The Truth About Massage Therapy: What You’re Actually Paying For

Ahhh, a good massage… truly one of life’s greatest pleasures. At least in my opinion. But the term “massage therapy” is one of those things that sounds official and meaningful, yet in reality, it’s a giant catch-all that can mean anything from a glorified lotion bath to highly skilled manual therapy.

And to keep it real? Most places are banking on you not knowing the difference, not asking questions, and just blindly picking from the spa menu.

For example, have you ever booked a “deep tissue” or “sports” massage, only to get the same lotion-and-glide routine with a little extra elbow thrown in? Yeah, me too. That’s because most therapists aren’t actually trained in deep tissue or sports massage. But that won’t stop businesses from up-charging you for trendy services they can’t deliver.

And while we’re on the topic of upcharges, let me address how I feel about “therapeutic add-ons” like cupping for an extra $30, gua sha for another $30, and of course, the CBD oil upgrade for an extra $30 to $40 for a product that probably contains less CBD than a wet roach.

Here’s the thing: these tools and topicals aren’t gimmicks. They have real therapeutic benefits, appropriate applications, and actual contraindications. A well-trained therapist should know when and why to use a technique, not just slap it on because it’s trending. These things aren’t party favors, and if you’re picking from a menu, I promis you are not receiving the real therapeutic application.

Now, I get it, technically, you could charge for extras. But I don’t. If you come to me for therapy, I’ll use whatever I think is necessary and appropriate to get you out of pain and move better. And if you ask me for something specific, expect a small, eloquent lecture explaining the pros and cons of your request, followed by something along the lines of, “Sure, if it’s necessary.”

I’m not going to charge you for something you may not need, or worse, charge you extra for something I know will help me do my job better. I know it’s not very American of me to avoid squeezing every last penny out of you, but I’d rather give you the kind of care that actually works, and have you send all your friends and family to me because you felt better after one session. That’s the kind of marketing I believe in.

But in an industry where the business model prioritizes sales over skill, most people don’t realize they’re overpaying for fluff while true therapeutic work is getting harder and harder to find.

And hey, if you love a relaxation massage or trying trendy therapies you see on Instagram, amazing. There’s absolutely a time and place for that. But if you’re looking for bodywork that actually supports your health, mobility, pain relief, and recovery, you need to know what to look for.

So let’s talk about it. In this article, I’m going to help you understand how to know what will actually work for your needs, how to find a therapist who knows what they’re doing, and how to avoid wasting your money on overpriced nonsense wrapped in fancy marketing.

What I Actually Do (And Why It’s Different)

But first, let me establish myself as an LMT extraordinaire: I’m a trained medical manual therapist and sports massage therapist, and I’ve been knuckle-deep in tense tissue since 2005. I’ve literally been doing this work since I had to use a fake ID to get a $2 PBR on college night.

In other words, I’ve been at this for a while. I know a lot about bodywork, and I know the business of bodywork. And I want you to get the care you actually need.

I can’t tell you how many times I’ve seen a new client and heard some version of: “I went to this other massage therapist for pain and tension, paid a ton of money, and left with nothing resolved.”

Again, I’m not here to knock spas or general massage therapists. But if you’re looking for therapy that actually helps you feel and function better, training and skill level matter.

Let me put it this way; would you go to just anyone with an opening to cut or color your hair? No. So why would you do that with your body, especially when you're in pain or recovering from an injury? Seriously. Make it make sense.

I specialize in medical manual therapy and sports massage. These are advanced practices that go way beyond the basics most therapists learn. My training includes myofascial release, trigger point therapy, neuromuscular re-education, lymphatic therapy, cupping, gua sha, and more. The difference is that I actually know how and when to use them. It’s not a guessing game. It’s not, “Let’s throw everything at it and hope something sticks.” It’s clinical decision-making based on what your body needs.

These specializations require actual education, continuing training, and years of experience. You can’t fake it with a YouTube video and a Groupon. But because there’s almost zero regulation in this industry, everyone’s suddenly “doing sports massage” or “offering cupping,” whether they’ve been properly trained or not.

Let’s Talk About Lymphatic Therapy

Now let’s talk about a trend that’s recently exploded: lymphatic therapy. As part of my medical massage education, I was trained in the Vodder method of manual lymph drainage. I later went on to earn additional certifications in medical lymphatic therapy and oncology massage.

That’s the kind of work used to support cancer recovery, manage lymphedema, and assist in post-operative healing. Real medical therapy. But lately, lymphatic therapy is being sold online as a miracle fix for bloating, water retention, fatigue, sluggish metabolism, and my personal favorite, body contouring.

So I signed up for a few cosmetic lymphatic therapy courses just to see what was being taught. And I can tell you this: the techniques are pretty much the same as traditional lymphatic drainage. The difference? A slightly different rhythm, a few tweaks in the protocol, and a whole lot more hype and sparkle.

Let me be very clear: there is no manual therapy that can reduce fat, melt cellulite, or reshape your body. The science just isn’t there. Unless human cell physiology has changed overnight (newsflash: it hasn’t), no amount of rubbing, rolling, or oil-slathering is going to contour your waistline or shrink your thighs. Sorry, not sorry.

That said, when done properly, real lymphatic therapy does offer plenty of benefits. There’s growing research, especially around cranial lymphatic drainage, showing its potential in supporting brain health, detoxification, and reducing inflammation. It can improve skin quality, support the immune system, and promote healing. But, and this is a big but, it requires consistency. It’s not a one-time miracle treatment. It’s a practice.

When I used to offer post-operative lymphatic care, it required daily sessions for weeks and frequent coordination with surgeons. I loved that work, but the time commitment was massive. I no longer have the availability to offer that level of care, which is why I now focus on maintenance care and general wellness. Still incredibly helpful, but with realistic expectations.

If you’re thinking about lymphatic therapy, just know this: it can be incredibly beneficial when used properly, by someone with actual training. But if someone promises body sculpting in 45 minutes, using rigorous techniques and tools that leave a mark? Run. Or at the very least, ask some really good questions. Like I said before, there is a time and a place for every kind of therapy, but only when performed by a trained and skilled provider. 

Sports Massage Is Not Just Elbows and Deep Pressure

Let’s move on to another widely misunderstood area: sports massage, which is not just a “deep tissue” massage where the therapist goes elbow-deep in your recovering muscle. True sports massage is a specialized practice that requires knowledge of anatomy, movement patterns, biomechanics, and the phases of injury and recovery.

Working with athletic bodies, and bodies in recovery isn’t about pushing harder. It’s about knowing when to apply pressure, where to work, and when to stop. A skilled sports massage therapist isn’t just digging into sore muscles; they’re assessing movement dysfunction, compensatory patterns, and tissue quality. They know how to spot signs of an injury that needs further evaluation, and they’re not afraid to say, “You should get this checked out by a doctor or PT.”

My first two years in practice I worked at a physical therapy clinic that specialized in sports injury and athletic performance. I was doing hands on work with as many as 15 people per day, performing anything from specific stretches to tissue release on marathoners, powerlifters, hockey players, dancers, football and basketball players, high school athletes, you name it. And in that time, I became intimately familiar with the unique needs, patterns, and demands of bodies that are pushed harder and more frequently than average.

That kind of training ground teaches you things that school never will. You learn how to assess what tissues are doing, how the body is adapting (or not), and what kind of manual therapy will actually support that person’s recovery and performance. And you learn what questions to ask because athletes know their bodies.

So here’s a reality check: if you’re booking a sports massage and your provider doesn’t ask you anything about your activity level, your recent training, or how your body is currently feeling? You are not talking to a therapist trained in this specific skillset. And if you’re paying extra for it? You’re getting ripped off.

A well-trained sports massage therapist will always ask about your training schedule, your movement habits, any recent injuries or tweaks, and how your recovery is going. They’ll observe how you move, how your tissue responds to pressure, and they’ll adjust accordingly. It’s not a routine. It’s a session tailored to what your body is asking for.

That level of care matters, especially if you’re trying to perform at your best, avoid injury, or recover smarter. This is where skill, experience, and intuition collide. It’s also why some of the most powerful work I’ve ever done with clients wasn’t about working harder. It was about knowing exactly what to do, and when not to do it.

Cupping, Scraping, and Other Misunderstood Modalities

Cupping and scraping (AKA gua sha) are modalities that are wildly misused in the spa and bodywork industry these days. These are powerful therapeutic tools when used appropriately, but they’re getting tossed around like party tricks lately, and frankly, it makes me cringe.

Both of these practices come from the rich and complex system of Traditional Chinese Medicine. In their original context, they’re used to move blood and qi along meridians, balance internal systems, and promote healing. There’s a whole diagnostic framework behind how and when to use them based on things like organ systems, energy flow, and pattern identification. Unless you’re working with a licensed TCM practitioner, chances are your provider is not applying cups or gua sha within that traditional framework.

That said, when these tools are used in a Western sports medicine context, they have a totally different purpose. In this model, cupping and scraping are used to increase local circulation, release fascial restrictions, reduce adhesions, improve tissue glide, and decrease muscular tension. These applications can be incredibly beneficial, especially for active individuals dealing with overuse, stiffness, or postural strain. But here’s the thing; it requires real training to understand when and how to apply them safely, especially when working around injuries, post-op sites, or inflamed tissue.

If you don’t know what you’re doing, you can actually hurt someone. I’ve seen poorly applied cups recently that resulted in deep bruising, hematomas, and tissue trauma. That’s not “breaking up stagnation”, that’s damaging tissue. These tools are not toys. They are medical modalities, and they should be treated with that level of care and respect.

And yes, I know you can buy cupping kits and gua sha tools online for twenty bucks. People are out here DIY-ing their own back treatments, and honestly? That’s your call. But if you’re going to do it yourself, at the very least: keep your tools clean, learn the basics, and don’t go scraping over every knot like you’re tenderizing meat (that knot might be a lymph node).

But when it comes to receiving care from a provider? Do your homework. Ask where they trained, how long they’ve been using these tools, and what conditions they use them for. A qualified practitioner should be able to explain their technique and how it fits into your overall treatment. They should also be asking you questions, about your health history, your pain tolerance, medications, and how your body typically responds to pressure and stimulation.

If someone is slapping cups on you five minutes into the session without assessing what’s going on or explaining why? That’s not therapeutic; that’s a red flag.

How to Find the Right Provider (And What to Ask)

Now that I’ve given you the breakdown, let’s talk about how to find someone who actually knows what they’re doing. Whether you’re seeking sports massage, lymphatic therapy, or anything in between, you need to ask questions, and yes, you have every right to.

Start by asking about their training. What certifications do they have? Who did they train with? If they get flustered or dismissive, that’s not a good sign. A well-trained therapist should be proud of their education and happy to talk about it.

Next, ask about their experience and their philosophy on care. Do they just do the same routine on everyone, or do they tailor their work based on what your body is telling them? Do they treat aggressively by default and tell you that “you need it,” or do they listen and adjust based on your pain tolerance, your goals, and your current state?

(And for the record, I will sometimes dig in and say “you need it”—but only if I know you, and only if we’ve established that kind of trust.)

Seriously though, get a feel for them as a provider. Do they take time to listen? Do they ask questions? Do they seem interested in you, or just pushing a trendy service?

And please, I beg you call them before booking. If they don’t make time for a quick chat or can’t answer your questions, that’s a red flag. If you’re booking at a spa where you don’t even know who your therapist will be, and you’re looking for clinical care? Probably not the place.

If you must go that route, ask what their hiring standards are. Do they require specific training in sports massage or manual therapy? Again, if the person answering the phone sounds annoyed or confused by your questions… walk away.

Know What You’re Paying For

Massage therapy can be an incredible tool for healing, pain relief, recovery, and well-being, but only when it’s done right. The truth is, this industry has very little regulation when it comes to how people label themselves or what they can offer. That means it’s up to you to know what to look for and to ask the right questions.

I know this might seem like a lot, but trust me, your body is worth it. You deserve care that’s rooted in skill, training, and real attention to what your body actually needs. Not just whatever’s trending on Instagram this week.

So be picky. Ask questions. Advocate for yourself. And when you find a provider who takes your care seriously? Keep them. Those are the people who make a real difference.

And if you ever have questions, or just want someone to shoot you straight, you know where to find me.