Massage Leaving You Anxious? 12 Potential Red Flags in Massage Therapy

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News reports frequently highlight misconduct, sexual assault, or trafficking allegations against massage therapists, making it easy to think such activity is rampant in the industry. While these incidents are, in fact, relatively rare in relation to the number of massage therapists in the United States, they are no less concerning. It should go without saying that any inappropriate touch or behavior is a red flag when receiving massage treatment, but other warning signs may be more subtle and may still indicate a massage therapist is not the right match for you. In some cases, these signs may mean the therapist is unfit to practice altogether.

Not every red flag means a massage therapist should be reported or their license should be revoked. Some of the items listed below may be acceptable in context, especially if the massage therapist is working with your best interests for healing, recovery, rehabilitation, or general wellness in mind. While inappropriate sexual conduct, aggression, or personal violations should never be excused, other behavior may be more complex and deserve further consideration.

You may consider it a warning sign if your massage therapist:

  1. Does not meet national and state requirements for practicing massage. When searching for a massage therapist in a directory online, be aware of each directory’s standards for membership. Massage practitioners who are listed with Massagetique must hold a current license in massage or a field related to bodywork in the state in which they practice.
  1. Is unprofessional in their communication. Good verbal, nonverbal, and written communication help develop trust and a solid therapeutic relationship. For a massage therapist, this also includes maintaining confidentiality in the client-practitioner relationship and gaining client consent to any and all treatment proposed.
  1. Is unprofessional in appearance or attire. Massage therapists show respect to clients and maintain professional office standards by wearing closed-toed shoes, dressing appropriately, and appearing clean and well-kept.
  1. Has poor hygiene or an unclean professional environment. A messy office, unclean linens, and unwashed hands are all signs your massage therapist may not use thorough cleaning methods between clients. Proper hygiene helps prevent the spread of germs and diseases, especially with regard to any other materials used in the treatment (hot stones, cupping products, or anything else that comes in direct contact with clients’ skin).
  1. Causes further pain or discomfort. When treating extreme injuries or working in conjunction with a chiropractor on spinal issues, a massage therapist may warn you there could be residual muscle soreness from treatment. However, most massage sessions will help repair muscles and ease tension–not create more of it. If you find you’re convincing yourself it has to get worse before it gets better, talk to your massage practitioner about the mode of treatment to see whether your experience is in line with their healing plan.
  1. Does not encourage simultaneous self-care objectives. Within reason, a good massage therapist will provide tips for how you can continue the healing process at home. These tips might include information on how and when to apply ice or heat for muscle soreness, light stretches to do on your own, or sleeping positions to lessen pain. When applicable, these suggestions can be an indication your massage therapist is helping you develop tools for healing on your own, rather than relying heavily on rehabilitative massage therapy for a longer term than necessary.
  1. Prescribes a new diet or eating regimen. Some massage therapists do possess certification and training in nutrition or food science, and they may incorporate this expertise into massage treatment—if they have arranged with a client to do so. Otherwise, such prescriptive advice lies outside the bounds of a massage therapist’s role.
  1. Prescribes vitamins, supplements, herbs, or any medication–natural/homeopathic or otherwise. Again, it may be acceptable for a massage therapist with the necessary education and qualifications to offer this type of advice. In certain cases, a massage therapist may also mention options for self-treatment meant to continue the work they do with a client. For instance, a spa treatment may include a bath with Epsom salts or a topical plant-based Arnica gel to reduce inflammation, either of which a massage practitioner may recommend for home use.
  1. Introduces a new type of therapy without your consent. Many massage therapists have expertise in specialty treatments beyond the various modes of massage therapy. For instance, someone may have training in cupping, using heated stones, or aromatherapy. Without first consulting a client and obtaining consent, however, it may be unethical for a therapist to begin using these alternative treatment methods.
  1. Does not respect your boundaries or stated treatment limitations. You, as the client, hold autonomy in seeking treatment. Only you know what your limits are with regard to privacy, emotional expression, exposure, duration of treatments, and nature of therapy. Any expressed boundaries outside the scope of the existing massage practitioners’ code of ethics must be acknowledged and respected by the massage therapist.
  1. Is not aware of a condition you describe or does not recognize the anatomy it affects. A good massage therapist should have a background in pathology. This means they should be familiar with both common and uncommon injuries or ailments that might affect the body. It may be a red flag if you mention an issue bothering you–for instance, a specific muscle group experiencing discomfort–and your massage therapist is unfamiliar with this area or issue.
  1. Offers advice on life, relationships, your mental health, or other matters unrelated to your reasons for seeking massage. Unless your massage therapist is qualified to practice certain modalities that include integrated body-mind treatment, such as Jin Shin Do, no aspect of mental health treatment is a part of typical massage therapy. Some people value conversation as an integral part of the massage session, but it may be in the best interests of both client and practitioner to keep it casual, rather than delving into deep emotional themes outside the realm of friendly conversation that may call for psychotherapeutic expertise.

The ultimate warning sign in receiving massage is your own discomfort as a client, so ongoing nerves or feelings of unease can be reason enough to seek a new massage therapist. If you find it difficult to relax during your massage for any reason, chances are your healing may be compromised by the tension in your body. Relaxation may take time, but comfort is critical from the beginning.

A massage therapist should be open to all feedback regarding techniques, demeanor, and conduct. If you are are interested in continuing a therapeutic relationship with your massage therapist and feel comfortable discussing issues that arise, bringing forward these questions or concerns may be beneficial to you both. However, assuming there are other massage therapists in your area who practice the type(s) of massage you’re seeking and who are accepting new clients, you may decide simply to move on and find someone who will be a better fit for your needs.


  1. Allison, N. (1999). The illustrated encyclopedia of body-mind disciplines. New York, NY: The Rosen Publishing Group, Inc.
  2. Beck, M. F. (2011). Theory and practice of therapeutic massage (5th ed). Clifton Park, NY: Milady.
  3. Gomez-Aceves, S. (2017, May 06). Manchester massage therapist charged with sex assault. Hartford Courant. Retrieved from
  4. National Certification Board for Therapeutic Massage & Bodywork. (2016). NCBTMB candidate handbook. Retrieved from
  5. Neal, D. J. (2017, April 13). Massage therapist accused of sexual battery on a female client. Miami Herald. Retrieved from
  6. Rood, L. (2017, April 12). Des Moines police arrest four after massage parlor complaints. The Des Moines Register. Retrieved from
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