Understanding Scope of Practice in Massage Therapy (Texas)

Suzan D. Walker LMT 104331
4 days ago
3 min read

Weathered Texas flag close-up, featuring a white star on blue and cracked red and white stripes. Rust stains visible, adding a vintage feel. — As a Texas State Licensed Massage Therapist, I follow the professional standards and laws that define what we can and cannot do in the scope of massage therapy.

I often get questions about what is and isn’t within the scope of massage therapy in Texas. With so many new techniques and trends circulating online, it can be confusing to know what a licensed massage therapist can legally and safely do. I want to take a moment to clarify what services I provide, what’s outside of my scope, and why these boundaries are important for your safety and well-being.

This office does not provide Clear Path Massage (uterus massage), Fundal massage, prostate massage, detox massage, physical therapy, psychology or chiropractic adjustments.

As a Texas State Licensed Massage Therapist, I follow the professional standards and laws that define what we can and cannot do in the scope of massage therapy. These standards exist to protect both the client and the therapist and to ensure safe, ethical, and effective care.

There are certain areas and techniques that are outside of the massage therapy scope of practice in Texas. For example, prostate massage or internal uterine massage are not allowed for massage therapists. Some new techniques, such as Clear Path or fundal massage, may claim to work internally with reproductive organs, but those are not permitted for licensed massage therapists. These types of services must only be done under the direct supervision of a medical doctor and within a qualified medical professional’s office. In some cases, a nurse or medical professional who is also licensed in massage therapy may be qualified to perform these techniques, but it must be within a medical setting where a physician is available.

While those techniques are not within our scope, we can work with the myoskeletal system and safely address the tendons, ligaments, muscular system, lymphatic system, and nervous system. These systems are an important part of therapeutic massage and structural bodywork.

It is also important to clarify that we do not work on private areas. However, we can perform structural massage near the groin area when it is appropriate for addressing muscle strain, injury, or imbalance. The groin area is often misunderstood as sexual, but in massage therapy it is treated as a structural region of the body that can experience tension or injury, just like any other area. Many women, including myself in the past, have experienced groin injuries, and there are safe, professional techniques to help release tension and restore function without crossing professional boundaries.

There are also techniques to address the coccyx (tailbone) area that do not involve internal work.

Note on Scope of Practice for Cosmetic and Post-Operative Clients

Massage therapists do not handle or work with bodily waste of any kind. This includes managing surgical drains, wound care, or any type of post-operative fluid drainage. These procedures are outside the scope of massage therapy practice and must be handled by a qualified medical professional.

For cosmetic and post-operative clients, this is one of the reasons why I require that all drains be removed before your massage appointment. My focus as a licensed massage therapist is on supporting your recovery safely through gentle lymphatic and structural work—only after your physician has cleared you for massage. This ensures your health, safety, and the best possible healing outcome.

If you are reading this, please know that I do not perform any sexual services of any kind. Communication is extremely important before and during your session so that we both understand your needs and maintain clear professional boundaries at all times.

If you have any questions before booking your appointment, please reach out. I am happy to explain what services are available and what techniques are best suited to help you safely.

With care and Support,

Suzan (Susan) Walker LMT

Massage therapy is not a substitution for medical treatment. The massage therapist cannot diagnose, treat or prevent disease. The therapist can only recommend products and services. Please consult a medical physician for further treatment.