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By Megan White, RMT

4 Minute Read

What is Gua Sha? You may have heard of it, or seen someone else take advantage of its benefits. But what are those benefits? Traditionally, it has been used for thousands of years and was used to treat people when they weren’t able to make it to a doctor.

Gua Sha originates from China. It is a scraping technique using tools to scrape over the skin, with lotion or oil, to help release fascia and soft tissues. When the tools are scraped over the skin a mild inflammation response is triggered. That inflammatory response is called hyperemia. Hyperemia is new, oxygen-rich, nutritious blood.

Detail of neck showing redness after gua-sha acupuncture treatment
So how do manual therapists use gua sha in their treatments to benefit the patient? While every therapist has their approach to treatment and the tools they use can differ, the technique is all the same. Warming the tissues using lotion or oil is essential, then tools are scraped over the skin in a long, quick, and light motion to start with pressure gradually increasing if tolerated.

Three different amounts of pressure are used to treat soft tissue dysfunctions. Light pressure is used to just bring that nutrient-rich blood to the area, this is good for patients that do not like a lot of heavy, deep pressure. Medium pressure is the most commonly used and is what should be used in most treatments. The medium pressure brings the blood to the area, decreases scar tissue, and can decrease muscle tension in more superficial muscles. Deep heavy pressure can be applied in more difficult cases when there is intense or very deep muscle tension, this can be uncomfortable and a great deal of communication needs to be had between the therapist and patient to ensure they are okay and no damage is inflicted.

Massage with medical metal massager
The scraping is applied to the skin over soft tissue dysfunction. This breaks up scar tissue and adhesions, allowing the muscles and fascia to be separated. Separating the muscles and fascia allows them to lengthen and heal. When scraping the tools over the skin it is possible that the skin with show petechiae with hyperemia. Petechiae is when small blood vessels in the skin called capillaries to break in response to the scraping. This is normal and usually happens when the soft tissues are particularly dysfunctional or have more scar tissue and adhesion preventing them from fully healing. The petechiae, while normal and nothing to worry about, usually leads to a superficial bruise that can be tender to touch for a day or two after treatment. The healing time of the petechiae differs individually depending on the patient’s healing and the intensity of it. Even with the superficial bruising being tender to touch, the muscle and soft tissue underneath generally will feel better than before.

There are many types of tools that can be used in a gua sha treatment. They are made from different materials, such as stone; including jade, quartz, and amethyst. Tools can also be made from stainless steel, titanium, horn, and wood. They come in many shapes and sizes depending on the area being treated and the preference of the therapist.

Selection of Gua Sha bone acupuncture tools
Incorporating gua sha scraping into a manual therapy treatment, like a massage can greatly benefit many different soft tissue conditions. Tendinitis, pulled or strained muscles, carpal tunnel, and plantar fasciitis all benefit from gua sha therapy because the scraping can decrease the tension in the muscles, as well and decreasing the scar tissues and adhesions that develop during the healing process. A lot of scar tissue will form during the healing process and it doesn’t always lay down in the correct place. Scar tissue can and will lay down in many different directions and the gua sha scraping will break away the scar tissue that formed incorrectly. This allows the tissues involved to return to their normal range of motion and continue to heal properly.

After receiving treatment with gua sha included it’s likely that a patient will feel more tired than just a treatment without it. A lot of fluids are moved around with the gua sha, like blood and lymphatic fluid, this causes the body to feel more tired than a regular manual therapy treatment would. Following the gua sha treatment, it is suggested to use a cool pack to the areas because of the mild inflammation response that the scraping causes.

Gua sha can greatly benefit many different soft tissue dysfunction, however open communication is very important and if the scraping is not tolerated, let your therapist know.