TL/DR: In 1915, Ohio's Platt-Ellis Act made massage a licensed branch of medicine, and in January 1916 Agnes Bridget Forbes of Dayton became one of the first state-licensed massage therapists in the country. That medical framing gave Ohio therapists a legitimacy few states could match. But the same distinction that defined the profession — massage as treatment of the body — left "relaxation" massage outside state licensing entirely, a gap that now fuels an estimated 300+ illicit massage businesses across Ohio. Efforts to close it have stalled for years, while therapists still can't bill insurance and still pay sales tax on their work. And in 2026, rather than closing that gap, the profession's advocacy energy went toward pulling Ohio out of the national massage compact and into a second, competing version — making Ohio the first and only state to adopt it, and splitting the profession in two. This is the story of how a century of hard-won legitimacy left Ohio massage both a pioneer and, today, strangely stuck.
History of Massage Licensing in Ohio
Ohio holds a distinctive place in the history of American massage therapy. Unlike any other state, massage in Ohio was — and for most of the twentieth century remained — a legally recognized branch of medicine, practiced under the direct jurisdiction of the Ohio State Medical Board. This gave Ohio massage therapists a form of legitimacy that practitioners in other states did not enjoy, yet now in 2026 they still lack the ability to bill health insurance (like WA State has had since 1996) and they still have to pay sales tax on services except if the client has a prescription for massage.
The 1915 turning point
The story begins in the late 1880s, when Ohio, like most states, attempted to crack down on “quacks and charlatans.” Only medical doctors were licensed to practice medicine, but pressure from other bodyworkers — osteopaths (licensed in 1902), then chiropractors — set off a slow chain of legislative events. Rather than handle each profession separately, Ohio’s legislature crafted a bill (The Platt-Ellis Act of 1915) covering a whole range of practices: chiropractic, massage, naprapathy, neuropathy, magnetic healing, chiropody, and more. These were treated as respected “limited branches” of medicine, each required to seek licensure from the state medical board.
The bill was signed into law in June 1915. Afterward, the Ohio State Medical Board created a Limited Branch Committee to oversee the new branches. In November 1915, the first licensing examinations were administered — Agnes Bridget Forbes of Dayton, Donald B. McDougall of Cincinnati, and others became among the first known state-licensed massage therapists in the entire United States.
In January 1915, the board had defined massage simply as “systematic friction, stroking, slapping, kneading, tapping, or manipulation of the body for therapeutic purposes.” The original scope of practice, effective January 1916, was remarkably broad — it permitted medical gymnastics, vibro-massage, helio-therapy (sun exposure), and thermo-therapy. Medical examinations and diagnoses, however, were forbidden.
The historic first state licensing exam for massage was given along with those for other newly licensed branches of medicine. The exams were administered over three days, from 8 AM to 6 PM, November 16 to 18, 1915. The examiners tested 223 candidates, administering 352 exams, because many candidates applied for multiple limited branch licenses. Only 6 of the 11 persons who were tested in massage passed.
However, the legislation signed by Governor Frank B. Willis on May 1, 1915, had grandfathered into licensing anyone who could qualify without examination based on five years of practice before the licensing date. After submitting an application to support that claim, with a fee of $25 (about $600 in 2016, by some reckoning of monetary inflation), a total of 126 people, either examined or exempted, obtained the first state massage therapy licenses effective January 4, 1916. Licensing continued to be processed for others exempted from examination for some time. By August of 1916, Ohio had issued 156 state certificates to practice massage.
AMTA OH Facebook post
Decades as a limited branch of medicine
For many years, Ohio massage therapists operated as bona fide limited medical practitioners, enjoying privileges unavailable elsewhere. Because massage was a recognized branch of medicine rather than a fringe trade, therapists carried a legitimacy in the eyes of the public and government officials that was hard to find in other states. Massage therapy also became the only limited branch of medicine in Ohio that could be practiced without a physician’s prescription.
Because the field already had legitimacy at the state level, there was little incentive to build a statewide massage association according to an article from 1993 in Massage Therapy Journal (below)1. Practitioners worked largely independently, concentrated in the metropolitan areas of Cleveland, Cincinnati, Columbus, Dayton, Akron-Canton, and Toledo. During this era only two massage schools operated in the state: the Central Ohio School of Massage in Columbus and the Buckeye College of Massotherapy in Akron.
The AMTA arrives and chapters form
The American Massage Therapy Association was founded nationally in 1943, in the middle of World War II. As it began forming chapters across the country, Ohio formed its first chapter in 1955, with Thelma Conley as its first president. That early chapter faded, apparently because Ohio’s therapists already had legitimacy through the medical board and felt the national association offered little they needed.
1975–1982: pressures for change
In 1975 the physicians on the Ohio State Medical Board began having trouble acquiring liability insurance for some procedures. This prompted the board to reexamine the scopes of practice for its limited branches. By this time there was a national trend to eliminate or combine limited branches; in Ohio, only chemotherapy, cosmetic therapy, and massage therapy survived as limited branches. Massage’s scope was narrowed to a single definition: “the treatment of disorders of the human body by systematically applied friction, heat, or by stroking, slapping, kneading, tapping or hand manipulation only.”
During this period, a small faction of therapists in northern Ohio began arguing that massage should actually be withdrawn from the medical board’s jurisdiction and placed under self-governance.
On September 13, 1982, fifteen massage therapists from Dayton, Cincinnati, Columbus, and surrounding areas met in Dayton to re-activate the Ohio Chapter of the AMTA. Ruth Ann Hobbs, an AMTA Eastern District Representative, spoke about the benefits of national membership, including malpractice insurance. Arline Mandas was elected the chapter’s first president. By 1983 the Ohio Chapter was organized and operational, with a treasury of about $1,600 and 40 members.
Around the same time, a competing effort emerged: Morton Bissel and others promoted a State of Ohio Massotherapy Board that would move massage away from the medical board to a private board setting its own educational and testing standards. The AMTA Ohio Chapter opposed this move away from the medical board.
The enduring tension over the word “massage”
Throughout this history runs a persistent concern in Ohio about the word “massage” itself, and the different connotations attached to medical versus non-medical massage. The battle to preserve the professional, positive meaning of the term in the public’s eyes was constant, and AMTA-OH repeatedly sought clarification of the definition from the Ohio State Medical Board.
Ohio’s history is genuinely unique because massage was licensed as a legitimate branch of medicine starting in 1915, Ohio therapists operated under an entirely different form of legitimacy than their counterparts anywhere else in the country — a heritage the author dates back over 78 years from the 1993 writing.
During the 1950s and early 1960s, Ohio occupied a unique and somewhat ambiguous legal position in the national landscape of massage regulation.
1. The Legal and Regulatory Paradox
Unlike states with explicit statutory “Massage Acts,” Ohio had no statutory law specifically regulating the practice of massage on its books. Instead, the Ohio State Medical Board had established rules and regulations governing “limited practitioners” under the State Medical Practice Act for Physical Therapy (under the supervision of the State Board of Medical Education and Licensing).
Under Section 3 of these Medical Board regulations, the state formally listed “Massage and Swedish movements”. To practice legally under these board rules, a practitioner was required to meet the following standards:
Completion of at least an 8th-grade education.
Completion of a course of study covering an instruction period of not less than one year.
Passing a formal licensing examination.
The Enforcement Loophole: Because there was no specific statutory massage law in Ohio, unlicensed practitioners could theoretically face prosecution under the general Medical Practice Act for “practicing medicine without a license”. However, the newsletters noted a major legal gray area: practicing medicine legally implies diagnosing and prescribing treatments—activities that massage technicians did not perform. Consequently, the association pointed out that it was highly unclear how enforcement of these rules could actually be legally sustained, and they had heard of no active prosecutions in the state.
2. Active Association and Chapter Growth
Despite the legal gray areas, Ohio had an active and highly dedicated community of professional practitioners:
100% Paid Membership Milestone: For the 1953–1954 association year, Ohio was celebrated as one of the very first states to achieve 100% paid-up membership for all its registered members, demonstrating a highly organized local base.
The Ohio Chapter of the A.A.M.M.: The Ohio State Chapter held its second official meeting in September 1955. Led by President Conley and Secretary-Treasurer Kinsinger, the chapter deposited its $68.00 charter check from national headquarters into the Huntington National Bank of Columbus, establishing a total chapter treasury of $77.00.
Cross-Border Networking: In 1959, Blandie Jones of Pennsylvania (one of the association’s most prominent legal advocates) traveled to Columbus, Ohio, to attend the 10th Annual Convention of the National Athletic Trainers Association.
3. Approved Massage Schools in Ohio (1960)
By March 1960, the national association officially recognized and approved two major Class A educational institutions in Ohio for professional training:
Dayton School of Physical Therapy: Located at 3 N. Williams St., Dayton, Ohio. Directed by Dr. R. H. Pedicord, it offered a 12-month residence course for $300.00.
Great Lakes College & Clinic (Mechanotherapy & Medical Massage): Located at 1900 Superior Ave., Cleveland, Ohio. This program required 744 hours of study plus 150 practical treatments, with tuition priced at $50.00 per month.
Massage Today in OH.
The very framing that gave Ohio massage its historic legitimacy has, a century later, produced an unintended vulnerability. Because Ohio anchored licensure to massage as the treatment of the body — a limited branch of medicine — anything falling outside "treatment" has always sat outside that jurisdiction by definition. Today the State Medical Board of Ohio confirms that "relaxation massage" is not even a term in Ohio law; it is simply how the public describes non-therapeutic work, which requires no state license at all.
Medical massage, also known as massage therapy, is done for purposes other than relaxation. If you will offer massage therapy, you must be licensed as a massage therapist by the State of Ohio Medical Board. Contact Ohio’s State Medical Board at (614) 466-3934 or http://www.med.ohio.gov/mt_about_massage_therapy.htm. [] Non-medical massage is simply for relaxation. Non-medical massage does not require state licensing. However, it is often regulated locally. Contact your local city or municipal officials. OH checklist
That distinction, a direct inheritance of the 1915 medical model, is now the very gap through which illicit operations move. A University of Dayton human rights report described the problem plainly: Ohio uniquely licenses therapeutic massage through the medical board, yet non-therapeutic "relaxation" massage operates with nearly zero oversight, a loophole that has fueled the spread of illicit massage businesses exploiting primarily foreign workers2.
In other words, the very distinction that secured Ohio massage its medical legitimacy in 1915 — the line between “treatment” and everything outside it — is now the seam through which exploitation enters. The report’s authors call for closing that seam by requiring all who perform massage in Ohio to be licensed, empowering townships to regulate massage establishments, and pairing enforcement with victim-centered services and de-stigmatizing language — reforms aimed at protecting both the vulnerable and the good name of a century-old profession.
The scale is not trivial — that report from 2021 estimated roughly 300 such businesses in Ohio, and state officials, including the Attorney General's human-trafficking task forces that raided four parlors in August 2025, have described these fronts as a growing problem hidden in plain sight among legitimate practices. The tension over the word "massage" that ran through the profession's entire twentieth-century history has thus never been resolved so much as relocated: what was once a battle to distinguish medical dignity from disrepute is now a battle to keep the profession's hard-won name from being used as cover for exploitation.
AMTA OH was working on efforts to end that loophole finally in 2019 but without success3. As of its Spring 2025 update, AMTA-OH reports that the American Massage Therapy Association is not currently pursuing legislative changes in Ohio, having shifted its strategy toward education and awareness. The chapter, working with the national organization, said they would be holding a series of “Legislative Listen and Learn” events at six colleges and universities with massage programs — inviting lawmakers to tour classrooms and simulation labs, meet students and educators, and hear directly from licensed therapists about the rigor of their training. The aim is to build the legislative understanding that earlier bills lacked, laying groundwork for a future push rather than forcing one now.
That makes the present moment a quieter chapter in a century-long story — not a fight on the House floor, but a slower campaign to convince lawmakers, one classroom tour at a time, that licensure is what separates a healing profession from a criminal front. I have not seen any evidence of these events happening in OH.
"Of all the problems facing massage in Ohio — an unclosed loophole, illicit businesses operating in plain sight — the resources spent this year went not toward those, but toward creating a second, competing interstate compact. That choice deserves scrutiny4. Whatever the intent, the effect is a profession split in two. A functioning compact requires seven member states; now there are two compacts, each needing to reach that threshold separately. Rather than one pathway for license portability, therapists face two incompatible ones — and the profession's limited advocacy capital is spent building a parallel structure rather than closing the gaps that endanger the public.
The Facebook posts on the AMTA-OH page and the AMTA National Page show the confusion and lack of transparency around what this really means. The comments were more concerned now about having to take CE classes and most missed the point about how they overrode the Original Compact Bill with inaccurate testimony
This isn’t even about the compact anymore and we can disagree about which version of the compact is better drafted. What is harder to defend is the choice to spend the profession's limited advocacy capital pulling one state out of a national agreement and into a parallel one — while the loophole that lets untrained hands operate in trafficking fronts remains, a decade of newsletters later, exactly where it was.
Update Aug. 19, 2026 — A story on linked caught my attention.
Ohio's newly proposed H.B. 744 (and bill analysis) is intended to combat human trafficking and illicit massage businesses by increasing oversight of massage establishments and tightening requirements concerning who may legally provide and advertise massage services. The goal is understandable, but it raises a larger question: Why does the solution to a sex-work and trafficking problem keep becoming more massage regulation?
Ohio's proposed H.B. 744 may finally address one of the most troubling weaknesses in the state's massage licensing law. By removing the requirement that massage therapy be performed for the "treatment of disorders" and defining it instead by the techniques being performed, the bill could largely close the loophole that has allowed unlicensed people to offer what they call "relaxation massage." It even specifically addresses advertising for "relaxation massage" and other massage methods. That is an important step toward making a massage license actually mean something. But the bill also preserves an old and questionable system in which townships can impose another layer of regulation on massage therapists who are already licensed by the State Medical Board, including local licensing, fees, police investigations, fingerprints, and even physical examinations for communicable diseases. If Ohio is going to modernize a massage law rooted in 1915, this is an opportunity to do more than close the relaxation-massage loophole. It is an opportunity to ask why legitimate massage therapists should continue to carry regulatory burdens created largely because massage therapy has been used as a cover for commercial sex and illicit businesses.
Don’t you think?
DISRUPTING ILLICIT MASSAGE BUSINESSES AND HUMAN TRAFFICKING IN OHIO Tony Talbott Bailey Johnson Ahmi’ Moore Jennifer Sobnosky OCTOBER 2021
FSMTB’s Statement: https://fsmtb.org/2026/07/08/ohio-no-longer-connected-to-the-impact/
OH Bill tracker - https://www.legislature.ohio.gov/legislation/133/sb105
https://www.legislature.ohio.gov/legislation/136/sb276/committee
AMTA’s testimony on the bill from Jada Thompson and testimony from NCBTMB president Christopher Deery claiming that there are NOT two compacts when indeed there are two compacts.
AMTA also wishes to clarify that there are not “two competing versions” of the compact. Rather, there is a single interstate compact undergoing appropriate legislative refinement—a standard and necessary part of the legislative process. Interstate compacts are statutory instruments, and legislatures retain full authority to amend and improve the language before a compact commission is formally established. These revisions are consistent with how professional practice acts are routinely updated to improve clarity, strengthen oversight, and address unintended consequences.
AMTA states clearly on their website that there are two compacts.
