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2010
Massage Profession
R E S E A R C H R E P O R T
Table of Contents
Introduction...3
Section 1. Consumers of Massage Therapy...4-14 1A. What changes are taking place in the U.S. population? ... 5-6 1B. What drives consumer use of massage therapy? ... .6-7 1C. Who gets massage? ... 7-8 1D. Why do consumers get massage? ... 9-11 1E. What obstacles are keeping consumers from getting massage ... 11-12 1F. Where are they getting massage? ... 12-14
Section 2. The Massage Therapy Profession...15-33 2A. Who is practicing massage therapy?... 15-18 2B. How much are massage therapists compensated for their work?... 19-23 2C. What are some of the biggest challenges facing massage therapists? ... 24-25 2D. Where are massage therapists practicing? ... 25-30 2E. What’s the latest on the spa industry and massage therapy? ... 30-32 2F. Are national massage chains still expanding? ... 32-33
Section 3. Special Look at Health Care and the Massage Industry...34-42 3A. The healthcare boom... 35-36 3B. Healthcare providers discussing massage therapy with patients ... 36-38 3C. Healthcare, CAM and massage therapy ... 38-39 3D. Massage and insurance ... 40-41 3E. Integration of massage into healthcare ... 41-42
Section 4. Training and Education of Massage Therapists...43-58 4A. Hours and types of training... 44-46 4B. Quality of massage training. ... 46-47 4C. Factors that most influence massage school selection ... 47-48 4D. Massage schools-trends and demographics ... 48-54 4E. Massage schools-accreditation ...54 4F. General factors affecting massage schools. ... 55-56 4G. Number of massage students graduating ... 56-57 4H. Massage student demographics... 57-58
Appendix—List of Sources...59
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Looking towards a new decade
The 2010 Massage Profession Research Report
Welcome to the 3rd annual Massage Profession Research Report, your gold standard for market data and trends that impact the massage therapy profession.
Whether you are currently working as a massage therapist or are looking towards professional practice, it makes sense to base your practice on research. To effectively build your practice and attract new clientele, you need a way to scan the current climate of the profession—including consumers, therapists, schools and the growing health care market.
Three Annual Research Studies
As an AMTA member, you can reap the benefits of AMTA’s commitment to doing the hard work of securing and analyzing this critical information for you! In the pages that follow, you’ll find the 2009 results from three benchmark surveys that track the state of the profession:
• The AMTA Consumer Survey (13th annual) was commissioned by AMTA to poll men and women on their use of massage therapy.
• The AMTA Industry Survey (5th annual) gained feedback from massage therapists on everything from compensation, to hours, to longevity in the industry.
• The AMTA Massage School Survey (3rd annual) secured feedback from schools with 500-plus hour programs.
Compiled from the results of these surveys, this report provides timely, relevant and complete data on the state of the market, supplemented by U.S. government statistics and information found in industry and business sources. (For methodology, see the appendix.)
Now, even more practical!
In our third year of providing this report, we’re excited to add even more practical application within these pages, including the new “Applying the Research” lists at the end of each mini-section. You can use these resources to:
Prepare for long-time practice — In this challenging economy, it’s more important than ever to respond to consumer trends. Statistics garnered from practicing therapists and consumers of massage therapy will help set the stage for a long and fruitful practice.
Increase your business know-how— We often hear from therapists that they wish they had more business training in massage school. In these pages, you’ll find concrete data that that can help you confidently build and market a successful practice.
We’d love to hear from you.
Let’s work together to take the massage therapy profession towards a bright future. If you have questions, suggestions, or identify additional information you need, please contact us anytime at [email protected].
Section 1 — Consumers of Massage Therapy
When more people seek massage, the profession becomes more prosperous. Consumer demand for massage drives longevity—of individual practitioners, massage school graduates, and our profession.
Key Concerns:
How is the economic downturn affecting consumer massage use?
How can you connect with the populations most likely to seek massage therapy? Is there information that can help you make informed decisions about how you approach the business of massage therapy?
How can you gear your services towards the markets most likely to grow?
According to AMTA’s 13th annual Consumer Survey conducted in July 2009, the number of consumers who said they received a massage in the last twelve months went up again by two percent as compared to the previous year. This is encouraging news, especially in the light of this difficult economic time.
In order to build continuing success, massage therapists need to identify categories of people more likely to use massage, and know what benefits of massage therapy most resonate with consumers.
Since clients may be cutting back on expenditures (and since most consumers don’t currently get a massage weekly), therapists need aroster of hundreds of clients in order to schedule
seventeen or more massages in a given week. In this section, you’ll….
• Explore the latest data and trends on the U.S. population and consumer use of massage therapy.
• See how data from AMTA’s annual consumer survey and the census sources can provide massage therapists with information to guide their marketing efforts.
• Recognize changes in consumer attitudes and use of massage therapy by characteristics such as age, gender, income and region of the country.
• Understand the massage therapy marketplace, so you can effectively plan for the future! These questions will be answered:
1A. What changes are taking place in the U.S. population? 1B. What drives consumer use of massage therapy? 1C. Who gets massage?
1D. Why do consumers get massage?
1E. What obstacles are keeping consumers from getting massage? 1F. Where are consumers getting massages?
1A.
What changes are taking place in the U.S. population?
The largest growth of the population will take place in the oldest segment. The
growing diversity is driven by the surge of Hispanics in the U.S.—a segment that is
also a large consumer of massage therapy.
According to the U.S. Census Bureau, the U.S. population is growing, but at a slower
rate.
According to the U.S. Census Bureau, the U.S. population grew from approximately 282 million in 2000 to 305 million in 2009. By 2050, the population is expected to grow to 392 million, a 39 percent increase from 2000. This growth will be caused by three primary forces:
1. People are living longer. 2. The birth rate remains steady.
3. More immigrants are coming into the U.S. than leaving. The total foreign born population in the U.S. is now 31.1 million, a record 57 percent increase since 1990. Despite these large increases in population, the rate of growth is actually projected to
decrease during the next six decades by about 50 percent. This decrease will be connected with the aging of the U.S. population and the correlated increase in the number of deaths. 1
The U.S. population is aging.
In 2000, the average age of the U.S. population was 35.3 years. As shown in the table below, the average age is expected to increase every year.
Year Average age of U.S.
population 2000 35.3 2010 36.9 2020 37.7 2030 38.7 2050 39.0 Figure 1. Average current and projected age of U.S. population.
The largest percentage of this growth will occur within the oldest segment (ages 85 and older). In 2000, there were 4.2 million Americans age 85 and older. By 2030, this number is expected more than double, and by 2050 more than double again to 19 million.1 The number of people in the 70-85 age bracket will also double between 2010 and 2050.
The U.S. population is becoming more diverse.
In 2009, the U.S. Census Bureau reported that the minority population in the United States reached an estimated 104.6 million, or 34 percent of the nation’s total population, as compared to 31 percent reported in 2000.1
The Hispanic population is a major driver of diversity. They:
• Represent the fastest growing group, with nearly one in six Americans, or 46.9 million, being of that origin.
• Keep the U.S. population growing dynamically with 25 percent of the births in this country and high immigration levels.
• Are predicted to contribute 45 percent of the nation’s population growth between 2010 and 2030, and 60 percent between 2030 and 2050. 1
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. Keeping track of the changing population trends and consumer massage use in the United States can be invaluable in better marketing your practice to the right audience. 2. As the population ages, consumers and healthcare professionals will increasingly look to
massage to help relieve pain and increase wellness. Consider ways your practice might support this trend.
3. Many massage therapists say that they wish they’d better understood the business of massage before they launched their career. Anticipating changes in consumer expectations can help you better target your marketing efforts.
4. Massage therapists can expect the number of Hispanic clients to increase in line with the population growth. What implications might this have for your practice?
5. With 33 percent of current consumer massage use coming from the Hispanic
population, bilingual therapists may have an opportunity to maximize their presence in the Hispanic market.
1B. What drives consumer use of massage therapy?
Today, twenty million more Americans take advantage of massage therapy than
did ten years ago. Overall, massage use has increased in eight of the last ten years,
but leveled off in the last four years.
Massage use has risen slightly again in 2009.
The 2009 AMTA Consumer Survey results show that:
• Twenty-two percent of all adult Americans had a massage at least once in the last 12 months, as compared to 20 percent in 2008.
• A third (34 percent) have received a massage in the last five years.
• Roughly 48 million people had a total of around 209 million massages in the U.S. in 2009, as compared to 43 million people in 2008.
• Levels of massage use have been relatively flat since 2005.
• In spite of weak economy, consumer massage use is still expected to grow, but at a much slower rate than in the last decade.
Overall, massage use has increased in the United States during eight of the last ten years in which AMTA has been tracking consumer use of massage therapy.
During the last four years consumer use has been less consistent in its growth. For example, with a spike in 2007 and a dip in 2008, 2009 consumer use for massage is still at the same level as reported in 2005 (see Figure 2 below).2
Consumer Use of Massage
15% 24% 22% 21% 21% 16% 20% 18% 22% 18% 17% 0% 5% 10% 15% 20% 25% 30% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 2. Total use of massage among adult, U.S. population.
1C. Who Gets Massage?
Gender, generation, education and income all affect the likelihood of consumers
using massage. Populations that are increasing the use of massage therapy include
men, older Baby Boomers, and seniors.
The state of the economy affected the demographic profile of those who get massage.
The 2009 AMTA Consumer Study showed that the main consumers of massage are:
Women…and more men than ever — Women continue to get massage at double the rate of men. However, the gap is slowly closing.
Adult Americans who received a massage
2008 2009
Men 12% 18%
Women 28% 26%
More men receiving massage compensated for the small decrease in women getting massage from 2008 to 2009. Next year’s numbers will help predict whether male acceptance of massage will continue to trend upwards.
Baby Boomers and up — Statistics show that as a person ages, they tend toward a greater acceptance of massage therapy. Possibly because they have more means to purchase massage.
• Older Baby Boomers (ages 55 to 64) have doubled their use of massage over the past 10 years, and those 65 and older have nearly tripled their use of massage.
• The overall increase in massage use is still driven by older Baby Boomers.2
College educated —In 2009, the correlation between the level of consumer education and massage use became even more pronounced than in 2008.
Level of consumer education Massage use 2008 Massage use in 2009 Completed college 28% 35%
Didn’t complete high school
7% 8%
Figure 4. Total use of massage among U.S. population by level of education.
As you can see in the above chart (Figure 4), those that have completed college were far more likely to get a massage than those who didn’t complete high school. Since generally higher educational level of consumers can be correlated with higher income potential, this may be a sign of weak economy in 2009.
Higher household income— Likewise, in 2009, massage use became even more strongly correlated with income than in the previous year. In 2009, 38 percent of those with household incomes of $75,000 received a massage in the last 12 months, as compared to 24 percent in 2008.
Applying the Research:
1. Although the state of the economy did not appear to decrease the overall rate of the consumer use in 2009, it did affect which consumers were most likely to purchase massage. Use these demographic profiles to help you target the consumers most likely to afford massage therapy.
2. Consider how you might better market to seniors andclientele in mid-life.
3. Marketing to men may open new streams of revenue, especially if male use of massage continues to rise. The rise in men getting massage may also encourage men who are considering massage therapy as a career.
1D.
Why Do Consumers Get Massage?
In 2009, massage for relaxation increased, as more consumers looked to massage
to reduce stress, including stress from a flagging economy. Using massage for
medical reasons also increased slightly.
Figure 5. Primary reasons for receiving last massage in 2009.
Consumers are seeking massage therapy for stress reduction and relaxation.
While use of massage for medical reason increased slightly this year (up to 32 percent from 31 percent last year), the use of massage for relaxation went up significantly.
Thirty-two percent of Americans that received a massage in the past 5 years said their last massage was primarily to reduce stress or relax — up from 22 percent since the recession started in 2007. Forty-nine percent of consumers say they have considered a massage to manage stress in the last year.2
What role does the economy play?
In 2009, 57 percent of Americans felt more stressed at this time than they did a year ago. Forty two percent felt that the current economic situation led them to feel greatly stressed, with those living in the North Central region reporting the highest stress levels (50 percent) and those living in the West the lowest (34 percent).3
Who was most likely to get massage to manage stress in 2009?
• Young consumers —55 percent of 18-34 year olds versus only 22 percent of 65+.
• Metro residents — 57 percent of consumers report that they are more stressed out this year than they were a year ago, and more metro residents agreed with the statement (60 percent of metro consumers vs. 48 percent of non-metro).
Massage is used more than ever for medical and health reasons.
Thirty-two percent of massage consumers had their last massage for a medical reason, which is slightly higher than last year’s results. Who relies on massage for medical reasons?
• Seniors — 41 percent of consumers over 65 years of age got their last massage for medical reasons (44 percent in 2008).
• Men — At 45 percent, significantly more males use massage for medical reasons than women (24 percent)
• Those in pain — 19 percent of consumers got their last massage specifically for either pain relief or pain management, with 46 percent of those 34-54 getting their last massage for this reason. (This is consistent with last year’s results.)
• Those with an injury — 5 percent of consumers received their last massage for injury rehabilitation, with 10 percent of those 55-64 getting their last massage for that reason (7 percent in 2008).3
Americans’ beliefs about medical applications of massage 2009
Massage can be effective in reducing pain. 86%
Massage can be beneficial to health and wellness. 85% Figure 6. Americans beliefs about massage in 2009.
The third most prevalent reason why consumers get massage is for pampering, a special indulgence, or just to feel good.
This reason accounted for 17 percent of recent massage purchases by consumers, which is down from 19 percent in 2008.
• Women are more likely to use massage for pampering or special indulgence (19 percent vs. 15 percent of men).
• Those 65+ are more likely to say they received their last massage for pampering reasons than any other age group.
• Those in the Northeast (28 percent) and the North Central (19 percent) are more likely to have received their last massage to be pampered.3
Applying the Research:
1. Women are most responsive to the idea of massage for pampering.
2. Older massage recipients are most likely to respond to a marketing message that
includes pain relief or treatment for a health condition. They also receive massage for a special indulgence.
3. Market massage to women for stress relief and relaxation. Men will be more likely to respond to a marketing message that highlights medical and pain relief.
4. Consumers are continuing to use massage therapy for medical and health reasons even with the downturn in the economy.
1E.
What obstacles are keeping consumers from getting massage?
Cost is the most-quoted obstacle that prevents consumers from having regular
massages. Women are more likely to cite cost as an obstacle, whereas men are
more likely to say, “I don’t feel I need it.”
The most common barriers to massage are cost, “don’t feel I need it,” and “too busy!” In data obtained at the end of 2008, 33 percent of respondents say that cost is the obstacle that prevents them from having regular massages. Two other obstacles include:
• Don’t feel I need it (22 percent)
• Too busy (14 percent)
Watch for new data this spring on the pricing of massage and other barriers to massage acceptance.
Will the current economic situation affect the price consumers pay for massage?
This is still unclear. What we do know is although consumer confidence is low and consumer spending is at the lowest in years, overall massage use is still on the rise as more people choose massage to relieve stress caused by the downturn and for medical reasons.
But we can make better decisions about pricing, by considering the volume of massages that clientele purchase at each price point. This chart from the 2008 AMTA Consumer Survey (Figure 7) demonstrates that the price a consumer will pay for a massage is elastic.4
Price and Volume for MTs
Price of Massage Number of Massages Total Amount Earned per Consumer $80 1.7 $136 $70 2.4 $168 $63 7.9 $490 $50 14.2 $710 $40 16.2 $648 Figure 7. Price and volume for massage therapists.
Highlights from Figure 7 (page 11)
As the price of massage increases, the average number of massages each consumer will obtain decreases. At both ends of the curve, the number of massages levels off. Whether you charge $70 or $80 dollars, consumers will get the same number of massages. The same is true on the low end of the scale, whether you charge $40 or $50. This suggests that it’s not good business to charge less than $50 per hour.
It is interesting to note that those who do not get massage perceive the cost of massage to be higher than the actual rate.4
Applying the Research:
1. Even when consumer confidence is low, massage therapy is still on the rise as a form of relaxation and stress relief.
2. When marketing to women, keep in mind that cost is a major concern. Men are more interested in whether they need a massage and/or whether it’s a priority.
3. Some of the most popular reasons for not getting a massage represent opportunities to reach out to new consumers and develop new marketing messages. Consider how you can better promote the value of massage, whether through a newsletter for your clients or through participating in National Massage Therapy Awareness Week.
4. Weigh the advantages and disadvantages of high and low pricing. Remember that in this economy, price is a major factor.
1F. Where are consumers getting massages?
Men and women prefer to receive massage therapy in different venues—women are
most likely to choose a spa, whereas men are most likely to receive it in a massage
therapist’s office.
Spa is the most frequently chosen venue for massage.
In the 2009 AMTA Consumer Survey, consumers were asked where they received their last massage. The results were consistent with the 2008 findings (see Figure 8 on the next page).
Figure 8. Where did you get your last massage in 2009?
What demographics affect where consumers receive massage?
Men and women prefer different venues:
• Women are far more likely to choose spas (34 percent of females vs. 9 percent of males).
• Men are more likely to choose:
o Massage therapist’s office/location (18 percent)
o Your home or home of someone you know (10 percent)
o Chiropractor’s office (9 percent)
Younger and older consumers have different preferences:
• Older consumers (55+) strongly favor getting massage at massage therapist’s office/location.
• Younger respondents (18 to 34 years old) have a preference for getting massage at a spa or at their home, or the home of someone they know.3
Applying the Research:
1. If you work for (or own) a private practice, you might consider some targeted marketing to older consumers, and to men as well.
2. The continued popularity of spa translates into job opportunities for young and experienced therapists alike. If you are searching for a position, look for ways to make viable connections within the spa market.
3. If you’re a student, take some time to consider the different settings of massage, who prefers them, and how this might impact your future career choices.
Interesting Consumer Trends of the Decade
• Consumer use of massage over the past year has increased from an estimated 15 percent of the non-institutionalized U.S. adult population in 1999 to 22 percent in 2009.
• The average number of massages that consumers reported having in a single year rose from 4.4 in 1999 to 6.5 in 2009.
• Use of massage among 45 and 64-years-olds more than doubled in the last decade, from 23 percent in 1999 to 49 percent in 2009.
• The use of massage therapy among men grew from 11 percent ten years ago to 18 percent in 2009, while the use among women grew by 8 percent in the last decade.
• The last ten years have shown an increased correlation between higher education and massage use. In 2009, 35 percent of consumers with a college degree used massage, as compared to 19 percent in 1999.
• Although the West region of the U.S. still leads in the overall massage use, massage acceptance among consumers in the South saw the highest growth in the last decade, nearly doubling from 12 percent in 1999 to 23 percent in 2009.2
It’s exciting to consider how the field of massage therapy will continue to grow and evolve over the next decade. 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 [email protected].
Section 2 — The Massage Therapy Profession
As a massage professional, understanding the latest trends as well as the
challenges facing the profession is key to your success. Incorporating up-to-date
demographics allows you to explore new approaches to building a successful
career.
Key Concerns:
How can you adapt your practice to reflect changes occurring in the massage profession due to the economy?
What are the latest trends in hours and compensation for massage therapists, and where do you fit into that picture?
How are today’s massage therapists finding and retaining clients?
Where are the best opportunities for therapists being created within the profession? In this section, you’ll…
• Learn the latest demographics of massage therapists.
• Gain insight into current challenges facing massage therapists.
• Understand the role of the current economy in the employment, compensation, and overall business outlook for massage therapists.
• Find practical ideas for incorporating the latest professional trends into your practice. As you answer these questions:
2A. Who is practicing massage therapy?
2B. How much are massage therapists compensated for their work? 2C. What are some of the biggest challenges facing massage therapists? 2D. Where do massage therapists practice?
2E. What’s the latest on the spa industry and massage therapy? 2F. Are national massage chains still expanding?
2A. Who is Practicing Massage Therapy?
In the last decade, the number of practicing massage therapists has increased by
around 83 percent! The profession is still adding massage therapists, but at a
slower rate than in the past.
5According to the 2009 AMTA Industry Survey, massage therapists in the U.S. are: • Mostly female — 85 percent of massage therapists are women, a fact that hasn’t changed
over the last few years.
• Older— The average age of a massage therapist is 49, which is a five-year jump from 2008. (See the figure 9 that follows for more on this trend.)
• Educated — 38 percent of massage therapists have a Bachelor’s Degree or higher, with 50 percent having completed some college, a vocational certificate or an Associate’s Degree. (See Figure 9 below.) This is roughly consistent with 2008 data.
Figure 9. Massage therapist’s profile.
2006 2007 2008 2009
Average Age 44 42 44 49
Education (Non-Massage)
High school grad or less 11% 14% 13% 12%
Some college 27 28 27 28 Associate’s Degree 15 14 14 12 Technical/vocational certificate 10 9 11 10 Bachelor’s degree 27 25 26 25 Master’s degree 9 8 8 11 Doctorate 1 2 2 2 Gender Male 15% 15% 12% 15% Female 85 85 88 85
Highlights from Figure 9:
The average age of massage therapists jumped from 44 in 2008 to 49 in 2009. This could have been caused by a slight change in the sample of the surveyed massage therapists.Stay tuned for next years data to see if this is a real trend or a statistical anomaly.
Most massage therapists are coming from another profession.
Eighty-three percent of massage therapists had a different profession prior to becoming massage therapists. This is consistent with last year’s data.
We also learned that:
• Seventy percent of massage therapists who consider themselves full-time and 78 percent of part-time practitioners were in a different profession prior to becoming massage therapists.
• Therapists working at spa/salon and health club settings arecomparatively more likely to enter massage therapy as their first profession. (These types of work settings may attract younger candidates with less prior work experience.)
• At 86 percent, sole practitioners are most likely to have had a different occupation prior to becoming a massage therapist (see figure 10 on the next page for more
information).
• Business, healthcare and education-related jobs are the most common careers therapists had before entering the massage profession.6
Figure 10. Was massage therapy your first choice?
Massage therapists are expanding their repertoire.
Therapists report using an average of seven modalities/techniques:
• This is in line with 2008 data, but up from five modalities reported in prior years.
• Top modalities practiced include Swedish massage, deep tissue, chair, trigger point and hot stone. (Similar to 2008 data.)
• Specialization in myofascial and craniosacral techniques has gone up significantly, which shows that massage therapists may be looking to become more marketable to clients that seek out massage for pain relief and wellness.
The number of massage therapists in U.S continues to increase. 5
In the last decade, the massage therapy profession experienced a fantastic growth—the number of practicing massage therapists has increased by around 83 percent!
But in the last couple of years, mostly due to the decreasing number of new graduates and the effect of the economy on the consumer massage demand, the growth has become more moderate and is likely to remain moderate to flat. The total growth in practicing massage therapists from the beginning of 2008 to the beginning of 2009 was 3 percent, which is similar to the previous year.
The following chart illustrates the growth of the total estimated number of massage therapists over time:
Figure 11. Total MTs By Year
(LMT and EMT Combined)
67,564 79,195 85,166 4% 3% 203,380 49,063 186,916 118,281 111,510 169,099 163,002 144,009 120,458 87,652 77,456 97,990 97,928 109,948 99,105 85,421 93,228 80,208 88,544 94,053 100,244 100,929 97,207 9% 11% 13% 20% 38% 15% 13% 12% 14% 6% 2% 4% 22% 1% 15% 1% 14% 4% 2% 15% 3% 3% 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 1996 (128,258) 1999 (157,664) 2001 (183.411) 2003 (217,386) 2005 (253,957) 2007 (269,343) 2009 (288,546) % Change in Total MTs % Change in LMTs Estimated MTs Licensed MTs
*LMT: licensed massage therapists, MT: massage therapists from non-licensing states.
Highlights from Figure 11:
In 2009 there were approximately 288,546 massage therapists in the United States, which is up from 280,969 massage therapists in 2008. The number of licensed practitioners has jumped to 203,380 compared to 186,916 licensed practitioners in 2008.
Applying the Research:
1. Massage therapists are now using an average of 7 modalities/techniques, with many specializing in myofascial and craniosacral techniques. To maintain professional success, you might consider specializing or incorporating a new technique into your repertoire. 2. Have you had a different profession prior to becoming a massage therapist? If so,
consider how you can use the lessons and skills acquired in your previous career to bolster your current practice.
2B. How much are massage therapists compensated for their work?
The economy is still a major player, with massage therapists receiving less tips
and depending more heavily on repeat business. Online advertising has doubled in
the past year.
How much are clients paying for massage?
• According to the results of the 2009 AMTA Industry Survey, clients pay an average of $63 per one hour of massage.
• Spa/salons charge the most at $64.60; health clubs charge the least at $61.10.
There is less discrepancy this year between hourly pay charged by massage therapists working in different settings. This may indicate convergence in the amount charged for massage across settings. We will track this data next year to confirm the trend. Note that this is a national average and individual prices for one hour of massage may very considerably.
Last year saw an increase in the average hourly wage of massage therapists.
On average, massage therapists earn $44.90 per hour. That includes a $34.50 average hourly rate and an average tip of $9.50. This is up from an average total of $41.50 per hour last year. Although last year we also saw an increase in average compensation, we will have to watch next year’s data to see if this is a consistent trend.
Excluding tips, employers pay massage therapists an average of $35 per hour. The table below shows that employed sole practitioners receive the highest pay, while health club and health setting practitioners get the lowest rate.
Setting/Practice Average hourly pay (excluding tips)
Sole practitioners $38.40
Health club massage therapists 33.80
Healthcare settings 34.70
Figure 12. An average hourly pay (excluding tips) by setting.
Massage therapists are working slightly more hours than last year.
On average, massage therapists work 20.4 hours per week, with health club and spa/salon employees averaging the greatest number of work hours per week. (This is slightly up from 19.4 hours last year). Massage therapists are paid for 15.9 of the 20.4 average hoursthey work per week. According to the estimate provided by the respondents of the 2009 AMTA Industry Survey, a full-time practice for massage therapy consists of about 27 hours per week, which is in line with the number of hours reported in prior years.
Therapists are receiving fewer tips.
Studies of various industries indicate that tipping decreases during tough economic times, which may explain why massage therapists received fewer tips in 2009, according to the 2009 AMTA
Industry Survey. The average tip received by massage therapists went down to $9.50 from $10.20 in 2008. How often therapists receive tips from clients decreased from 53 percent last year to 44 percent this year.
Tips for spa/salon massage therapists are still most generous, while sole practitioners receive the lowest tips ($8.90 down from $9.70 in 2008). Massage therapists working in spas/salons and health clubs receive tips most often; those working in healthcare and as sole practitioners receive tips least often.
Few employers offer health benefits.
A relatively small percentage of massage therapists receive health benefits from their employers (19 percent), and this has changed little in the past four years. Spa/salon and health club massage therapists are the most likely to receive health benefits (57 percent).
Massage therapists depend more heavily on repeat clients.
In 2009 massage therapists saw an average of 44.3 clients each month, an increase from 40.9 clients last year. However, the percentage of new customers therapists saw on a monthly basis continued to trend downward.
This means that repeat clients are taking up the majority of appointments – in fact, around 74 percent! (See below). With the effects of poor economy and growing difficulty in attracting new clients, massage therapists should focus more than ever on meeting their repeat clients’ needs.
Figure 13. Clients of massage therapists.
Highlights from Figure 13:
Repeat clients comprised a large majority of the customers massage therapists saw on a monthly basis in 2009 (In 2009, 74% as compared to 65% in 2007).
Sole practitioners and massage therapists working in health care settings are most likely to have a larger share of repeat customers (80 percent for sole practitioners and 72 percent for health care practitioners).
Total Clients % New Clients % Repeat Clients
2006 2007 2008 2009 2005 2006 2007 2008 2009 2005 2006 2007 2008 2009 Total 42.9 41.1 40.9 44.3 28% 31% 35% 29% 26% 72% 69% 65% 71% 74% Sole Practioner 40.8 36.8 40.4 45.1 20% 24% 26 23 20% 80% 76% 74 77 80% Contractor 42 39.0 39.3 44.3 35% 37% 41 33 32% 65% 63% 59 67 68% Spa/salon 49.6 43.8 43.4 45.7 63% 57% 54 45 45% 37% 43% 46 55 55% Healthcare 57.1 51.8 45.2 53 26% 27% 30 28 28% 74% 73% 70 72 72% Health club 49.8 40.6 42.8 43.7 37% 42% 36 37 29% 63% 58% 64 63 71% Full-time 69.3 70.4 63.6 67.1 27% 30% 51 46 46% 73% 70% 49 54 54% Part-time 27.8 40.7 35.1 43.1 29% 32% 53 41 40% 71% 68% 47 59 60%
Total Clients % New Clients % Repeat Clients
2006 2007 2008 2009 2005 2006 2007 2008 2009 2005 2006 2007 2008 2009 Total 42.9 41.1 40.9 44.3 28% 31% 35% 29% 26% 72% 69% 65% 71% 74% Sole Practioner 40.8 36.8 40.4 45.1 20% 24% 26 23 20% 80% 76% 74 77 80% Contractor 42 39.0 39.3 44.3 35% 37% 41 33 32% 65% 63% 59 67 68% Spa/salon 49.6 43.8 43.4 45.7 63% 57% 54 45 45% 37% 43% 46 55 55% Healthcare 57.1 51.8 45.2 53 26% 27% 30 28 28% 74% 73% 70 72 72% Health club 49.8 40.6 42.8 43.7 37% 42% 36 37 29% 63% 58% 64 63 71% Full-time 69.3 70.4 63.6 67.1 27% 30% 51 46 46% 73% 70% 49 54 54% Part-time 27.8 40.7 35.1 43.1 29% 32% 53 41 40% 71% 68% 47 59 60%
Massage therapists continue to depend on bartering.
On average, therapists barter massage services about 9 times per year, slightly less often than noted in prior years. Healthcare and health club massage therapists report a significantly higher average value of bartered services compared to other work settings. However, the average dollar value of services bartered each year dropped significantly from $596 in 2008 to $535 in 2009.
Figure 14. Percentage of massage therapists bartering services.
Highlights from Figure 14: Three-fourths of massage therapists (72 percent) report bartering massage services in 2009, slightly less than in 2008 (75 percent).
Clients and therapists are finding each other online.
Referrals continue to be the most effective source of new client traffic and the way clients find massage therapists. However, online advertising has doubled since 2008.
Medium 2006 2007 2008 2009
Referrals 80 79 87% 87%
Online (Net) 18 19 24% 51%
Internet/website --- --- 24 28
Social media --- --- --- 37
General Print (Yellow Pages, Newspapers, Newsletters)
30 29 28% 28%
Community/Local Events 10 21 22 20
Radio 2 3 3 2
Business Cards 2 2 2 3
Figure 15. Sources of new clients for massage therapists.
In the same vein, although the same percentage of therapists advertising their services remains relatively stable (68 percent), the mediums they use to advertise have sharply changed. Online
72% 75% 67% 73% 77% 2009 2008 2007 2006 2005
advertising grew more than 40 percent in the past year—largely driven by the addition of social media. See the chart above for more information on how therapists promote their services.
Massage therapists say the economy is having a negative effect on business.
When asked whether business improved, stayed the same or declined, significantly more massage therapists reported a decline in business than last year:
• Only twenty-five percent reported that business had improved (compared to 42% in 2008 and 56% in 2007).
• Thirty-eight percent reported that business had stayed the same (compared to 31% last year).
• Thirty-eight percent said business declined (compared to 27% in 2008).
This means that business either stayed the same or declined for 76 percent of massage therapists (compared to 58% in 2008 and 37% in 2007) (see figure 16 below). This is a very significant and worrisome number.
Figure 16. Compared to last year, your massage business has….
Business outlook varies across the work settings
o There are more opportunities in healthcare: comparatively, healthcare massage
therapists (32 percent) were the most likely to report improvements in business, which reinforces growing employment opportunities for massage therapists within healthcare system. (Read more about healthcare trends and employment opportunities in section 3 of this report).
o Employees of spas are feeling the economic pressure: massage therapists working at spas/salons (28 percent) were the least likely to report business improvement over the past years. This is significant change from reported improvements in business at
spas/salons in 2007 (66 percent) and 2008 (39 percent). The explosive growth of spas is over and this, along with other economic pressures, is affecting business outlook for
massage therapists working at spas/salon. For more information on the spa industry, refer to page 31.
Applying the Research:
1. Where do you fit into the current professional trends for massage therapists? Use the latest information about compensation, tips, and hours for each setting to make educated decisions as you build your career.
2. As with most people in the United States, the economy is a major concern for massage therapists. This shows itself in a significant increase in the percentage of therapists whose business declined in the past year and in other concerns about the industry. 3. Seventy-four percent of appointments in 2009 came from repeat clients. With this in
mind, massage therapists should focus more than ever on meeting their repeat clients’ needs.
4. Online advertising, driven mostly by social media, has doubled since 2008. Is your practice up and running online? Incorporate some of AMTA’s online marketing tools for members, including a free website building tool, as you make a plan to build or increase your online presence.
2C. What are some of the biggest challenges facing massage therapists?
While respondents to the 2009 AMTA Industry Survey say that industry perception
of massage therapy continues to be their biggest challenge (see below),
business/economic issues took a close second.
It seems that massage therapists are being affected by the economic recession.
Many are seeing their business decline and see their client base get smaller:
• Forty-three percent of respondents cited business/economic issues as being their biggest challenge.
• Nineteen percent of all respondents marked “poor economy” as the top industry challenge, making it one of two most prevalent responses. This is in line with 2008 data but drastically higher than in 2006 and 2007, when the poor economy was cited as challenge for only two and three percent of respondents. Figure 17 below illustrates the top challenges expressed by massage therapists.
Figure 17. Top challenges facing massage therapists.
2006 2007 2008 2009
Industry Perceptions (Net) 53% 52% 47% 45% Being recognized/respected as healthcare
professionals
23 17 15 19
Public awareness of the benefits of massage 13 10 5 5
Bad history/poor reputation 8 3 2 4
Benefits of massage therapy to public 8 9 9 9 Recognition from insurance companies 6 4 5 4
Credibility 4 4 8 6
Maintaining professionalism 3 * 1 1
Yellow pages with sexual ads for massage 1 8 8 5 Under qualified massage therapists - 5 5 3 Business/Economy Issues (Net) 30% 34% 43% 43%
Licensing legislation 7 5 5 2
Maintaining steady business/finding new clients 7 8 7 4
Too much competition 6 7 4 5
State/government regulations 6 5 3 4
Difficulties with insurance 2 2 1 4
Poor economy 2 3 20 19
Inadequate standards for certification - - 3 3
Job Factors (Net) 28% 27% 22% 24%
Avoiding personal injury 6 11 8 7
Adequate knowledge/training 6 3 * 1
Low income 5 5 5 7
Sexual boundaries 4 1 1 1
No health insurance as a massage therapist 4 3 4 3 Full-time therapists getting burnt out 3 3 5 4
Finding/maintaining employment 2 2 1 1
Education Issues (Net) 4% 2% 6% 7%
Finding a good school/training program 2 1 2 1 2006 2007 2008 2009
Industry Perceptions (Net) 53% 52% 47% 45% Being recognized/respected as healthcare
professionals
23 17 15 19
Public awareness of the benefits of massage 13 10 5 5
Bad history/poor reputation 8 3 2 4
Benefits of massage therapy to public 8 9 9 9 Recognition from insurance companies 6 4 5 4
Credibility 4 4 8 6
Maintaining professionalism 3 * 1 1
Yellow pages with sexual ads for massage 1 8 8 5 Under qualified massage therapists - 5 5 3 Business/Economy Issues (Net) 30% 34% 43% 43%
Licensing legislation 7 5 5 2
Maintaining steady business/finding new clients 7 8 7 4
Too much competition 6 7 4 5
State/government regulations 6 5 3 4
Difficulties with insurance 2 2 1 4
Poor economy 2 3 20 19
Inadequate standards for certification - - 3 3
Job Factors (Net) 28% 27% 22% 24%
Avoiding personal injury 6 11 8 7
Adequate knowledge/training 6 3 * 1
Low income 5 5 5 7
Sexual boundaries 4 1 1 1
No health insurance as a massage therapist 4 3 4 3 Full-time therapists getting burnt out 3 3 5 4
Finding/maintaining employment 2 2 1 1
Education Issues (Net) 4% 2% 6% 7%
Highlights from Figure 17:
Look in the “2009” column to see what were reported as 2009’s top challenges by category and subcategory. Top challenges include “poor economy,” and “being recognized as healthcare professionals.” Note that net categories may include multiple responses.
Other top challenges included difficulties in communicating the benefits of massage therapy to the public, low income, avoiding personal injury and education issues.
Applying the Research:
1. One of the top challenges reported by massage therapists is the current economic situation. Think of some adjustments you can make in your business plan to help you thrive in difficult economic times.
2. Massage therapists cite being recognized and respected in the healthcare industry and credibility as main concerns. As a practicing massage therapist (or someone preparing for practice), what can you do to boost your credibility within this growing industry?6
2D. Where are massage therapists practicing?
Massage therapists tend to work in multiple settings and are becoming more
specialized. Future employment prospects look good but massage therapists will
need to be prepared for working in various work settings.
According to the results from the 2009 AMTA Industry Survey question, “In what type of massage setting do you work?”
• More therapists are working from their home or office— My office (38 percent) and My home (38percent) reported higher percentages than in 2008.
• Employment in the spa/salon setting went down —by six percentage points as compared to last two years.
• Employment within the healthcare setting appears stable.
• Less therapists are practicing at the client’s business or home—which could be related to the economy. (Next year’s data will help confirm if this is a true trend.) See the chart on the next page (figure 18) for the visual representation of this data.
Figure 18. In what type of massage setting do you work?
More massage therapists describe themselves as sole practitioners, and many work in multiple settings.
In 2009, more massage therapists described themselves primarily as sole practitioners (74 percent as compared with 67 percent in 2008), and fewer as spa/salon employees.
While the trend continues of massage therapists to work in many settings, we find that more massage therapists working in spas and health clubs also have some of their own clients. This might have led to an increase in the reported sole practitioners (see figure 19 below).
2006 2007 2008 2009 Sole practitioner/partner in own business 68% 56% 67% 74% Self-employed contractor to other business 25% 20% 25% 22% Spa/salon employee 17% 29% 29% 23%
Health care setting
employee 13% 24% 27% 25%
Health club employee 3% 7% 8% 9%
The number of hours therapists work has increased slightly.
From the 2009 AMTA Industry Survey. See figure 20 and 21 below for more details about balance between daily massage and other tasks.6
Figure 20. Facts about massage therapist’s work week and more.
20.4 hours The hours that the average massage therapist works in a week (19.5 in 2008).
27 hours a week What most massage therapists consider a full-time practice (consistent over the last 3 years).
14 hours a week For the 40% of therapists who want to work more hours, the number of extra hours they would like.
4 hours or 26% of their workweek
The amount of time the average therapist spends per week on business-related tasks.
15.8 hours or 74% of their workweek
The amount of time the average therapist spends per week performing massage (increased from 15.0 in 2008).
Figure 21. An average workday of a massage therapist.
Massage therapists tend to have multiple sources of employment.
Over 54 percent of massage therapists’ income is earned from jobs in professions other than massage therapy, down from 58 percent in 2008. The decline in secondary income sources is most likely caused by declining work opportunities due to unemployment and not by declining need of massage therapists for secondary income.
11% 10% 7% 72% 11% 10% 7% 72% 10% 10% 6% 74% 2007 2008 2009 Giving massages Marketing
General business tasks Other tasks
As see in the chart below (figure 22), sources of secondary income massage therapists work at: other forms of bodywork occupations (26 percent), healthcare related jobs (22 percent),
education (21 percent), business/professional occupations (13 percent) and fitness (12 percent).
Figure 22. Sources of secondary income for massage therapist-2009 data.
Massage therapists continue to move towards increased specialization
The average number of modalities reported practiced remained unchanged, at 7, but grew from 5 modalities in 2005.At the same time, more therapists are specializing in myofascial and
craniosacral techniques. Massage therapists may be specializing in more modalities to become more marketable to clients, especially those that seek out massage for pain relief and wellness.6 To see more details on top modalities practiced by therapists, see figure 23 below:
Figure 23. Top modalities massage therapists specialize in.
2005 2006 2007 2008 2009 Swedish 78% 76% 82% 89% 84% Deep Tissue 70 66 70 82 77 Trigger Point 41 35 43 52 49 Sports Massage 37 32 40 49 45 Neuromuscular 35 29 28 31 33 Myofascial 33 28 29 41 46 Reflexology 33 28 31 46 45 Chair 32 32 37 58 52 Hot Stone 30 39 40 55 47 Prenatal/ Pregnancy 29 28 30 49 44 Therapeutic Touch 21 17 17 23 22 2005 2006 2007 2008 2009 Swedish 78% 76% 82% 89% 84% Deep Tissue 70 66 70 82 77 Trigger Point 41 35 43 52 49 Sports Massage 37 32 40 49 45 Neuromuscular 35 29 28 31 33 Myofascial 33 28 29 41 46 Reflexology 33 28 31 46 45 Chair 32 32 37 58 52 Hot Stone 30 39 40 55 47 Prenatal/ Pregnancy 29 28 30 49 44 Therapeutic Touch 21 17 17 23 22
Highlights from Figure 23:
Among massage modalities, Swedish (84 percent) and deep tissue (77 percent) still rank as the most frequently practiced modalities.
Employment opportunities are expected to grow for massage therapists.
According to the most recent U.S. Department of Labor information, employment opportunities for massage therapists are expected to grow at a faster than average rate as more people become interested in alternative medicine and holistic healing.
It is estimated that between 2006 and 2016 massage therapists are likely to see a 20 percent increase in job opportunities as more people learn about the benefits of massage therapy.10
In January 2010, the company Simply Hired, the large search engine and recruitment network, released their figures for employment trends for 2009. According to their data, massage therapy positions in health care were up 166 percent in the past year. This figure is difficult to
substantiate from other sources, but it is a good indicator that massage as part of health care is a growing employment opportunity for massage therapists.12
Massage therapists view their work as a profession.
The vast majority of the AMTA Professional members surveyed in the 2006 AMTA Body of Knowledge Survey consider massage therapy to be a profession (89 percent profession, 6 percent trade).8
The results of the 2009 AMTA Industry Survey, surveying massage therapists at large, confirmed that the majority of massage therapists (94 percent) view the industry as a profession rather than a trade.
This perception is only strengthening compared to the previous year (89 percent). Therapists working in a health care setting are the most likely to view massage therapy as a profession, and those working in a health club setting are least likely to view massage as a profession.
Figure 24. Perception of an industry as a profession vs. trade.
3% 6% 91% 3% 7% 90% 2% 8% 89% 2% 6% 94% Profession Trade Don't know/don't care/other
Applying the Research:
1. The pressures of the profession and the economy may force massage therapists to
diversify. If this trend continues, it will be very important to familiarize yourself with the differences and requirements of working at various massage settings.
2. Massage therapists may be specializing in more modalities to become more marketable to clients, especially to clients that seek out massage for pain relief and wellness.
3. Data shows that more therapists are working from their home or office, while employment in spas went down in comparison to the last two years.
4. Healthcare providers and insurance companies are beginning to recognize massage therapy as a treatment and preventative measure for many types of injuries. Consider what additional training you’ll need, or business practices you may want to implement, to take advantage of this trend.
2E. What’s the latest on the spa industry and massage therapy?
While the number of spa visits continues to increase, the industry showed some signs of
slowing in 2008.
Spas are where most consumers receive massage.3
According to the results of the ISPA 2009 U.S. Spa Industry Update, the:
• Number of spa visits in the United States grew 16 percent from 2007 to 2008.
• Revenue the spa industry generates grew 17 percent from 2007 to 2008.
• Spa revenue per establishment dropped one percent from 2007 to 2008, and 41 percent since 2001 when the revenue was $1.024 million.13
Year Estimated spa visits Estimated spa industry revenue
Spa revenue per establishment
2006 111 million 9.4 billion $ 624,000
2007 138 million 10.9 billion $ 607,000
2008 160 million 12.8 billion $ 601,000
Figure 25. Information on spa revenue and visits.
As of 2008, the number of spas was still growing in the U.S.
The number of spas in the United States has grown by more than 300% from 4,557 in 1998 to 21,300 in 2008, but the growth rate between 2007 and 2008 showed some signed of slowing (see figure 25). Here are some other indicators of slowing in the spa industry:
• The average revenue per spa establishment declined from $726,000 in 2005 to $601,000 in 2008.
• The average number of visits per spa establishment declined from 9,790 in 2005 to 7,486 in 2008.
• The average number of full-time employees per spa reached record low of 15 employees in March 2009.13
• According to the 2009 AMTA Industry Survey, massage therapists working at spas/salons were the least likely to report business improvement over the past years.
We will see if the economy had an effect on the overall growth of spas in the United States, when the rest of 2009 numbers are released by ISPA.
4,557 5,300 8,025 9,18610,4969,865 10,128 13,757 17,900 21,300 0 5,000 10,000 15,000 20,000 25,000 1998 1999 2000 2001 2002 2003 2004 2006 2007 2008 Growth in Spa Locations (US)
Figure 26. Growth in massage spas.
Fewer massage therapists worked in spas in 2009.
According to the 2009 AMTA Industry Survey:
• Twenty-three percent of massage therapists report working primarily in a spa or salon as compared to 29 percent in 2008.6
• The number of self-classified sole practitioners who work secondarily as spa/salon massage therapists has increased nearly 40% compared to last year’s results. This may indicate that more massage therapists perceive themselves primarily as sole
practitioners but they are also working in spas or salons as an additional source of income beyond their client base.
The decline in the percentage of massage therapists working at spas/salons may also indicate that although the spa industry is a major employer of massage therapists, its growth may be slowing. We will know more when we see the 2009 growth numbers for the spa industry.
Applying the Research:
1. Spa industry revenue is trending up, but revenue per establishment is trending down. This might be due to more spa locations opening up and having to split the total spa industry revenue.
2. The growth in the spa industry showed some signs of slowing; the number of spa visits per establishment declined and spa employment reached an all time low.
3. While the number of massage therapists working primarily in salons decreased, working in a spa is a second source of income for many sole practitioners.
2F. Are national massage chains still expanding?
Some massage therapists see national chains as detrimental to the profession.
Other massage therapists see them as a place to get steady employment and
potential benefits.
National massage chain expansion is slowing.5
National massage chains were growing for years as new players entered and current chains expanded into new locations.
Seeing the growth of spas and the consumer acceptance of massage, these organizations found a niche in the market — offering a branded product in numerous locations. As opposed to spas, these companies only offer massage, although some firms are testing locations that offer more traditional spa services.
Because massage therapy is the only service on the menu, national massage chains are able to cut overhead from less profitable services and offer lower cost massage. The number of these firms and the lower prices available could have a significant impact on massage use in the future and employment opportunities.
Probably due to the current economy, the growth within some national massage chains seems to be slowing down slightly this year. This is something we will watch in the future and report back to you.5
Currently, only 1 percent of consumers reported receiving their last massage at a national massage chain.3 This number is expected to grow as more chains open, and consumers look for a lower cost massage. Additionally, consumers may not understand the difference between a spa and a national massage chain.
The main players in the massage chain market include:
Massage Envy, a franchise concept that offers a subscription-based model, is fast becoming a large employer of massage therapists. Since 2002, Massage Envy has grown from one location in Arizona to 800 clinics in 2009. They offer a subscription-based model for $49 a month. This is very close to the ideal price of massage to maximize revenue based on the elasticity model shown earlier. Massage Envy is also currently offering facials as a new service, and some of their locations have began offering traditional spa services.
Massage Heights began in San Antonio, Texas in 2004. Today, they have 58 franchises in Arizona, California, Colorado, Florida, Georgia, Iowa, Kansas, Maryland, Michigan, Missouri, North Carolina, Nevada, Texas, and Washington, which grew from 52 last year. Massage Heights is built on a membership model where the fee is $49.99 a month for one massage, with additional massages costing $39.99.
XPressSpa and Massage Bar have been opening in many airports throughout the country. XpressSpa was in 16 airport terminals in the U.S. as of 2008, 32 locations in 2009, and decreased to 25 locations in early 2010. They offer massage services, as well as some spa services.
Massage Bar is currently in 10 U.S. airports, which is no change from last year.
Zen Massage Centers, another franchise concept was open in 8 states. However, in 2010 they only operate in 7 states including Florida, Georgia, Kansas, North Carolina, South Carolina, Tennessee, and Virginia. They closed their locations in California over the past year. In 2009, they offered basic massage services at $40 per session. This year, consumers must call each location for details and pricing. Prices vary by location, but most are advertising $39.95 or $49.95 per session.
Elements Therapeutic Massage was also looking at becoming a major franchise in the massage therapy industry. They reported around 90 wellness studios in 2010.
Other companies expanding in the market include The Great American Backrub, The Great Metropolitan Backrub and several other regional chains.
Applying the Research:
1. Because chains mostly offer only massage, they are able to cut overhead and offer lower cost massage. This is expected to attract more customers in the future, as in the current economy many are looking for a lower cost massage.
2. Massage Envy is fast becoming an employer of massage therapists, expanding from one location in 2002 to over 800 in 2009.
