Brush Up on the History of the Massage Therapy Profession

By Patricia J. Benjamin, August 27, 2015

How much do you know about the history of your profession? If you’re like most massage therapists, just some general references to ancient Greeks and a man from Sweden named Ling. Even less is understood about how the massage therapy profession evolved in America—many believe it started in the 1970s in California.

The real story of how massage therapists arrived at where we are today is full of countless surprises and interesting characters, much like a family history going back generations. We can see ourselves in our predecessors and, through understanding our history, recognize the forces that shaped who we are at this moment as a profession.

Having an underlying sense of history is important for massage therapists emerging as modern health and wellness professionals. Knowing where you came from, the core of your professional identity, provides a strong foundation from which you can move into the future with integrity.

Recounting former times also spurs “aha moments” as the world of the past opens up and we understand for the first time how things we see today came to be. Our profession begins to make more sense—the diversity, the independent streak, the holistic viewpoint, the affinity for natural healing, and the singularity of our vocation as massage therapists.

Tracing the professional lineage of massage therapists in America today takes us back to colonial times and continues from there through generations of practitioners advancing to the present day. Progress through the decades was impacted by national and world events, advances in science and medicine, and religious and social movements—the larger context in which massage therapists of the past lived and worked.

Follow along as I take you through ten of the most influential moments in the massage therapy profession’s history.

One.

We begin in colonial times. As an occupation, massage therapy dates back to the 1700s, where forerunners of today’s massage therapists were called rubbers. Rubbers were experts in treating orthopedic problems with manual rubbing and friction. You might look at the influence they had on massage therapy this way: They established the occupation from which the profession of massage therapy later developed. 

Medical rubbers were typically women hired by surgeons to assist with the rehabilitation of patients after surgery, and with treatment of lameness and joint diseases. Rubbers had little education, but possessed a knack for hands-on therapy. Their basic techniques were simple, but were modified to produce different effects. Rubbers incorporated joint movements into their treatments to increase range of motion, and to get lame patients walking again. 

Before medical licensing laws limited their practices, some rubbers worked independently in competition with regular doctors. They found clientele in their towns and city neighborhoods, chiefly by word of mouth, and many became successful entrepreneurs. This was one of the few occupations by which women could make a living outside of the home in those times. Rubbers were gradually replaced by the better educated and more highly skilled masseuses and masseurs in the early 1900s.

Two. 

A different type of manual therapist called a medical gymnast came to America in the 1850s and elevated hands-on treatment to a new level. Medical gymnasts used a system of movement and manipulation developed by Pehr Henrich Ling of Sweden to promote health, prevent disease, and treat illness and injuries. They were graduates of a two-year education program at the Royal Central Institute in Sweden (est. 1813) that included study of anatomy and physiology, hygiene (health), pathology, movement prescriptions, and work in clinics and hospitals. This model of education was used in establishing training schools for medical gymnasts in the United States, like the famous Posse Gymnasium in Boston, which opened in 1890. 

The Swedish movement approach was scientific and holistic, two principles that remain deeply ingrained in the field today. Ling insisted that movement and manipulation prescriptions be based on anatomy and physiology, and be proven by clinical trial and measurement. He also believed in the unity of the person—body, mind, and spirit—and that movement profoundly affects the whole person in maintaining or restoring health. Medical gymnasts laid the groundwork for a unique profession of highly skilled hands-on specialists outside of conventional medicine.

Three. 

The titles masseuse and masseur became common in the 1880s, referring to manual therapists trained in the soft tissue manipulations developed by a European medical doctor named Johann Mezger. Mezger outlined the classic categories of massage techniques: effleurage, petrissage, friction and tapotement. Vibration was added later. Medical gymnasts soon integrated massage into their overall approach, a combination sometimes referred to as mechanotherapy. 

By the early 1900s in America, massage had become the dominant term for manual therapy in general, and masseuse and masseur for hands-on specialists educated in the traditions of Ling and Mezger. Masseuses and masseurs continued to work both within conventional medicine as doctors’ assistants, as well as in private practice as independent practitioners. Ohio was the first state to regulate massage as a “limited branch of medicine,” and Agnes Bridget Forbes became the first licensed masseuse in North America in 1916.

Four. 

Massage became linked with magnetism and magnetic healing in the latter 1800s. Magnetism was thought to be a divine healing force transmitted to an ailing patient through touch and motion. Magnetic healers would either pass their hands over the body without contact, or in some cases use light touch and stroking to stimulate vital energy. Magnetic masseurs combined this early form of energywork with standard massage. The idea that massage could impart a vital power reinforced its holistic nature, and expanded the notion of massage to include energy therapy. By the 1900s, the concept of magnetism had largely disappeared from massage textbooks.

Five. 

Massage and hydrotherapy have a long association. Hydropathy required bath attendants to apply a lowskilled type of rubbing and friction as part of the treatments. This is the origin of many spa services today, such as body wraps and scrubs. When water treatments were put on a more scientific basis in the late 1800s, they were referred to as hydrotherapy. 

Massage and hydrotherapy were often combined in comprehensive treatments for a variety of illnesses and injuries, and masseuses and masseurs were employed to give them. Independent massage practitioners began to include forms of hydrotherapy in their services, particularly different types of baths. Health reformers in the 1890s advocated for such natural approaches to promote good health, and as alternatives to conventional medicine.

Six. 

The familiar full-body general massage given on a padded table with the client under a drape was unheard of prior to the 1880s. General massage had its origin in the famous Rest Cure for a condition called neurasthenia, a kind of debilitating melancholy common among society ladies in the late 19th century. The most extreme form of the Rest Cure involved forced bed rest, liberal feeding and elimination of all stimulation thought to agitate the patient mentally.

During the bed rest period, full-body general massage was given for circulation and to increase the patient’s appetite, a kind of substitute for exercise. The Rest Cure eventually fell out of favor, but a generation of well-connected women and men had been introduced to general massage for convalescence after an illness, rejuvenation and as an overall health measure.

The popularity of general massage greatly increased the demand for independent masseuses and masseurs in the early 1900s. This type of general massage is a forerunner of today’s wellness and relaxation massage. 

Seven. 

Swedish massage had evolved by the 1930s. This was not what we call Swedish massage today, but a whole system of physiotherapy. Swedish masseuses and masseurs utilized soft tissue manipulation, movements, hydrotherapy and electrotherapy for applications ranging from general health promotion to treating diseases to rehabbing injuries. They worked as physiotherapists in conventional medicine (prior to physical therapy licensing in the 1950s), and in YMCAs, public baths and spas, and beauty parlors. Many opened private practices in their neighborhoods in the form of health clinics and reducing salons. 

Doctors regularly referred patients to Swedish masseuses and masseurs up to the 1950s. During this same time, the American Association of Masseuses and Masseurs, (established in 1943 and now the American Massage Therapy Association), began to lay the foundation for the current profession in the United States by establishing educational and ethical standards for the field.

In 1954, AAMM issued a policy statement asserting the right of masseuses and masseurs to practice independently from organized medicine, and reaffirming the usefulness of Swedish massage as a natural healing approach.

Eight. 

The terms massage therapy and massage therapist began to replace former designations for the profession in the 1960s. By that time, the titles masseuse and masseur had fallen into disrepute, and massage parlor, once an innocent label for a massage business, alluded to a house of prostitution.

In 1958, the AAMM changed its name to the American Massage & Therapy Association, and from that point on encouraged calling the profession massage therapy and practitioners massage therapists. The “&” was dropped in 1983, reinforcing the identity of the unified profession as massage therapy. The term therapy was defined generally as promoting good health and encompassed the whole range of applications envisioned by Ling over a century earlier.

The title massage therapist was readily understood by the general public, and helped give the field legitimacy as a health profession.

Nine. 

The field of massage therapy went through a period of transformation between 1970 and 2000. The counterculture movement of the 1960s spawned a generation looking for greater meaning in their lives, and revived an interest in natural healing.

The human potential movement, epitomized by the Esalen Institute in California (est. 1962), fostered new types of manual therapy, such as Rolfing and Esalen massage. Hands-on approaches from Asia—including acupressure from China, shiatsu from Japan, and Ayurvedic massage from India—were embraced in America.

The term bodywork was coined to encompass the diversity of manual therapies that surfaced in this period. The wellness movement, fitness boom, concern about unhealthy stress, and growth of alternative medicine all contributed to a rising public interest in massage therapy, which expanded its scope to include diverse massage modalities.

Escalating consumer demand for massage therapy, and an increasing number of men and women wanting to become massage therapists, revitalized a field that had become somewhat stagnant. 

Ten. 

The emerging massage therapy profession took more definitive shape in the 1990s as a variety of organizations were created to further solidify the profession’s foundation, including The Massage Therapy Foundation, for example, whose focus on research has helped better quantify the benefits of massage therapy. Additionally, the massage therapy profession saw more and more states pass licensing laws, starting with 17 in the 1990s and increasing to 45 today.

This regulation, among other things, like more rigorous research and increased consumer awareness, has worked to further legitimate the massage therapy profession within the health and wellness arena. 

Understanding some of the pivotal moments in the massage therapy profession’s history is one way to get a better grasp of where we are today. These 10 moments don’t represent the entire scope of the history of massage therapy, but do give you a general overview of how the profession developed which can help us better navigate the future.