Fit, Phat and Farting
By Aran Bright
Remedial Massage is a funny old place these days. We are all trying to find our groove amongst an ever-changing environment of health funds, science, politics and general confusion about what a massage therapist even does. To assist you in the process of finding your groove, may I present the FIT, PHAT and FARTing model of massage therapy.
(Special mention to Mikey Robins, who first coined the phrase. I can only assume he spells phat with a “Ph”, and quite frankly it suits our purposes to spell it this way, as you will soon see.)
Let’s break it down…
FIT in this context isn’t actually about tight buns or ripped abs, but instead an acronym to rephrame how we can perform testing:
Instead of complex range of motion testing designed to find flaws in human beings, let’s start by asking a couple of simple questions:
“G’day! How can I help?”
“Are there any movements you are having trouble doing, and if so, can you show me?”
FIT means ‘let’s investigate functions that our clients are having trouble with in real life’. This could include:
- Turning your head
- Being able to sit for long periods
- Getting dressed
- Putting on shoes
- Doing cartwheels
- Painting and plastering a ceiling.
If your client is having trouble with a movement, then ask them to show you. The simple question, “Can you point or touch and show me where it is bothering you?” is a great way to clarify where they are feeling their symptoms.
The key point here is to let them tell their story, let them feel in control of the interaction by listening intently rather than dominating the space as a therapist. Science is telling us to move away from therapist-led approaches and, in my opinion, good listening is paramount to good quality service.
Clarify Client Function
At this point, you have established your target functional movement, as determined by your client. Once this is clear, you could investigate further by breaking it down into more localised ROM testing … or not.
What if someone doesn’t have a functional problem and they are just looking for a relaxing massage? Then don’t worry about it, let the client inform you what they are looking for in their massage and get started. Worried about health funds? Then sure, include a palpation assessment or quick cervical ROM, but just keep it to the point and meet the needs of the client.
PHAT is another acronym:
There are as many ways to perform massage as there are massage therapists. This is something that should be embraced – perform your techniques in a way that feels good for your body.
The PHAT method is simple and best explained face-to-face, but the principle is as follows:
- Palpate the target tissue
- Position the body in such a way as to achieve maximum relaxation of the target tissue
- Hold that position and wait for a softening of the tissue
- Adjust the client position to achieve further relaxation
- Give the client time to relax further.
Repeat the process until a noticeable change in symptoms is achieved.
The PHAT concept is to break the habit of forcing tissue to release. For whatever the reason, this is a concept that is so ingrained in the psyche of massage therapists and the community as a whole, it will probably never go away. But it is not necessary for massage therapists to rely on pressure to see decreases in muscle tone. Instead, we just need to send the right signals to the client’s nervous system to trigger a relaxation effect.
There are numerous methods that use this principle: strain-counter strain, positional release, indirect myofascial technique, Onsen technique, orthobionomy, progressive relaxation, the list goes on. The point is that we can use positioning of the client to facilitate relaxation and apparent softening of the client’s tissue without the need of force or pain.
In this case, farting is not the favourite past time of pre-pubescent males, it stands for:
Range of Motion
This can take the form of passive stretching, muscle energy, yoga, Pilates or whatever form of mobility training you – or more importantly, your client – may prefer. This approach, combined with the PHAT methodology allows the client to experience movement with the “guards down”. Hopefully, through the process of massage and relaxation, the client can find fluid safe movement, and learn the tools to maintain this in their own time.
The FIT, PHAT and FARTING approach is designed to help improve or maintain client function. The acronyms are there to help you keep in mind what you need to focus on at any stage of a massage treatment, assuming that the client has functional goals in mind. For the most part, massage therapy is an effective form of pain management to assist with symptoms of musculoskeletal pain and injury.
If we want to explore improving or maintaining function, then there are ways to do this that don’t involve using heavy pressure to achieve functional outcomes.
*Fit, Phat and Farting is an introduction to the Functional Release Technique workshop Aran is presenting at the 2019 AMT Conference in November. It promises to be 2 days of practical learning for those lucky people enrolled in Aran’s workshop.*
About the Author
Aran Bright started his career as a massage therapist in 2002 after graduating from the Australian College of Natural Medicine in Queensland. In 2006, Aran completed his Diploma of Remedial Massage and, in 2007, his Bachelor of Health Science in Musculoskeletal Therapy. Aran graduated from University of Queensland with a Graduate Certificate of Sports Coaching, completed a Certificate IV in Fitness and an Advanced Diploma of Myotherapy. He currently runs his own businesses, Bright Health Training and Brisbane Workplace Massage, with his wife, Sheree.