12/25/2025
As I wrote two weeks ago, the world of CE is chaotic. It can be difficult to find the courses you need as we have no real information center for CE courses. There's the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), where most of us get our CE courses approved. The listing of courses and providers on the NCBTMB website is only somewhat helpful -- some of those listings are out of date or not being currently offered. The quality of courses is alllllllll over the map.
Yet, as I pointed out in my last article (What Massage School Doesn't Give You), continuing education courses are a vital part of your professional growth, especially your growth from competent to skilled to excellent. So why is something so critical look like a yard sale -- maybe you'll find what you need, maybe you won't. Maybe you'll find something great, maybe you won't. Maybe you'll get more than your money's worth, maybe you won't.
There's almost no consistent advice in our profession (possibly none) on how to specialize if that's what you feel drawn to do. What are the different ways you can specialize? What courses make sense if you find yourself wanting to specialize? While trying to explain this to students in a massage school last year, I developed The Tree of CE.
Is this something the massage community agrees on? Oh, hell no. Honestly, once our community moves past the phrase "massage is good", we quickly dissolve into competing opinions about almost everything it seems. I created this based on my experience and the experiences of other massage therapists, especially new therapists.
I do, however, think is this a defensible approach to understanding professional growth and development, especially if you want to take your practice in a specific direction. It's not about where you work (private practice, employment, etc.). It's about what you offer your clients based on your experience, your education, and what you like to do.
So, how do you read this tree?
The baseline: the green grass at the bottom of the tree is for all those things everyone needs to study and be competent in, regardless of any urge for specialization. These are also courses it may be wise to repeat regularly either because of state regs, because of advances in the field, or because when you need the info, you need it right now (CPR / First Aid).
General practice: a little bit of this, a little bit of that. Virtually all new massage therapists start in General Practice. Plenty of us also stay here long-term because it feels right. Continuing ed is a little bit of this, a little bit of that. Your toolbox is more broad than deep.
Relaxation/Spa: masters of relaxation. Focus on relaxation and esthetics. Continuing ed includes wraps, scrubs, advanced relaxation techniques, etc.
Sport: practitioners like working with athletes — professional, amateur, weekend — and the injuries that come with them. I might classify this as “population specific” but so many people already use this term that I included it here. Focused on helping clients improve performance. Continuing ed focuses on injury recovery and performance enhancement, such as k-taping, stretching, etc.
Muscle Mastery: the ultimate muscle nerd (maybe that's what I should have called this category), they are all about the muscles — location, function, attachments, agonist, antagonist, common injuries, the works. Continuing ed focuses on muscle-specific issues like trigger points, neuro-muscular therapy, orthopedic massage, etc.
Medical: works with people with complicated body issues, including chronic conditions. Like sports, they are comfortable focusing on a body part / area for a entire session and do not feel the need to do “full body”. Continuing ed does deeper dives into pathologies and modalities such as visceral manipulation, manual lymph drainage, scar release, etc.
Body-Mind: practitioners focus on the integration of the body and the mind They are often drawn to the effects bodywork can have on mental health. Continuing ed focuses on classes on working with trauma, somatic experiences, and modalities that accentuate the body-mind connection. There may be additional education / degrees in things like psychology.
Eastern: practice is based on bodywork traditions from Asia (China, India, Japan, Korea, etc.) Conversant with meridians, reflexology, etc. Continuing ed includes accupressure, Auyervedic work, etc.
Energy: combines work with both the physical body and the energetic body. Conversant with chakras, auras, energetic health and anatomy, etc. Continuing ed includes courses on chakras, reiki, auras, alignment, etc.
Modality-specific: specializes in one modality such as craniosacral, myofascial release, Rolfing, etc. Works to attract clients who are a "best fit" for their chosen modality. Continuing ed will take practitioner into deeper levels of that modality.
Population-specific: specializes with a specific population. Populations may be defined by physical challenges (Parkinsons’s, cancer, etc.) or by social reality (LGBTQ+, elderly, etc.). Continuing ed will focus on specific pathologies common for that population, enhanced understanding of the population, and any modalities that may be well-suited for their preferred population.
Practitioner-created: combine types, modalities, and skills in a way that is unique to them. Continuing ed is whatever makes sense for them.
Are these "branches" exclusive? No. If you choose to specialize in Muscle Master, you can still take courses in relaxation because you want to. You can have a practice that's a combo of two branches. You can jump branches! Start in one but move to another as your career advances. This isn't about exclusivity, it's about guidance for those trying to figure this out.
For many years, my practice was a General practice. I was definitely more of a "broad toolbox" than a "deep toolbox". When I moved from DC to NC, I went to work for a Medical practice, where I focused a lot more on people with more complicated health situations, benefitting from my training in manual lymph drainage, myofascial release, and scar release, plus 17 years of being a massage therapist.
What has your path been like?
