Dominos Are Falling

This is not merely a prediction.

It’s a pattern.

And patterns are important—especially in a profession that often notices change only after it's already happening.

The Current Dominos At Play

Across the United States, the educational pipeline for massage therapy has been quietly reshaping itself. Not with a dramatic collapse. And not in a single headline. But with a series of small, reasonable developments that, when taken together, start to look like dominos tipping in a dangerous direction.

The first domino: we have far fewer massage schools than we used to. Fifteen years ago, the U.S. had roughly 1,600 massage therapy programs. Today, that number is under 900. In other words, nearly half of the educational infrastructure that once fed our profession has disappeared.

That alone should give us pause.

The second domino: the remaining schools are graduating relatively small classes. The average massage program now produces only about two dozen graduates per year.

That’s not a robust workforce pipeline.That’s a trickle.

The third domino: the demand for massage therapists has not disappeared. If anything, it's grown. Employers across the industry report tens of thousands of unfilled massage therapist positions nationwide.

So we now have a widening gap:

• Fewer schools

• Smaller graduating classes

• Ongoing workforce shortages

When supply shrinks and demand remains high, something will step in to fill the gap. That’s not speculation. That’s how labor markets work.

And this leads to the fourth domino:

When Employers Become Educators

When a profession cannot produce enough graduates to meet demand, employers won’t simply wait and hope the problem will fix itself. They will build their own solutions.

We are already seeing the earliest versions of those solutions: employer-driven training pathways and franchise-affiliated educational models designed specifically to solve therapist shortages. In Arkansas, apprenticeship pathways were initiated by franchise owners. While major franchises provide their own continuing education and online training platforms.

Franchises continue to show an interest in the realm of education.

From a business perspective, this makes perfect sense.

From a workforce perspective, it makes perfect sense.

From an access perspective, it may even look like progress.

And this is where the dominos have the potential to collapse into each other. Because once employers begin building education pipelines to solve staffing shortages, a new question emerges:

What would happen if the largest employers become the largest educators?

A Perspective From Inside the System

Before I go any further, I want to be transparent about my position in this conversation: I work as a massage therapist inside a franchise environment.

My perspective isn’t coming from the outside looking in—it’s shaped from inside the system—watching the dominos line up in real time. And because of that, I see two truths at once.

I see the good every day. Franchises introduce thousands of people to massage for the first time. They make massage accessible and routine. They create stable employment and sustainable income for therapists. They normalize massage as part of everyday wellness care.

Those contributions matter greatly.

So this isn’t an anti-franchise argument.

But working inside the system also means I see how franchises are built to function. They're designed around risk management, consistency, and brand protection. That’s not an inherent flaw—it’s just how franchises work in every industry.

The challenge is that those priorities don’t stay confined to business operations. Over time, they shape how massage is practiced, how therapists are trained, and how the public understands what massage therapy is.

Policies designed to minimize risk slowly become the guardrails of practice.

Guardrails become habits.

Habits become expectations.

Expectations become the public’s perception of our profession.

This is how the scope of massage can narrow without anyone ever intending it to.

We can already see hints of this in how certain clinically legitimate body regions—like the glutes and abdomen—are frequently treated as off-limits in many franchise settings because they are perceived as higher risk. When millions of clients experience massage under those guardrails, those guardrails start to feel like the boundaries of the profession itself.

This is how public perception is quietly shaped.

Not through debate.

Or professional consensus.

Through repetition.

Remember how I said these dominos will start to connect?

Imagine a future, decades or centuries from now, where the clinical knowledge and the practical skills of abdominal and gluteal massage are no longer just absent from entry level education, but lost entirely from the practice of massage therapy all together.

Because if employers also become educators, then their policies, their priorities, and their risk tolerance won’t just shape workplaces.

They'll shape the profession itself!

The Threat That Feels Like Convenience

What makes this trajectory so easy to miss is that none of the individual steps feel alarming. In fact, they may even feel helpful.

Schools struggle with enrollment.

Some must close.

Workforce shortages grow.

Employers step in to train therapists.

Access increases.

New pathways emerge.

Every step makes sense in isolation. Every step feels like a solution.

And this is exactly how large structural shifts happen inside professions. Not through dramatic upheaval, but through a series of practical responses to immediate problems.

Sometimes the biggest threats don’t feel like threats while they’re happening.

They can feel like convenience. Accessibility. Innovation.

Relief to the system.

But underneath it all is a slow shift in where influence lives.

Until one day, these shifts become the new normal.

Massage therapy has a long history of mobilizing after change is already underway. We may advocate state-by-state, issue-by-issue, reacting to developments as they appear. But national-scale trends move differently. They unfold slowly, quietly, and across many small decisions made across many different places. By the time we collectively pause to examine the trajectory, our landscape has already shifted.

We’ve seen this pattern before:

When the U.S. Department of Education proposed restoring Gainful Employment regulations and tightening Pell Grant eligibility from 150% of program length down to 100%, the massage profession suddenly realized:

Oh crap… federal policy can reshape our entire education pipeline.

Schools, organizations, and advocates mobilized quickly as the implications became clear. Some states even raised their minimum classroom hours in response. But the urgency of that reaction revealed something deeper.

Instead of proactively examining whether our educational structures needed to evolve—and leading that conversation ourselves—we found ourselves responding to outside forces already in motion. It was a powerful reminder that national-scale changes can reshape massage education long before the profession collectively decides to engage with them.

This is more than a criticism of our profession. It’s a confrontation of our own patterns.

We are a profession made up largely of caregivers, clinicians, and small business owners. We focus on our clients, practices, and communities. We solve the problems directly in front of us. But large-scale structural change won't announce itself as a problem. It'll emerges as a series of solutions.

And right now, those solutions are beginning to lean in the same direction.

The Questions We Need to Ask Now

If this trajectory continues, we need to be honest about the questions it raises:

• Who gets to define the full scope of massage therapy?

• Who safeguards our clinical breadth and professional autonomy?

• Who protects the diversity of practice models and educational philosophies that have made this profession unique?

  
  

I'm talking practical prognostication here!

We must look at current trends and ask "what happens if we never intentionally change course?"

Because we're faced with what a concentration of influence can ultimately lead to.

When the largest employers become the largest educators… When the primary gateway to receiving massage becomes the primary gateway to learning massage… And when risk-management policies quietly shape public expectations…

The profession itself begins to narrow.

Not because anyone wanted it to. But because no one intentionally claimed the space.

This Is Not a Prediction. It’s a Choice.

Let me be clear: this is not just a warning about franchises taking over massage therapy. Franchises are part of this profession. They will continue to be part of this profession. They provide access, opportunity, and visibility that matter deeply.

But this is a warning about what happens when a profession unintentionally drifts toward deference to a single dominant gatekeeper.

Healthy professions don’t rely on one entry point. They cultivate many:

• Independent schools.

• Apprenticeships.

• Degree based programs.

• Continuing education providers.

• Professional organizations.

• Researchers.

• Educators.

• Clinicians.

• Practice owners.

  
  

A profession stays expansive when many voices actively shape its future.

Right now, these dominos are still standing. But they are close enough that we can see how easily they could fall into one another.

Luckily, we still have time to decide which ones we want to catch.

Professions are not defined by what they allow to happen. They are defined by what they choose to protect, cultivate, and stand for.

And this is the moment for massage therapy to claim its space.

Accompanying Vlog: https://youtu.be/kzWZ3yu-mCs?si=ARgs43s4XeydI0N2 and https://www.tiktok.com/@kirbyclarkellis.mti/video/7625640868191472910?is_from_webapp=1&sender_device=pc&web_id=7560755222181692983

Peace and Healing,

Kirby Clark Ellis, MTI