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A Firmer Focus: Explore a Career in Deep Tissue Massage

Thinking about a career in massage? Consider exploring deep tissue techniques.

therapists elbow presses into laying patients shoulder
chelsea lin

Written and Reported by Chelsea Lin
Contributing Writer

If you’ve ever been on the receiving end of a deep tissue massage, you know that this style of massage therapy is anything but relaxing. That’s because where Swedish, or foundational, massage can be superficial—with gently gliding strokes over the muscle—deep tissue work requires slow strokes with acute pressure to treat both the muscle and the connective tissues.

This type of massage is often used to reduce tension and break up scar tissue that’s built up around an injury. Think of deep tissue massage as more akin to physical therapy, used to treat issues like chronic muscle pain, strains, and tendonitis.

Studies have shown deep tissue massage can also improve heart and lung function and relieve stress.

Here are the steps you’ll need to take if you want to pursue a career in this intense form of massage therapy.

Therapy Overview

Deep tissue massage is very common. Someone experiencing stress-related shoulder pain can generally find this on any spa menu, while an athlete with a muscle injury may go in for recurring deep tissue treatments with their physical therapist.

According to Cindy Williams, a licensed massage therapist and instructor with more than 20 years’ experience, anyone pursuing a career as a massage therapist can expect deep tissue massage to be a part of their foundational training.

In fact, Williams says massage education in general is evolving to include ways it can be used in a more traditional healthcare setting, which involves taking a clinical look at how massage therapy can affect the tissue of the body.

If you like the idea of digging deeper—so to speak—when it comes to massage, deep tissue may be the right fit for you.

Deep Tissue and Swedish Massage: What’s the Difference?

Swedish massage—what most people in the U.S. would identify as a “classic” massage—is designed to promote as much mental relaxation as physical. Deep tissue massage, on the other hand, prioritizes the physiological benefits.

According to Williams, deep tissue massage generally uses firmer and more sustained pressure, particularly in “problem” areas that are causing the client discomfort. Because of the more intense nature of this type of treatment, Williams says it can be more physically demanding on the part of the massage therapist.

Required Training and Education


Because it is such a common type of massage, you can expect any postsecondary or occupational massage school to offer deep tissue training.

Finding the right school is as much about the education as the environment you’ll be learning in, and the teachers you’ll be learning from. If you’re able to, take a visit to the campus to confirm if it feels like a place you’ll enjoy spending time. You’ll want to ask how long the school has been around, whether it’s accredited with the state you plan to practice in, and what kind of career placement opportunities they may be able to offer once your studies are complete.

What will you be studying? Well, typical massage coursework covers classes in anatomy, physiology, and kinesiology—to give you an understanding of how the human body moves and functions—as well as business management, since many therapists end up working for themselves.

Hands-on training is obviously an integral part of any massage educational program. In fact, deep tissue training involves learning how to use not only your hands, but your elbows and forearms as well, in order to get into the layers of a muscle. Sports massage programs may include deep tissue training as well.

Expect to spend between $5,000 and $20,000 on your education and licensure and remember that you’ll need additional funds to cover books, supplies, and perhaps even a massage table. Financial aid may be available, so include that in your list of questions to ask early on.

Going Back to School as an Adult: Can I Do This?

Massage programs are regularly filled with students of all ages, with varying degrees of real-world career experience, says Williams. She says it’s extremely common to see students pursue massage who have had other careers, or who have become parents and are looking for more flexibility in their professional lives. She’s even had empty nesters who find massage after raising kids.

What would she tell older students worried about learning this new skill? “I would just say, ‘Right on. You’re in the right place.'”

How Long Does It Take?

Because each state has different educational and licensing requirements for massage therapists, training could take you only a few weeks or up to two years. The amount of time you’re able to dedicate to your studies can also affect your school-to-practice timeline.

Massage therapy training can take as little as a few weeks to up to two years.

What About Online Training?

You may be able to take some core massage therapy classes online—subjects that aren’t hands-on like business management, the sciences, or ethics—but Williams warns that some states require you to take certain courses in person, as part of their licensing standards.

What Kind of License Do I Need?

The licensing requirements to practice massage—including deep tissue—depend on the state you live in, making it somewhat challenging to navigate as a student.

With the exception of Minnesota, Vermont, Kansas, California, and Wyoming—where licensing is based on municipality and not state regulations—states have a minimum number of educational hours you must complete to practice as a massage therapist. These hours could be as low as 500 or as high as 1,000.

Most states also require you to pass one of a few national licensing exams:

  • National Certification Examination for Therapeutic Massage and Bodywork (NCETMB)
  • National Certification Examination for Therapeutic Massage (NCETM)
  • Massage and Bodywork Licensing Examination (MBLEx)

Your schoolwork should prepare you for the exam, but additional study guides and training prep resources can be found online.

Even the terminology for licensed practitioners changes from state to state: Some use “licensed massage therapist,” others “licensed massage practitioner,” and still others “licensed massage and bodywork therapist.”

All these state-to-state differences can cause problems if you’re trained in one state and move to another, Williams says, and you may find yourself taking additional classes to make up the difference. Some states go as far as specifying what, if any, classes can be taken online rather than in person.

Requirements for massage therapists can vary widely from state to state.

Williams offers an example of an all-too-common scenario: A licensed practitioner with more than 20 years of experience could potentially move from Washington to New York, for example, and find that their West Coast training didn’t include classes in a subject required by New York’s licensing board.

“I would have to go back to school and gain those hours in order to get my license in New York,” says Williams.

Do I Need to be Certified?

rolled towels arranged with candles and oils

The word “certification” can be confusing in the world of massage therapy. Many massage practitioners, once they’re licensed, pursue board certification through the National Certification Board of Therapeutic Massage and Bodywork.

Many who do so say board certification gives you a competitive edge, demonstrates your understanding of current techniques and therapies, and lends credibility to your title. The certification is optional to practice, however, while licensure is required.

Board certification is optional for massage therapists, while licensure is required.

The word “certification” is also used when talking about specialization. Many licensed massage therapists will pursue additional training so they can become more skilled in massage types such as prenatal massage, palliative care massage, and craniosacral therapy, a type of deep tissue massage.

These specialty certifications aren’t required to practice, but—like board certification—they can help set you apart from your competition.


The average annual salary for a massage therapist in the U.S. is $49,860, according to the U.S. Bureau of Labor Statistics. But Williams points out that the figure doesn’t take into account the rather dramatic pay difference you may encounter when you work for yourself versus working for someone else; in a spa or massage franchise.

Massage Therapists

National data

Median Salary: $49,860

Projected job growth: 18.3%

10th Percentile: $29,040

25th Percentile: $39,080

75th Percentile: $67,300

90th Percentile: $90,530

Projected job growth: 18.3%

State data

State Median Salary Bottom 10% Top 10%
Alabama $25,670 $18,780 $56,460
Alaska $127,470 $41,710 $151,400
Arizona $49,920 $29,920 $93,010
Arkansas $38,440 $25,480 $51,800
California $58,920 $30,830 $100,830
Colorado $51,010 $28,640 $72,520
Connecticut $66,140 $33,650 $122,620
Delaware N/A N/A N/A
District of Columbia $50,500 $40,150 $76,340
Florida $46,720 $29,000 $74,130
Georgia $46,720 $19,310 $71,890
Hawaii $61,520 $23,120 $104,050
Idaho $57,220 $31,810 $75,730
Illinois $60,880 $34,370 $95,840
Indiana $49,930 $33,770 $80,470
Iowa $47,450 $31,980 $63,510
Kansas $47,090 $22,280 $68,560
Kentucky $47,110 $23,500 $81,110
Louisiana $35,580 $18,780 $70,300
Maine $44,930 $27,550 $95,250
Maryland $57,860 $35,980 $101,330
Massachusetts $49,740 $35,840 $92,870
Michigan $58,240 $31,410 $87,240
Minnesota $48,600 $43,540 $74,870
Mississippi $45,330 $30,850 $108,440
Missouri $28,730 $23,190 $68,990
Montana $52,260 $22,430 $95,970
Nebraska $55,990 $25,910 $83,000
Nevada $36,010 $18,520 $63,470
New Hampshire $62,400 $40,960 $75,690
New Jersey $48,250 $29,960 $71,190
New Mexico $41,510 $26,080 $67,600
New York $49,350 $34,250 $97,690
North Carolina $55,170 $32,470 $108,330
North Dakota $49,330 $29,500 $80,110
Ohio $47,140 $29,640 $74,060
Oklahoma $47,350 $26,240 $54,080
Oregon $77,080 $34,430 $93,600
Pennsylvania $58,940 $29,170 $95,800
South Carolina $44,500 $17,560 $65,060
South Dakota $41,500 $29,650 $69,540
Tennessee $49,010 $20,450 $65,450
Texas $48,100 $24,290 $76,280
Utah $51,100 $24,420 $83,550
Vermont $80,360 $27,590 $103,760
Virginia $52,870 $25,060 $83,010
Washington $76,290 $39,160 $99,960
West Virginia $48,550 $25,690 $76,130
Wisconsin $47,180 $19,110 $78,990
Wyoming $49,650 $31,150 $53,900

Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

If you work in private practice, Williams says, “You have the freedom to increase your rates based on your own perceived value of your work.” It’s up to you—as your own boss—to set your hourly rate. “And I’ll tell you what: If you stand behind that, and you do good work, people will pay it.”

If you choose to practice as a sole proprietor, your salary will depend on the hourly rate you choose to charge.

Entrepreneurs need to also take into account the passive hours—the bookkeeping, marketing, client engagement, and other business tasks—that go unpaid.

“I tend to tell students it’s more about your personality than anything else,” Williams says. “Do you enjoy marketing yourself? Do you enjoy going to networking events? Do you enjoy keeping your own books and having more flexibility and freedom?

“If you enjoy those kinds of things, then self-employment’s totally the way to go. Whereas, if you’re the kind of person that really just wants to show up to work, do your job, and go home, then working for somebody else is the way to do it.”

Career Outlook

According to the BLS, employment of massage therapists is projected to grow 18.3% through 2032, a rate much faster than the outlook for general employment. This increase in demand is likely the result of healthcare providers finally understanding the health benefits of massage and including it in patient treatment plans.

Massage Therapist Job Growth through 2032


much faster than average for all careers, says the BLS

Williams says the profession is constantly evolving, especially as people begin to appreciate massage for its physiological benefits and not just as a “woo-woo” relaxation technique.

“We’re being looked at more clinically regarding how we’re affecting the tissue of the body,” says Williams, such as how the different types of force— gliding, shearing, torqueing, for example—are applied. “We’re really trying to break down the physiological approach in order to interface with physical therapists, chiropractors, and medical doctors.”


“(Massage school) is just a great place to go if you’re looking for something different,” says Williams, who pursued massage training a couple of years into a corporate career that left her feeling defeated and miserable. Her mom bought her a massage to relieve her stress-induced headaches, and Williams says it was such a profound experience that it changed the trajectory of her life.

“Massage is such soulful work. What other job do you have where you really get to make a very direct and immediate impact on someone’s life? I’ve never had another job where people leave it totally loving me,” says Williams. “They can’t wait to see me again. It’s just a really positive, loving environment to be in all the time.”

Positive vibes aside, Williams points out that the job does involve a certain amount of physical work—particularly for practitioners of deep tissue massage. Typical complaints include pain in the low back and shoulders, which she says can be alleviated by practicing proper form and prioritizing adequate stretch time for yourself. 

cindy williams

With professional insight from:
Cindy Williams
Massage Therapist