Being a massage therapist goes beyond mastering techniques—it’s about cultivating a professional identity within a broader community. This community should bring together individuals who share a commitment to massage therapy, foster collaboration, and promote regard and respect for one another.
A strong professional identity is built on a unified vision, shaped by core values and ethical principles that guide practice standards and decision-making responsibilities in client care. A recognized professional identity influences how the massage therapy profession is perceived and how therapists see themselves within it. Establishing a professional identity enhances confidence and deepens the sense of belonging in the massage therapy field.
Professional identity is dependent on two factors:
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A definition of the profession
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A professional practice framework
The massage therapy community has neither.
The lack of both within the massage therapy field plays a key role in the profession’s struggles, including inconsistent legislation, public misperceptions, internal professional discord, and barriers in connecting with other health-care providers. If we, as massage therapists, cannot settle on a formalized title for our occupation, how can we expect the public to properly acknowledge our work?
If we, as massage therapists, cannot settle on a formalized title for our occupation, how can we expect the public to properly acknowledge and integrate our work?
A unifying definition of massage, massage therapy, and the practice of therapeutic massage is necessary. A definition precisely explains the fundamental state or meaning of something. Based on this definition, a professional framework of massage therapy can be developed. A professional framework is a set of guidelines that shape how a profession operates. This keeps a profession consistent, supports professional identity, and helps individuals grow while maintaining integrity.
Defining a Definition
Massage therapy, as a discipline, has evolved through the integration of historical healing practices, scientific advancements, and professional regulations. Today, therapeutic massage is an evidence-informed approach. Ongoing research continues to clarify physiological mechanisms and therapeutic efficacy, reinforcing massage therapy’s role in integrative health and well-being care. The practice of massage therapy is regulated in 45 states. Massage therapy requires formal education and licensure, underscoring its legitimacy as a health-care occupation. Ethical considerations, including informed consent, scope of practice, and professional boundaries, are central to its practice to ensure safe and effective client-centered care.
However, all these elements are fragmented. Because the massage therapy community does not have a unifying definition of who we are and what we do, these advances are not formalized into a professional practice framework, hindering ongoing appreciation of the value of therapeutic massage.
The definition of massage and massage therapy practice is the starting point. The first step is a name. Currently, massage therapy seems to be the most common term in use. Massage therapists provide therapeutic massage. However, crafting a unifying definition is complicated by varying governmental regulations and the vast array of forms and styles practiced today. A clear and concise definition of massage must capture the essential techniques shared across different methods. Complicating the creation of a unifying definition is the reference point for the definition.
Our professional growth and identity for the future depend on what we commit to now.
Definitions can be based on:
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Cultural roots: Names like shiatsu (Japan) and abhyanga (India) highlight traditions.
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Techniques: Terms like myofascial or lymphatic emphasize method.
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Purpose: Sports massage or prenatal massage define the client’s needs.
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Marketing: Strategic and customized branding differentiates practitioners in a competitive market.
Massage therapy definitions generally fall into a few main categories. Some focus on manual therapy, describing it as hands-on work targeting soft tissues. Others are shaped by legislation and regulations, outlining the legal scope of practice. Then, there are definitions from professional organizations. Following are some examples I’ve found.
Manual Therapy Category
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Massage is a form of manual therapy where mechanical forces are applied to the body as part of therapeutic care.
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Massage therapy is a manual therapy practice that uses massage as the primary approach to care. Massage therapy increasingly overlaps with wellness and medical care.
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As a form of manual therapy, massage focuses on health and well-being, stress management, pain management, and mobility support.
Legislation and Regulation Category
Licensing laws often define massage therapy as a regulated professional practice based on manipulation of soft tissues for therapeutic purposes, emphasizing health and well-being. Licensing definitions attempt a broad general focus to protect the public. The Federation of State Massage Therapy Boards (FSMTB) developed a Model Massage Therapy Practice Act that defines massage therapy as the “manual application of structured touch to the body’s soft tissues.”
The FSMTB’s defined scope of practice includes:
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Assessment, evaluation, and treatment for therapeutic purposes
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Application of techniques, such as pressure, friction, stroking, rocking, kneading, percussion, or vibration
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Stretching, both active and passive, within normal anatomical limits
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Use of manual methods or mechanical/electrical devices that replicate or enhance hand techniques
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Application of topical agents, such as lubricants, scrubs, or herbal remedies
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Hot or cold therapies to aid in treatment
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Use of hydrotherapy applications
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Client education to support individual health goals
Professional Organizations Category
The massage therapy leadership organizations coalition developed the Entry-Level Analysis Project (ELAP) that includes the following definitions:
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Bodywork: A broad category encompassing diverse methods, styles, and approaches—including massage—that aim to positively influence the body. Techniques may involve soft-tissue manipulation, energy work, movement retraining, or postural correction.
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Massage: The ethical and professional application of structured therapeutic touch, intended to improve soft-tissue health, movement, posture, and neurological function.
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Wellness-Oriented Massage: Massage performed in relaxation-focused or wellness environments to promote stress reduction, relaxation, and overall well-being.
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Health Care-Oriented Massage: Massage provided in medical or clinical settings to support therapeutic changes, manage specific health conditions, or address symptoms effectively.
This brief overview highlights the problematic issues. The massage therapy community does not have unifying definitions, and an outline for developing a professional practice framework would include values and ethics, entry-level education, required skills, practice responsibilities, legal standards, and ongoing professional development. This is why we do not have a cohesive professional identity.
A Path Forward?
Amid all this confusion there is clarity—several evidence-informed definitions exist. The Massage Therapy Foundation convened a two-day Best Practices Symposium in 2010. Key themes identified during the discussions included:
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The complexity of defining massage therapy
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The multidimensional nature of massage therapy, encompassing physical, emotional, and professional dimensions
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Influential factors shaping massage therapy practices, such as cultural diversity, scientific advancements, and regional regulations
An outcome of the symposium highlighted that the massage therapy profession faces ongoing challenges in establishing universally accepted definitions for massage, massage therapy, and professional practice. The terms massage and massage therapy are often used interchangeably, despite representing distinct concepts. Research by Ann Blair Kennedy addressed these challenges. Her paper, “Clarifying Definitions for the Massage Therapy Profession,” focused on differentiating terminology and aligning professional practice by refining the definitions and scope of massage therapy.1
Here are the definitions put forth in her research:
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Massage: Massage is a patterned and purposeful soft-tissue manipulation accomplished by the use of digits, hands, forearms, elbows, knees, and/or feet, with or without the use of emollients, liniments, heat and cold, handheld tools, or other external apparatuses for the intent of the therapeutic change.
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Massage therapy: Massage therapy consists of the application of massage and non–hands-on components, including health promotion and education messages, for self-care and health maintenance. Therapy, as well as outcomes, can be influenced by therapeutic relationships and communication; the therapist’s education, skill level, and experience; and the therapeutic setting.
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Massage therapy practice: Massage therapy practice is a client-centered framework for providing massage therapy through a process of assessment and evaluation, plan of care, treatment, reassessment and reevaluation, health messages, documentation, and closure in an effort to improve health and/or well-being. Massage therapy practice is influenced by the scope of practice and professional standards.2
Kennedy also identified these benchmarks for therapeutic massage, which follow a client-centered process:
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Assessment: Identify client needs (e.g., well-being, stress, pain, function) through tools like scales, physical evaluations, and client input.
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Evaluation and plan of care: Analyze findings, set goals, and create a treatment plan incorporating evidence, client input, and professional expertise.
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Treatment: Perform planned soft-tissue manipulation, adjusting techniques based on client feedback.
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Reassessment: Measure outcomes after the session to guide future plans.
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Health messaging: Provide guidance to maintain or enhance treatment results.
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Documentation: Record all stages to track progress and ensure continuity.
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Closure: Conclude sessions to support client transition back to daily life.3
A Call to Action
The massage therapy community needs to take action to formalize and adopt unifying definitions and then develop the massage therapy professional practice framework. Our professional growth and identity for the future depend on what we commit to now.
Stay informed by following updates provided by ABMP. Contact each of the organizations and state your views. Participate in grassroots initiatives or start a local group that can speak to local and state governments. Use social media to create and distribute surveys, then provide those surveys to massage therapy organizations. Respond to “call for comment” from massage therapy organizations when given the chance. Inform and encourage massage-based businesses where you work to be proactive. You can be part of this process.
Author note: Special recognition is due to Ann Blair Kennedy and others for their leadership and contributions in advancing clarity and structure within the profession. The work of Kennedy, Jerrilyn Cambron, Patricia Sharpe, Ravensara Travillian, and Ruth Saunders is foundational.
Notes
1. Ann B. Kennedy et al., “Clarifying Definitions for the Massage Therapy Profession: The Results of the Best Practices Symposium,” International Journal of Therapeutic Massage & Bodywork 9, no. 3 (September 2016): 15–26, https://ijtmb.org/index.php/ijtmb/article/view/312.
2. Kennedy et al., “Clarifying Definitions for the Massage Therapy Profession: The Results of the Best Practices Symposium.”
3. Ann B. Kennedy et al., “Process for Massage Therapy Practice and Essential Assessment,” Journal of Bodywork and Movement Therapies 20, no. 3 (July 2016): 484–96, https://bodyworkmovementtherapies.com/article/S1360-8592(16)00008-5/fulltext.
