiring requirements remain steady in 2012
Ninety-three percent of schools require “experience as a practicing massage therapist” to
qualify as an instructor, comparable to 92 percent in 2011. Similarly, schools are looking
for instructors who currently practice massage therapy, have teaching experience and
have experience with specific modalities.
Hiring challenges
Twenty-six percent of schools said they had trouble hiring instructors for their program
compared to 22 percent last year. Of those schools that had difficulty hiring instructors:
· Eighty-two percent of schools said they found instructor candidates lacking in
classroom management skills compared to 66 percent of instructor candidates last
year.
· Sixty-seven percent said they found instructor candidates lacking in teaching
experience compared to 83 percent last year.
· Sixty-one percent of schools said prospective teachers were lacking in course
planning and curriculum development skills compared to 41 percent of teacher
candidates last year.
Teacher Training
Seventy-four percent of schools provided teacher training in 2012 down from 80 percent
of schools in 2011. Of those schools that provided teacher training:
· Ninety-four percent provided in-service training compared to 98 percent last year.
· Fifty percent provided 1 to 10 hours of in-service training compared to 38 percent last
year.
· Eighty percent provided a peer/monitor relationship compared to 78 percent last year.
· Forty-eight percent provided reimbursement for continuing education compared to 60
percent last year.
· Twenty-five percent provided over 50 hours of internships with another
teacher/teacher trainer compared to 44 percent last year.
How much are instructors paid?
According to the 2012 AMTA Massage School Survey, which surveyed instructor pay for
2011, the average hourly pay schools provided their instructors in 2011 was $27.40, up
from $27.00 the previous year. Here is more information on the breakdown of massage
therapy instructor pay in 2011:
Total
Individually
Owned
Part of
Larger
Corporation
Public
Institution
2011 Average Hourly
Instructor Pay by School Type $27.40 $24.90 $22.20 $34.80
Figure 40. 2011 average hourly instructor pay
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Public institutions and corporation schools paid instructors less in 2011than in 2010,
$2.10 and $2.00 less per hour respectively, while individually owned schools paid $0.50
more per hour in 2011.
What percentage of schools provides benefits to instructors?
Forty-six percent of schools provided benefits to their instructors in 2012 compared to 53
percent last year. Those schools that provided benefits to instructors increased their
benefits:
· Eighty-eight percent provided medical insurance compared to 86 percent last year.
· Eighty-six percent provided retirement services compared to 76 percent last year.
· Seventy-nine percent provided dental insurance compared to 76 percent last year.
· Sixty-nine percent provided life insurance compared to 56 percent last year.
Applying the Research:
1. As many massage therapy instructors have little formal teaching experience, consider
offering your instructors training in classroom management and/or course planning.
2. Does your school offer benefits to teachers? Consider offering benefits as a way to
attract the most qualified instructors.
Pleases help us collect information that will benefit the massage education industry by
sharing your school’s challenges and successes at research@amtamassage.org.
American Massage Therapy Association 63

4F. Graduates
Some students may find it difficult to find a job in massage therapy or a job
that will support them until they can build up a client base. Schools with a
formal placement program continue to see a large percentage of students
finding employment.
The number of graduates per school declined in 2012
According to the 2012 AMTA Massage School Survey, the average number of graduates
of 500-plus hour massage schools was approximately 37.0 in 2012, down from 48.5
graduates in 2011.
Schools continue to help new graduates find jobs
While getting ready to graduate, some students may find it difficult to obtain employment
in massage therapy that will support them until they can build up a client base. This is
one of the major reasons why new therapists leave the profession. In light of this, ninetyone
percent of schools now offer some kind of job placement services to their students:
· Fifty-three percent of schools provided a job board or book that students can use to
look for jobs in 2012 compared to 41 percent of schools last year.
· Thirty-eight percent of schools offered a formal placement program for graduates
in 2012, compared to 49 percent in 2011.
· Schools that had a formal placement program placed 80 percent of their graduates on
average in massage therapy positions versus an 83 percent placement rate last year.
Some of the specific job placement services schools provided to students include
assistance with resume writing, cover letter writing and interviewing skills. Additionally,
many schools with a formal job placement program establish relationships with massage
therapy businesses and held job fairs for students at their school.
Applying the Research:
1. Many schools are doing more to help students find employment after graduation.
What placement services does your school currently offer? How can your staff go the
extra mile in helping your students find jobs?
2. Refer your students who are AMTA members to the AMTA website where they can
access the AMTA Job Bank and Career Guidance section, for marketing information
and tools to help them start their practices.
American Massage Therapy Association 64

4G. Students
Student demographics and attrition rates remained steady in the last year.
More schools offered financial aid to students in 2012.
The average student age is 31 years old
According to the 2012 AMTA Massage School Survey, the average student is 31 years old
with 54 percent of student populations consisting of 30 year olds or younger. Twenty
percent of students are in the 20 to 25 year old age range, the largest of any group.
Massage therapy students are mostly female
Seventy-nine percent of massage therapy students are female with male students making
up 21 percent of the student body. This data is consistent with past years.
A number of students have learning disabilities
According to the 2012 AMTA Massage School Survey, school administrators estimated
that roughly 9 percent of massage therapy school students have special needs, i.e. ADHD,
physical and other disabilities, which could require personalized learning plans.
Student attrition rates remain steady
Nineteen percent of all students who entered an entry-level massage program in 2012 did
not graduate, indicating the same attrition rate as in 2011.
· Forty-five percent of schools said their attrition rate was less than 10 percent in 2012,
compared to 35 percent of schools reporting this in 2011.
· Fourteen percent of schools had an attrition rate over 30 percent.
· Individually owned massage schools had lower average attrition rates (18 percent)
compared to public institutions (21 percent) and corporation schools (22 percent) in
2012.
More schools offering financial aid to students
According to the 2012 AMTA School Survey, 75 percent of schools offered financial aid
to their students, up from 71 percent a year ago. Of those schools that offered financial
aid:
· Ninety-one percent offered federal programs.
· Seventy percent offered payment plans.
· Sixty-six percent offered loans compared to 58 percent last year.
· Other financial aid programs mentioned were scholarships and state/organizational
grants.
Applying the Research:
1. How can you leverage your older students’ experience to help younger students
develop? Have you considered incorporating a mentoring program to help younger
students with their writing and oral communication skills?
2. Does your school have personalized lesson plans for students with learning
disabilities? If not, it’s something you might want to consider for your program.
American Massage Therapy Association 65

3. Have you heard about AMTA’s Scholarship for Schools program? For more
information, please send an email to scholarships@amtamassage.org
American Massage Therapy Association 66

Section 5 — Massage Therapists’ Use of Technology 6
Massage therapists are increasingly using technology in their professional
and personal lives. It is important that students of massage therapy be
aware of the fast-changing trends in technology and learn to make best use
of these tools in their practices.
This section discusses how and to what degree massage therapists are using technology in
their practices and their personal lives.
Key Questions:
What are the trends in the use of technology by massage therapists?
How are massage therapists using technology to enhance their practices?
In what ways can schools employ technology in their classroom?
Key Findings:
· Ninety-nine percent of massage therapists browsed the Internet and 79 percent
browsed social media in 2012.
· Therapists increasingly used social media to stay in touch with clients.
· Almost two-thirds (65 percent) of massage therapists reported owning a smart phone
such as an iPhone, Android or Blackberry in 2012, up from 51 percent in 2011.
As you review these topics:
5A. Massage therapists’ performance of basic online tasks
5B. Massage therapists’ overall use of technology
5C. Social media and massage therapists
5D. Massage therapists’ use of websites for their practices
5E. Massage therapists’ smart phone use
American Massage Therapy Association 67

5A. Massage therapists’ performance of basic online tasks
Therapists perform online tasks at a level generally consistent with the
overall population.
According to the 2012 AMTA Technology Survey, massage therapists performed Internet
tasks such as browsing the Internet and managing a profile on an existing website at a
rate consistent with the rest of the general population. Therapists, however, spent
significantly less time reading blogs (58 percent) than the general population (78
percent). See figure 41 below.
Massage therapists compared to the overall population 2012:
Figure 41. Percentage of massage therapists who perform Internet tasks. General Population data 11
American Massage Therapy Association 68

5B. Massage therapists’ overall use of technology
Massage therapists improved their use of technology over the past year.
Ninety-nine percent of therapists browsed the Internet in 2012. The number of therapists
who have built their own websites has increased as well, up to 46.5 percent in 2012 from
38 percent in 2011.See Figure 42 below.
Figure 42. Trends of massage therapists’ technology skills from 2008, 2010, 2011, and 2012
American Massage Therapy Association 69

5C. Social media and massage therapists
Seventy-nine percent of massage therapists browsed social media and 48
percent used social media sites on a daily basis in 2012.
· Facebook continued to be the most popular social network used by massage
therapists. Of massage therapists who used social media, 81 percent used Facebook,
up from 78 percent in 2011 and 63 percent in 2010. Seventy percent logged onto
Facebook on a daily basis or multiple times per day. The 2012 figure lags behind the
general population, as 96 percent of the U.S population that uses the Internet is on
Facebook. 12
· LinkedIn use continued to increase among massage therapists as well, up to 47
percent in 2012 from 41 percent in 2011. Massage therapists used LinkedIn more than
the general population as 28 percent of the U.S. online population used LinkedIn.
· Twitter use by massage therapists more than doubled in 2012, increasing to 27
percent over 10 percent in 2011 and just 8 percent in 2010.
Figure 43. What social media sites do you use?
American Massage Therapy Association 70

Massage Therapists use social media for professional purposes
Massage therapists continued to use social media to stay in touch with clients. In 2012,
36 percent of massage therapists used a social network to stay in touch with clients.
That’s a 3 percentage point increase over 2011. See Figure 44 below.
Figure 44. Main reasons for visiting social network sites
5D. Massage therapists’ use of websites for their practices
Close to half of all massage therapists have websites for their practices, with
47 percent reporting this in 2012, a 7 percent increase over 2011.
The most common functions on their websites in 2012 were Contact Me page (93
percent), directions or map (61 percent), links to other sites (38 percent), client reviews
(35 percent) and gift certificates (27 percent). Only 10 percent of massage therapists
indicated that they use an online appointment scheduler in 2012, down from 12 percent in
2011 and 23 percent in 2010.
American Massage Therapy Association 71

5E. Massage therapists’ smart phone use
Sixty five percent of massage therapists own a web enabled smart phone
such as an iPhone or Android device in 2012. That is a 14 percentage point
increase over 2011.
Figure 45. How massage therapists use their smart phones
Highlights of Figure 45 - How massage therapists use their smart phones: On
average in 2012, 42 percent of the time massage therapists spent on their smart phones
was for phone calls and 32 percent for texting. Additional functions account for
secondary use of smart phones.
Applying the Research:
1. Massage therapists are expanding their use of technology for businesses and personal
purposes. How is your school addressing the use of technology as an educational and
professional resource in your business/marketing classes?
2. More massage therapists have their own websites and use smart phones. Discuss with
students how to make best use of their websites and smart phones to promote their
practices and communicate with clients.
If you have suggestions or identify additional information you need, please contact us at
research@amtamassage.org
American Massage Therapy Association 72

Appendix
List of Sources
1. All data in “Section1 – Consumers of Massage Therapy” and “Section 3C –
Consumer use of massage as part of an integrated approach to health care,” and where
otherwise specified, are from the 2012 AMTA Consumer Survey and previous years’
AMTA Consumer Survey, unless otherwise noted.
2012 AMTA Consumer Survey. CARAVAN® Opinion Research Corporation
International conducted the annual consumer survey during August 9-12, 2012,
among a combined national probability sample of 1,010 adults (504 men and 506
women), aged 18 and older, living in private households in the continental United
States. The survey has indicated margins of error at the 95 percent confidence
interval of plus or minus three percent. Commissioned by AMTA, this is the
sixteenth annual massage therapy survey of American consumers.
2. All data in Section 1A are from U.S. Census Bureau, Population Division
3. From data compiled by AMTA, 2012.
4. AMTA Consumer Awareness Program data collected 2012.
5. All data in “Section 2 - The Massage Therapy Profession” and “Section 3 - Health
Care and the Massage Profession,” and where otherwise specified, are from the 2012
AMTA Industry Survey and previous years’ AMTA Industry Survey, unless
otherwise noted.
2012 AMTA Industry Survey. Association Metrics conducted an annual AMTA
Industry Survey during August 2012. A total of 1,258 qualified surveys were
received. The survey has indicated margins of error at the 95 percent confidence
interval of plus or minus two percent. The objectives of the AMTA Industry
Survey are to gain insight into the profession in order to provide AMTA members,
consumers and other professionals with “state-of-the-industry” information by
tracking and benchmarking, among other trends: information on massage
therapists working in different work settings, their income, compensation,
requirements, practices, training, education, demographics, and more. The 2012
AMTA Industry Survey is the eighth annual survey on the massage therapy
profession.
6. All data in ”Section 5 – Massage Therapists’ Use of Technology,” and where
otherwise specified, are from the 2012 AMTA Technology Survey, unless otherwise
noted
2012 AMTA Technology Survey. AMTA staff conducted an annual Technology
Survey in October 2012. An electronic survey was emailed to 5,000 professional,
graduate, and student massage therapists. A total of 344 responses were received.
American Massage Therapy Association 73

The survey has indicated margins of error at the 95 percent confidence interval of
plus or minus five percent.
7. All data in Section 2E are from the ISPA 2012 US Spa Industry Study, unless
otherwise noted.
The study was commissioned by the International Spa Association (ISPA). The
survey was launched on a bespoke Internet registration site in February 2012 and
ran until early May 2012. The number of responses to the full survey was 614.
The survey has indicated margins of error at the 95 percent confidence interval of
plus or minus 4.3 percent.
8. Bureau of Labor Statistics website, U.S. Department of Labor, Career Guide to
Industry, Healthcare.
9. U.S. Department of Health and Human Services website, Fact Sheet: Essential
Health Benefits: HHS Informational Bulletin.
10. All data in “Section 4 – Training and Education of Massage Therapists” are from the
2012 AMTA Massage School Survey, unless otherwise noted.
2012 AMTA Massage School Survey. AMTA staff conducted an annual
Massage School Survey in September 2012. An electronic survey was emailed to
930 massage school contacts. A total of 134 surveys were received. The survey
has indicated margins of error at the 95 percent confidence interval of plus or
minus 8 percent. This is the sixth annual survey conducted by AMTA on the
trends and information pertaining to massage therapy schools in the United States.
11. Wave 6 – The Business of Social Media; Social Media Tracker 2012
Wave 6 - The Business of Social Media is part of Universal McCann’s ongoing
research program aimed at exploring the massive changes occurring in
communication technologies. The studies have been conducted annually since
2006. The Social Media Tracker has retained the same methodology from Wave 1
through Wave 6, enabling comparison between data sets. All surveys have been
scripted and hosted on Universal McCann’s in-house online research system,
Intuition.
12. Accrediting Organizations:
ABHES: Accrediting Bureau of Health Education Schools
ACICS: Accrediting Council for Independent Colleges and Schools
ACCET: Accrediting Council for Continuing Education and Training
ACCSC: Accrediting Commission of Career Schools and Colleges
COMTA: Commission on Massage Therapy Accreditation
NACCAS: National Accrediting Commission of Cosmetology Art
American Massage Therapy Association 74

About the American Massage Therapy Association
The American Massage Therapy Association® represents more than 56,000 massage
therapists, graduates, students, and massage schools. AMTA works to establish massage
therapy as integral to the maintenance of good health and complementary to other
therapeutic processes; to advance the profession through ethics and standards, continuing
education, professional publications, legislative efforts, public education, and fostering
the development of its professional, graduate, student, and school members.
Copyright Disclaimer
This document contains proprietary information of the American Massage Therapy
Association, as well as other organizations. If you wish to reproduce these materials or
use them in any other way, you must request permission from AMTA or other owners of
the original materials. For permission to reproduce any AMTA data contained in this
report, please call 877.905.2700. If consent is granted, attribution to AMTA and other
sources specified in this document should be made. All rights reserved.
AMTA School Members: FREE Non-member: $79.99
Copyright ©2013 American Massage Therapy Association
American Massage Therapy Association 75

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