Gua Sha

Gua Sha is a technique in which a stone tool of quartz or jade is scraped over the skin to reduce muscle tension, fascial adhesions, or stagnant qi. “Gua” means to scrape or rub and “sha” represents the red appearance that comes to the surface of the skin after it has been scrapped. A quick google search of Gua Sha will bring up many extreme examples of what these marks can look like. But do not be alarmed! Typically, the resulting sha is less than a subtle redness in appearance. However, occasionally gentle scrapping will result in a large reaction of sha. As acupuncturists, we view this as a positive release of stagnation (see the TCM section below) and will continue to encourage the sha to emerge. The sensation felt by the patient is often described as “a relief”, “deeply relaxing”, or “enjoyable”. Even when strong sha (redness) occurs, the patient doesn’t perceive the sensation as painful, although to achieve a therapeutic effect it can occasionally be “intense”.

To perform Gua Sha, the practitioner rubs or scrapes along the surface of the skin and either feels for bumpy adhesions or looks for reddening on the surface of the skin. Similar to cupping, the benefits of this can be described from both a Chinese Medicine perspective and a biomedicine perspective. Ultimately, Gua Sha is often used to treat areas of muscle tension, but can also be indicated for treating colds, asthma, allergies and channel pathologies. Gua Sha has been used traditionally for thousands of years and is similar to techniques taught to modern day physical therapists and chiropractors.
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Guasha Tool

Biomedicine:
From a western perspective Gua Sha may be used to release areas of adhesions in the fascia. Fascia is connective tissue, made largely of collagen, that is found throughout the body. Every organ, nerve, vein, artery, muscle and tissue of the body is sheathed in envelopes of fascia. The job of fascia is to support and protect surrounding structures. If range of motion or movement in an area of the body has been limited, fascia often becomes sticky or adhered to itself or adjacent muscle. This can decrease optimal functioning of the muscle and may lead to pain. Frictioning the tissue adds warmth to the underlying fascia and allows it to return to it’s natural gelatinous state, melting away any adhesions that may have formed. Additionally, stroking over an area with a Gua Sha tool increases blood flow, which increases oxygen and healing nutrients brought into the tissue and allows it to effect not only the more superficial muscle, but the deeper structures as well. The scientific name for the redness that occurs is petechia. Petechia is not simply reddening of the skin, but little red dots that appear within the overall reddened area when blood that has been stuck in the tissues is released to the surface through broken capillaries. Remember, blood’s job is to deliver oxygen and nutrients to tissue and remove carbon dioxide and waste from the tissues of the body. If blood is sitting stagnant in the tissues, it isn’t doing it’s job.

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Strong Petechiae reaction from Gua Sha. The client reported no painful sensation and a marked improvement in shoulder tension post-treatment

Traditional Chinese Medicine:
Traditionally, acupuncturists will use Gua Sha to scrape along energetic meridians. Eastern philosophies recognize that factors such as wind, heat, cold and damp become trapped in the exterior layer of the body and cause pain by obstructing the flow of qi and blood in the channels. Where the sha or petechia appears on the skin indicates where qi is stuck or stagnant in the channel. By continuing to scrape the area, the qi is released to the surface and the practitioner looks for symptoms to resolve. Following this theory, Gua Sha may be used for much more than muscle aches and pains. It may also be used to boost the immune system, relieve symptoms of the common cold, increase circulation, and work with balancing psycho- emotional issues.

Treatment:
In our clinic, Gua Sha is incorporated based on the preferences of the patient and the profesional perspective of the practitioner. When indicated, it will be added into an acupuncture treatment and lasts no more than 10 minutes. First, oil is applied to the skin surface and then the practitioner will use a smooth stone tool or Chinese spoon to stroke or friction over the area. The sensation is similar to a very deep massage in that one moment it may be perceived as intense and the next as extremely relaxing. The practitioner will respond to your level of sensitivity and keep open communication. We recommend increasing water intake after a session involving Gua Sha. Water will help reduce the viscousity of the blood so that it can properly nourish and heal the recently worked tissue.

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Subtle redness from Gua Sha. No Petechiae

Referecnes:
The Gua Sha Book by Leta Herbman and Jayne McElroy
Photos provided by The Missoula Meridian