When Massage Quits You
Sometimes the choice is made for you.
Originally published January 2022 | Updated for 2025
Being a massage therapist is a rough gig. Among the challenges are focusing on a single person for 60-90 minutes straight, deciphering what clients aren't saying (there’s a lot they don’t say), and an estimated 259 loads of laundry per week.
Despite these challenges, massage therapists are a dedicated group. Massage therapy is a profession that becomes to define you, propping up a corner of your identity in ways other careers simply don't.
So what happens when you can't massage anymore?
Tangible Factors: When Your Body Becomes the Barrier
The Disability Reality
Disability represents the only minority group with open enrollment—you're either disabled or will be if you live long enough. For massage therapists, this reality carries particular weight since our bodies are our tools.
Hypermobility and Progressive Dysfunction
My disability primarily manifests as hypermobility. Since massage school, I've known my thumbs hyperextend dangerously without support. Since elementary school, my elbows performed "party tricks" that grossed people out. Only recently did I recognize the accumulated joint dysfunction:
Right SI joint, ribs, and radial bone subluxations
Jaw opens excessively wide
Knees hyperextend backward
Ankles roll painlessly
All finger joints hyperextend
The Ehlers-Danlos Suspicion
While Ehlers-Danlos syndrome remains the likely diagnosis, it's still a diagnosis of exclusion, and I lack life-threatening vascular symptoms. My core issue is that dysfunctional collagen makes ligaments ineffective at maintaining joint stability.
Fatigue: The First Warning Sign
Before the mechanical issues became obvious, fatigue emerged as my primary limitation. Six-massage shifts began leaving me so depleted that driving home felt dangerous. It was as if every ATP molecule in my body had been consumed. I progressively reduced to five sessions, then four. Sessions longer than 60 minutes became impossible.
At the time of this writing, exceeding six massages weekly requires recovery days and likely triggers SI joint dysfunction. When ligaments fail, muscles compensate—and muscles require energy to function continuously.
The Economic Reality
Unless I begin charging premium rates, six massages weekly won't sustain a living wage.
The Community Connection Crisis
How many massage therapists push through similar limitations? How many work through outright injuries? When your livelihood depends on physical capability, minor cuts or accidents threaten financial stability.
More significantly: what happens when you hit the wall and simply cannot massage anymore?
For many therapists, massage represents community and identity. Clients become social and business connections. We accompany people through pregnancies, life transitions, and losses. Can you abandon hands-on work while remaining part of this community? Will the community accept your continued presence?
Intangible Factors: When Your Brain Becomes the Barrier
The Neurodivergent Massage Therapist Experience
I describe myself as a highly-sensitive, introverted HAM radio with bipolar disorder. Each trait creates unique challenges in a profession built around human connection and energy exchange.
Introversion in a People-Focused Profession
Introverts don't thrive on group work, need processing time, feel depleted after social interaction, and recharge through solitary activities. Susan Cain's "Quiet" brought mainstream attention to these traits, but the massage industry still operates as if all therapists are energized by constant client interaction.
Highly Sensitive Processing
Highly Sensitive Persons (HSPs) represent 15-20% of the population, characterized by depth of processing, overstimulation susceptibility, emotional reactivity, and subtle sensory awareness. HSPs absorb and process internal and external stimuli faster and more intensely than the average person. This creates therapeutic advantages—creativity, empathy, emotional depth—but also vulnerability to overstimulation. Roughly 70% of HSPs are introverts.
I am a HAM Radio
HAM radios operate independently, transmitting and receiving various signals across vast distances. Like these radios, I both absorb and broadcast emotional information, processing the subtle energetic exchanges that define therapeutic touch.
Bipolar Disorder
Bipolar disorder causes alternating depressive and manic states, sometimes simultaneously (mixed episodes). My hypomanic episodes don't involve reckless spending or dangerous behavior, but they do create project obsession, insomnia, impaired non-verbal signal recognition, and persistent mental loops.
Physiologically bipolar disorder relates more closely to epilepsy than depression, sharing pharmaceutical treatments, sensitivity to light, and sleep changes. I've learned to anticipate episodes around equinoxes (due to the rapid light changes) and daylight saving transitions.
“Therapy” But Not “Therapy”
Massage therapy programs deliberately avoid the "therapy" aspect of the profession. With 500-hour programs barely covering basic massage skills, anything relating to psychology remains laughably outside our scope of practice. Yet clients consistently use massage as proxy psychotherapy, often unconsciously.
Touch encourages emotional release, and those emotions are often the difficult ones.
Co-regulation and Energetic Exchange
Co-regulation theory explains how people use others to manage emotional states through continuous reaction and adjustment. This exchange can become lopsided, with one person regulating while the other receives. I suspect touch facilitates this emotional transfer significantly.
As an introverted HSP with bipolar disorder, I receive and process information quickly and deeply while struggling to regulate my own moods. Despite fifteen years of attempting to develop solid emotional boundaries (taught in all massage programs), the combination has proved overwhelming.
This manifests as:
Canceling sessions due to unstable mental states
Finding difficult clients impossible to manage rather than merely challenging
Anticipatory anxiety that triggers cancellations
Three work days per week (my physical maximum) requiring full recovery days in between
Paradoxically, exceptional therapeutic skills due to heightened sensitivity
The result: a finite shelf-life approaching expiration.
Update
It is now 2025, and I don’t see clients anymore. I work in my home office, writing, creating podcasts, and running the Healwell Community of Practice.
I’ve discovered that I like being around people. Last month I attended the International Massage Therapy Research Conference, and it was a blast. I met people who are as excited and concerned as I am about the profession’s possibilities and challenges. I was around people for twelve hours a day, and while I needed recovery time, I didn’t feel like I had been hit by a truck.
My ribs are still too mobile, but B12 injections help my ligaments function better. My bipolar disorder is well managed with medication, although daylight savings remains incredibly disruptive (and dumb).
I am lucky. For most massage therapists, leaving the table means leaving the profession and taking their experience and knowledge with them. Our brain drain is off the charts.
There is so much work to be done, and so many therapists who want to do it, but very few avenues to get paid. The profession needs people who understand public health, policy, education, research, communication, and at least six other areas that didn’t immediately come to mind. We need people who can write, and create solutions, and make connections outside of our profession.
If you’re one of those people, Healwell has made a place where you can find others like you.