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Ralph Stephens Reflects on Four Decades in Massage

Massage therapy educator and practitioner Ralph Stephens has announced his retirement from the massage field after a career spanning 37 years as a therapist and educator.

A well-regarded provider of sports, neuromuscular, medical, neural reset and seated massage CE who, at the height of his teaching career spent 250 days a year traveling and presenting at schools and conferences around the world, Stephens authored the first textbook on chair massage.

Stephens first began practicing massage in 1986 in Iowa City, Iowa. Over the course of his career, Stephens, now 75, was involved in many massage therapy committees and boards, and was always an outspoken commentator on the direction he thought the massage field needed to head.

“Ralph has been my friend and colleague in bodywork for many years. I am honored that he served as the major promoter and instructor for Neural Reset Therapy,” said the technique’s developer, Lawrence Woods. “We should all respect the efforts he has made to bring transparency to the behind-the-scenes actions of our governing organizations.”

Stephens is a 2008 inductee into the Massage Therapy Hall of Fame. “Ralph proved you could do anything,” said the hall of fame’s founder, Mike Hinkle. “He came from a farming family and now is in both the Iowa Rock and Roll and Massage Therapy Hall of Fame. Ralph is truly a pioneer of massage.”

Ralph Stephens upon receiving the 2017 Alliance for Massage Therapy Education (AFMTE)-BioFreeze-Bon Vital’ Continuing Education Provider Instructor of the Year Award.
Ralph Stephens upon receiving the 2017 Alliance for Massage Therapy Education (AFMTE)-BioFreeze-Bon Vital’ Continuing Education Provider Instructor of the Year Award.

In 2017, Stephens was awarded the Alliance for Massage Therapy Education (AFMTE)-BioFreeze-Bon Vital’ Continuing Education Provider Instructor of the Year Award. He is an AFMTE founding member and founding board of directors member.

“There are few leaders who are also exceptional educators who impart a legacy impact on a profession,” said Stephens’s colleague, Benny Vaughn LMT, NCTMB, ATC, LAT. “Ralph Stephens is such a leader whom I have had the privilege to work with at multiple levels within the massage profession. With deep and profound gratitude, I say, thank you, Ralph Stevens!”

Stephens sat down via Zoom with MASSAGE Magazine’s editor-in-chief, Karen Menehan, to reflect on the successes and missteps he’s seen in the massage field, why massage therapy is still not considered incorporated into our health care system—and how hanging out in a bar when he was a drummer led to almost four decades in massage.

Karen Menehan: You have seen the massage field evolve over almost 40 years. Tell us about the changes you’ve seen.

Ralph Stephens: When I opened my practice, I was the first practice in Iowa City, Iowa, to be open to anybody. There were a few therapists practicing, but they were only working on women. I was the first open-to-the-public shop, and I joined the chamber of commerce. At my first mixer, the first person I met asked me, “What do you do?” I said, “I’m a massage therapist.” He literally pulled his hand back, stepped back, shook his head, and walked away.

Now, when you introduce yourself and somebody asks you what you do, and you say, “I’m a massage therapist,” they go, “Oh, I’ve got this pain back here.”

Massage has become so much more accepted, so much more mainstream.

Therapists used to be looking for people to work on. Now we’re looking for therapists to work on the people that want to be worked on. That’s really a huge shift.

Over quite a while, the public has come to accept us. Now, sadly, it appears that the profession is not as attractive to potential therapists as it was back in the ’80s and ’90s.

KM: Why do you think it is that it’s less attractive now?

RS: Two things happened. First, we oversold the profession to people—“Make $80 an hour! Control your own time!”—and really, you’re not making $80 because you’re paying rent, and advertising, and utilities.

Second, when I came into the profession, schools were recruiting people mostly who were professionals already. We were recruiting people looking for a career change and for a way to work and be independent in a less stressful environment.

Then when licensing became more common, recruiting was aimed at people coming right out of high school. When we started recruiting right out of high school, people were looking for is a job. And of course, the franchises opened and that became the job.

When I went to school, they emphasized that you’re going to have to go out and build a practice. Now they’re training people to be employees who go out and go to work.

There’s nothing wrong with that, and that’s perfect for some people.

KM: What advice do you have about building a private practice?

RS: This isn’t going to win me any points, but when you’re in our situation, you have to market to the people that can afford the services. The best way to help the poor is to not be one of them.

I don’t mean that disrespectfully, because I never turned anybody away who honestly came to me and said, “I need help. I just can’t afford,” in that day, $35 an hour. I did something for them, and they did something in exchange for me. We worked out something. A guy put a stereo in my truck. People brought me stuff from their garden.

I always worked out something with somebody that really came and needed help. And I also did well enough that I could take time and donate it to the homeless shelter or to an organization and feel good about it.

The people who really became successful got a practice going and then went on and took advanced training—neuromuscular or craniosacral, or some of the advanced work that let them really help people in pain and do more work.

Grow your practice that way.

KM: I often hear from massage therapists that the public still doesn’t understand that massage is health care that is needed on a regular basis.

RS: It’s always been a bit of a challenge to convince people to do this regularly, because our whole health care paradigm is when you’re really hurting or when you’re really sick, then you go to the doctor or you go to the emergency room, or if it’s a muscle tear and you’re an athlete or something, you go to the massage therapist.

And as soon as you get that fixed, well, you go back out and do what you do. When you can’t stand it anymore, well, then you come back for another massage.

I wish that our profession would have developed more self-esteem for what it is that we do, and would have really recognized the full potential for soft tissue therapy.

You know, all we talked about—relaxation, stress reduction, oh, maybe with a headache, because that comes from stress—but oh, we were so careful not to treat anything. “Don’t offend the doctors. Oh, no.”

We didn’t promote this profession to the public as a health care profession. We promoted it as this auxiliary thing to do that is good for you and it helps your health, but it’s relaxation, it’s stress reduction. We ran away from so much of the potential.

KM: Why is it that you think that massage still isn’t fully integrated into health care? Because I hear that a lot too. Massage therapists want to be part of medical care and they want to be respected. What would it take for that to change?

RS: In order for that to change, we have to have a consistent deliverable. You’ve got massage therapists out there doing first-class medical massage work, helping people recover from injuries and from surgeries and from all sorts of conditions—[offering] all the benefits that soft tissue therapy can provide. And we’ve got people that barely know which end of the oil bottle to squeeze and are just, you know, mechanically doing the same routine on everybody.

I’ve worked with a lot of MDs. They say, “Where can I find somebody else like you?” I go, “Well, I’ve got these students, but I can only train so many. And there’s some other people out there training some really good people.” But for the most part I would say 50% to 60% of massage therapists never learned enough to be respected by the medical profession.

We didn’t have a consistent deliverable. If we had a consistent deliverable that insurance companies could come to believe in, we might have a better chance of coming in under advantage plans, for example, in Medicare and wellness programs that some businesses have.

KM: The problem is lack of consistency in massage education—which is another refrain I hear.

RS: Absolutely. The profession grew so fast. When I came in, the people owning schools and teaching at schools were experienced therapists.

Then, national certification defined continuing education as that which is taught that is beyond the level of entry-level education. But what’s entry-level education?

It’s a list. What 12 muscles does every massage therapist know and know how to palpate? What strokes does everybody know and know how to apply them properly? What body mechanics does everybody coming out of school know?

I’ve had so many doctors tell me, “I’ve referred to this massage therapist and they wound up chanting and, and waving crystals. I can’t send my patients to people like that.”

KM: Do you have anything that you’d like to say to the national organizations in terms of how to create that consistency in massage education that you talked about?

RS: Sometimes I’m afraid the train’s left the station. You know, we started trying to do that back in the ’90s with the National Certification Board for Therapeutic Massage and Bodywork, and the Commission on Massage Therapy Accreditation and the Massage Therapy Foundation, and great work has been done by all those organizations.

But I still think that we spent too much time trying to be accepted by the medical profession and not enough time selling ourselves to the public for what we really had the potential to do for them.

I know that’s a bigger market to reach, but still, those are the people that pay us.

KM: We want to think of massage therapy as a health profession, yet people are providing it out of their home studio or as mobile services—so it doesn’t seem like chiropractic or physical therapy or anything else that you might get a referral for from your doctor. How do we promote it as a health care profession when it hasn’t achieved that status?

RS: One of my pet peeves has been that we are so desperately trying to be accepted by a system for financial reasons. In other words, the PTs went from doing a lot of hands-on work to running machines and just doing exercise programs and evaluations and things like that because they could see more patients in an hour.

I remember an editorial for physical therapists that stated, “Be careful not to get involved in doing massage because the patients will like it and want it, and it’s a poor use of the physical therapist’s time and resources.” In other words, you can’t bill enough for it.

I think chiropractic and acupuncture and massage should have gone together and said, “We are an alternative system.” We had the opportunity to go together with a couple of the other alternative providers and say, “We are an alternative to that, we’re going to help keep you well. And yeah, you may have to pay us for it, because the insurance company is part of that allopathic system.”

But there are plenty of people that could [pay]. And we could have gained acceptance and then found our way into that possible insurance system because people were demanding it—but we didn’t promote ourselves as an alternative. We tried to join a system where the last thing they want is wellness.

KM: Do you feel like the time has passed, like it’s too late for clients to understand that massage is health care?

RS: No, people are looking for an alternative. But again, we have to have a consistent deliverable so that when somebody goes to a massage therapist, they can at least get a minimum standard.

KM: Hundreds of CE specialties are taught, all these different, branded systems of bodywork. At times it seems like that could further dilute any semblance of consistency. What do you think about that?

RS: Well, a couple of things. One, there’s all those things in chiropractic too. They’ve got all their different types of things that they do. They have different teachers, but they’re all chiropractors.

None of them are saying, “Oh, I’m not a chiropractor. I am a Gonstead,” or “I’m not a chiropractor. I’m an activator practitioner.”

No. They’re chiropractors, and they do these various things, but they’ve all got a foundation of chiropractic. While some chiropractors advertise particular techniques, for the most part, the number-one thing they advertise is that they’re a chiropractor.

The public doesn’t understand all the different names, all the terminology, but they understand terms like sports massage, medical massage, maybe orthopedic massage, things like that that make sense to somebody—or relaxation massage, stress reduction, relaxation, nurturing, those things that the public can understand.

And we’re all massage therapists.

KM: Why and how did you become a massage therapist?

RS: I was a musician on the road. I stumbled at a party one night, and my back was kind of hurting. Being on the road as a drummer is hard on the body.

This guy said, “I saved myself from back surgery with foot reflexology.”

I said, “A foot what?”

He said, “Take off your shoes.”

And he punched and poked around on my feet. And I’m yelping and hollering and everybody’s laughing.

And he says, “There, now you won’t feel as bad as you should tomorrow morning.”

And I didn’t. I went, “Wow, that was really cool.”

Then [my band went to] Fargo, North Dakota, and kind of the grandfather of massage in North Dakota was a guy by the name of LL Bakke. Across from the bar we were playing was his house. He had this sign out front, LL Bakke Massage. And I was curious about massage now. I called him up one afternoon because we couldn’t practice, we were just hanging out, doing nothing.

I said, “Can I get a massage?”

And he goes, “Well, you’re in luck. I just had a cancellation. Can you get here in 10 minutes?”

I went, “Yeah, I’m just across the street.”

He’s like, “Oh, no, I don’t take anybody out of that bar.”

I go, “No, no, no, no. I’m the drummer in the band, you know, I’m sober, you know, I really want to learn about massage.”

“OK, come on over. I’ll take a look at you,” he said.

I walk over and go into his house and he gave me, still one of the best massages I’ve ever had. I walked out of there barely touching the ground, and I said, “This is better than playing people music. I’ve got to learn how to do this.”

I had a teaching degree in industrial arts, teaching people to work with their hands. Shop, we used to call it. I hadn’t used it, because I never wanted to teach in public schools—but all of a sudden I could be a teacher. I’ve got this degree, and I know how to teach people to work with their hands.

I started teaching for the first massage school in Iowa, and then started teaching continuing ed when I got certified in sports massage. [Readers may explore Stephens’ library of massage CE videos here.]

Ralph Stephens at a continuing education workshop

I just caught the wave and I kept being asked, you know, “Wow, you want to be on the national board of directors? Do you want to do this? Do you want … ?” I’d say, “Sure, I’ll do that too.”

Now I am able to retire. I don’t have a summer home in Aspen or anything, but at least I’m not worried where my next lunch is coming from.

KM: When you think about your career as a massage therapist, do you feel like you did the right thing for yourself? Do you feel fulfilled by what you did with your career?

RS: You know, I was so blessed to discover this profession. It was totally by accident. The profession has been so good to me. It’s been a wonderful career.

KM: What are you doing in your free time now?

RS: Gardening. We just harvested a whole bunch of onions, and are getting ready to plant a second crop of plants for the fall harvest. Playing golf, and I have four grandchildren that live about 30 miles away, so I see them more, which I hardly got to see when I was on the road all the time. Doing more yoga, and just trying to take care of myself as that ticking old man time sets in, you know, it takes a little more maintenance on an old machine.

KM: I really want to hear from your heart, not having to do with education or regulations, what would you say to the new massage therapists starting out? How would you like to inspire them?

RS: Always stay curious. Learn more. Nobody will ever learn all there is to know about the human body almost at any level.

Never stop learning. Find the best people you can find and study with them so that you can provide the best care to your patients.

Also, if you want to help people with massage therapy, you have to get massage therapy. You have to take care of yourself so that you can help others.

There’s so much that soft tissue therapy has to offer people on so many levels of wellness. Remember that it’s such a gift to be able to touch another human being and to help them in ways that only we can.

Because, we’re the ones that spend an hour with them. We’re the ones that can listen to them. We’re the ones that actually touch them. Nobody else does what we do. And it’s so needed. So needed.

You know, I’m still getting massage. And I just took a course in a brand new technique.

KM: You’re never really going to stop, are you?

RS: No, because how do you stop doing what you love to do? That’s another thing. Never has there been a day that I haven’t loved doing what I do. I’ve loved every aspect of this profession. What a great group of people I got to work with.

Being able to publish and work with MASSAGE Magazine was a great honor for me, as was the fact that I got to work with Massage Today and write for them for so many years and say whatever I had to say.

It’s just been such an amazing journey that I’m so grateful for.

Karen Menehan

About the Author

Karen Menehan is MASSAGE Magazine’s editor-in-chief – print and digital. Her articles for this publication include “This is How Diversity, Equity & Inclusion Practices Make Business Better,” one of the articles in the August 2021 issue of MASSAGE Magazine, a first-place winner of the national 2022 Folio Eddies Award for editorial excellence.