Massage therapist Kimberly Pucka enjoyed taking in-person continuing education (CE) two to three times annually throughout her 28-year career. Then came COVID-19 and the attendant shut-down of almost everything in early 2020.

That year and during 2021, CE providers carried on with their pivot to online courses, especially as state boards of massage suspended in-person CE requirements. Now, in 2022, massage therapists and educators alike are eager to get back to in-person technique education.

Yet, the past two years have provided the opportunity for CE providers to hone their online offerings, and many educators and therapists have embraced the opportunity to offer a hybrid model of education than this field has ever seen. What's become clear, say providers, is in-person and online education can, for many modalities, not only coexist but work effectively in tandem better than ever; however, some portions of massage education require in-person learning.

"I am very much looking forward to in-person education in 2022," said Pucka, who practices in Lafayette, Indiana, and who plans on attending three in-person CE weekends this year. "I just don't get the same results from [online CE] as I do when I attend in-person education. Life at home and work does not allow me to focus. Reading or watching a screen for hours is not my thing. When I practice a technique I don't really know if I am doing it right or not. I get up from my chair and I feel drained."

The challenges Pucka has with online education are not unique to her; many massage therapists and educators say that in a field that's all about human connection and hands-on work, to really get it, most massage technique education needs to take place in person, for several key reasons.

The In-Person CE Advantage

While classes in business and ethics can easily be consumed online, massage therapists and CE providers alike say that benefits of in-person technique education include receiving feedback from an instructor, connection to fellow students, and the embodied understanding of a modality or technique that can come only from placing one's hands on a fellow human.

"The biggest boost in effectiveness that I've seen from in-person courses is the ability to physically touch each other, creating a deeper emotional bond between the provider and the students that enhances learning and retention," said educator Irene Diamond, RT, who created Active Myofascial Therapy—The Diamond Method.

That connection within a classroom can keep students motivated to stay focused on learning, whereas sitting at home in front of a computer, it's easy for a student to walk away or get distracted "with no ability for the teacher to rein them back," said educator Jimmy Gialelis, owner of Advanced Massage Arts & Education.

With in-person education, the educator, too, can offer touch in the form of correcting hand placement, body mechanics and use of tools—fine-tuning that can't happen online.

"Over the years we have seen the results of online cupping training," said educator Shannon Gilmartin, co-owner of Modern Cupping Therapy Education Company, "and unfortunately the results are predominantly negative—oftentimes harmful results like inappropriate suction pressures, soft tissue damage and oversights of common contraindications."

Cupping therapy educator Jesse MacLean, sitting director of the International Cupping Therapy Association, said her organization's educators need to be able to see inside the suction cups and observe such changes in the skin being worked on as color changes, mottling, tissue morphing, odors, discharge and emotional reactions. "We then educate the student on what they are seeing, how to interpret the changes in relation to the patients' constitution and presenting condition, and how best to alter, if necessary, current and future cupping dosages for patient comfort and optimal outcomes," MacLean explained.

Although some technique educators require solely in-person education, some other CE providers say portions of education can be presented effectively online, which brings us to the new model of hybrid massage education.

The Hybrid Model

One silver lining the pandemic generated was being presented with the challenge of figuring out how to make computer-based education work well, said David Lobenstine, owner of Body Brain Breath CE. Lobenstine began creating on-line courses in 2018 and said he's been pleasantly surprised by the effectiveness of online instruction. "I definitely accelerated my course creation during the pandemic because I couldn't do anything else," he said. "I realized that while the classroom will always be my first love, it is also amazing to be able to connect with fellow therapists online and teach people wherever they are."

Educator Thomas Myers, owner of Anatomy Trains Structural Integration, believes future massage CE classes will be hybrid in-person/online offerings, and said that his company has already launched hybrid education. "You can take some of our courses online for partial credit to fulfill CE, but you haven't completed the course for our records until you have done the in-person portion," Myers explained. He is one of countless educators who turned to increased online course development during the pandemic to keep students engaged—and to stay in business.

"[In 2020] all our activity stopped dead," said Myers. "In order to survive, we needed to do what everyone else was doing, go online. In the process, I have learned a lot about what works online and gained significant respect for what can be taught online, with a bit of imagination."

Although more can be taught online than he initially assumed, Myers feels that online education is "still a distant second-best to having your hands on the body, being able to feel what the student is doing, hearing their breath, the essence of teaching touch that requires presence."

Still, innovative CE providers have created online education that better meets the needs of massage CE students than it did pre-2020.

Educator Michelle Roos, co-owner with her husband, Paul Kohlmeier, of Cupping Canada and Cupping USA, said this is in no small part due to students' preference. "Our feedback has been that many students prefer live [education] online as there is more direct time with the instructor and they can hear all questions asked and answered," Roos said. "In a classroom setting the instructor walks around helping each group, and all discussions may not be heard."

And, said educator Til Luchau, owner of Advanced-Trainings.com, "It's now clear to many of us that, with the right learning design, people can learn a lot more online than they do in person, at least in some of the critical aspects of our work—theory, principles, strategizing, clinical decision-making." However, he added, although educators have gotten better at including "the body sense" in online learning, computer-based education cannot completely replace in-person courses.

Some CE providers, like educator James Waslaski, integrated manual therapy and orthopedic massage, are also now using technology within in-person training. "We use two screens to increase retention for visual learners," he explained. "The first screen is to give participants a close-up look at all of the hands-on techniques and the second screen shows the anatomy, physiology and pathology involved in each technique. Combined with supervised hands-on training, we cater to every style of learning by including visual, kinesthetic and auditory learning styles throughout the entire seminar."

Luchau has also created an in-person/technology amalgam in his classes. "We're using hybrid models that give people pre-event previews and post-event reviews of the material they learn in an in-person class," Luchau said. "We're also piping both remote learners and remote teachers into our in-person courses, making it easier than ever to learn together no matter where we are in the world, or how cautious we might want to be around in-person get-togethers."

If you feel cautious about in-person CE due to COVID-19, there are actions you can take to stay safe, which we'll look at next.

Know Before You Go

We are still living in a pandemic; as of mid-May, more than 64,000 new COVID-19 cases were being diagnosed daily, according to the US Centers for Disease Control and Prevention (CDC), and rates of transmission varied widely from state to state. Before traveling to an in-person CE class, you can input your destination into the CDC's "COVID-19 By County" tool to see transmission rates and make an informed choice about masking and social distancing.

No U.S. states mandate mask-wearing any longer, although some departments of health recommend masking up when social distancing isn't possible, and local jurisdictions can implement their own COVID-19-related regulations.

The CE providers we spoke with are following state and local regulations related to live classes, but some CE providers are implementing additional precautions, such as taking temperatures, filtering air, employing rapid tests, requiring students to wear masks, social distancing when possible, and having students present proof of vaccination.

Waslaski said he believes today's massage classroom environment is safer than ever before. "Therapists are taking hand-washing and cleaning the massage-treatment area between clients to a whole new level," he said. "In most cases, medical release forms are being used, tables are being distanced, HEPA air purifiers are being used, temperatures are being taken daily, masks are being used according to CDC guidelines in each individual state, and people are not attending live classes if they feel something that could be as simple as a common cold."

Crystal A. Howard and Mike Hinkle, representatives of the Florida State Massage Therapy Association's conference and the World Massage Festival, respectively—annual conventions usually attended by thousands of people—both said 2022 attendees are encouraged to wear a mask if they feel most comfortable doing so, despite there not being a legal requirement to do so.

If your in-person CE is being held at a massage school, you can call the school to find out what precautions are in place, suggested educator David Weintraub, owner of Bodyworks DW Advanced Massage Therapy. Weintraub also noted that if a live CE class is being held at a multi-function facility, keep in mind the facility's management might have its own requirements.

"Later this spring I'll be teaching for a state chapter that rents out the meeting hall of a senior housing complex," said Weintraub. "Their needs might be more strict than local, city or state regulations, but we will of course, follow their guidance in order to be respectful of the elderly folks living there."

Are You Ready?

Everyone will emerge from their "COVID cocoon" at different rates, depending on their health and inner feeling of safety, said Anatomy Trains' Myers, whose in-class requirements have been changing along with the scientific advice. "For a while we required proof of vaccination, but now we are using instant tests more and more to guarantee the sanctity of the classroom," he said.

"There is no doubt that learning massage is up close and personal, and there is no way to be completely safe without cutting off that presence," Myers said, "but that said, most of your colleagues are as concerned about getting COVID as much as you are, so you are working with a high-awareness, low-risk population generally."

You might be ready to get back to in-person CE, like massage therapist Stefanie Gambino, who over the course of her 17-year massage career had taken in-person CE almost exclusively until the pandemic hit. In late March of this year, Gambino drove from her home in Coram, New York, to a hotel in Long Island, 45 minutes away, to attend a five-day manual lymphatic drainage course, her first in-person class since early 2020.

"I feel there is a place for online, home-study, and live webinar courses, but there are some courses you just need to take in person," Gambino said. "It felt really good to get back in the classroom and meet other massage therapists from my area."

While learning in person again might seem strange at first, your in-person experience might feel just as wonderful, if not better, than it did before the pandemic shutdown, said Gilmartin, "Everyone is so excited to be back in the classroom," she said, "and [to be] sharing with the body-working community as we did before, which is such a huge part of what we do."

Karen Menehan

About the Author

Karen Menehan is MASSAGE Magazine's editor in chief–print and digital. Her recent articles for this publication include "Massage in the Hospital: At Work on the Pain-Care Team" and "As Clients Return, Massage Therapists Vanquish Touch Deprivation."