Ethics of Massage Therapy

By Michael L. Metzger

Power of Touch

Touch is one of the most basic human needs, documented for thousands of years. It occurs in every culture. Touch also affects animals. Equine massage (for horses), canine massage (for dogs), and feline massage (for cats) have been popular for years. Though the animal is on the receiving end, studies have also shown that petting animals lowers stress, high blood pressure, and depression in humans. Doctors have taken notice of these studies and have even prescribed pets as part of the healing process. Programs involving pets in hospices and retirement homes are also becoming popular.

Touch can be used as a method for:

  • Communication,
  • Learning,
  • Comfort,
  • Building self-esteem,
  • Expediting the body’s healing potential.


Scientific research proves that deprivation of touch can cause significant obstacles for healthy personal development and immune function in the body. Touch is essential for our survival, if used ethically.

Starting in the womb through our adult lives we use touch to communicate, evaluate, and navigate through life. When used appropriately, touch can yield incredibly positive results in the body. Unfortunately, some people misuse massage by doing mass-produced “assembly line massage” or sensual/sexual massage. This could be due to a lack of proper education or just for their own selfish motives. Unethical people giving these types of massage accomplish devastating results by:

  • Showing disrespect for the entire massage and bodywork trade,
  • Increasing the negative stereotypes of massage,
  • Hurting the reputation of professional certified massage therapists with proper education who legally practice massage.

Physiology of Touch

The human body is covered by approximately 18 square feet of skin, making it the largest sensory organ. Unlike other sensory organs, the skin remains in a constant state of readiness. The sensory nervous system sends a constant flow of information to the brain. Through the skin and the sensory nervous system we can detect information such as change in pressure, temperature, pain, and pleasure. For the blind and deaf this function is critical for survival. Scientific studies have proven that the skin, muscles, and fascia (connective tissue in the body) can even store remnants of emotional or physical issues from the past or the present. Dr. Tiffany Field, PhD at the University of Miami, is one of the foremost experts in the world in myofascial therapy and emotional release. Dr. Field’s research on the benefits of massage on the human body have concluded that any physical and/or emotional distress, whether from car accidents, divorce, moving to a new home, or past/current relationship issues for example, will be stored in the fascia for years. During a massage-therapy session some clients will have what is called an “emotional release.” The client’s emotional release comes from this fascial memory and can manifest unexplainably in tears or less commonly in laughter and other emotions. California state-approved massage-therapy schools teach students about fascia and emotional release and how to prepare ethically to help the client.

A Local Perspective

As a massage therapist and California state-approved massage instructor for more than 20 years, I’ve experienced quite a cross-section of massage-therapy issues.

In my opinion, all massage-therapy appointments fall into two main categories—wellness and therapeutic massage.

The main approach of wellness massage is for preventative maintenance. Massage increases circulation for many physiological benefits. These physiological benefits are not necessarily focused on specific muscular conditions or complaints. For example, I have worked on some clients for stress/tension, immune system issues, injury prevention, and so on.

The therapeutic massage-therapy approach always requires a higher level of education and advanced massage-therapy techniques.

Common issues I have treated with therapeutic massage therapy are allergy and sinus headaches, bursitis, tennis and golfer’s elbow, thoracic outlet syndrome (numbing and tingling down the arm), frozen shoulder, rotator cuff, carpal tunnel, sciatica, patellar/ meniscus (knee) complications, shin splints, and so on.

Code of Ethics

Most massage therapists follow a code of ethics belonging to one of two massage-therapy organizations.

The largest, most popular, and reputable organization is Associated Massage and Bodywork Professionals, ABMP ( The other common organization is American Massage Therapy Association, AMTA (

The code of ethics in general contains the following important points:


1.Commitment to provide the highest-quality bodywork to the client,

2.No discrimination/prejudice toward the client or colleagues,

3.Demonstration of professional excellence within the confines of previous education and training,

4.Respect for the client’s right to privacy,

5.Conduct of bodywork within the scope of all city, county, state, and federal laws,

6.No tolerance for intimate, sensual/sexual relationship with any massage client.

7.Also, the massage therapist does no harm physically or emotionally to the client and does not let his or her own emotions affect clients or coworkers.

8.And massage therapists understand that they are not to diagnose client issues, prescribe medications or drugs, and they are not to manipulate the skeleton of the client in any way (no chiropractic).

The best approach when seeking a professional massage is to first and foremost look for a certified massage therapist who received his or her education from a state-approved or accredited massage school. The therapist should have 250 hours of basic massage-therapy certification and some regular continuing education. The massage therapist should also be able to provide references and give a price in advance. A few local massage businesses have been known to verbally increase their prices even during the massage!

Ask what method of payment the therapist accepts as some therapists are independent contractors. Check out the office. Look for cleanliness and ask if the massage therapist is a member of a professional organization and if she or he has insurance coverage to practice massage specifically. You also have the right to ask where the therapist received an education.

Finally, make sure you report any massage therapist who you feel is practicing unethically to the police department or a local state-approved school. I hope and pray that your future massage experience is professional, healthy, and ethical.