As a manual physical therapist, I’m always looking for new ways to work with the body and was recently introduced to gua sha, a 2000-plus year old Chinese medical treatment involving scraping the skin with a spoon or a coin. Gua sha originally used either a spoon or a coin in order to scrape the lubricated skin in one direction in order to free the chi stuck in an area, such as the lower back, neck, shoulders, thighs, etc. I’ve been told this was often performed at home by grandma, who would just pull a soup spoon out of the kitchen drawer or a coin out of her pocket and perform gua sha on someone. It is highly effective and has evolved a bit in modern times.

What is happening when we perform gua sha? The skin is lubricated, and the tool of your choice is applied to the skin. With gentle pressure, you scrape the skin in one direction repeatedly. What I am looking for is some redness, possibly even a little bruising in the area. Don’t worry, the bruising is mild and does not last long, no more than in cupping. Using a more Western medical model, what is happening is the fascial layers are stuck in that area. When tissue is tight, it does not get good blood flow. Without good blood flow, the tissue can’t get nutrition, nor can it get rid of its waste products efficiently. This is often associated with inflammation in the area. When we apply pressure with a gua sha tool and scrape the skin, we are creating a “wave” in front of the tool, giving the fascia, skin, and muscle tissues a little stretch, which can be enough to free up anything stuck under the skin. The bruising is a good thing because it tells us that the area was indeed stuck, and we have restored the blood flow to that area, therefore reducing pain and inflammation while also restoring normal function.

Chinese medicine believes different materials vibrate at different frequencies and have different energetic properties which will impact the stuck chi in varying ways. This may not be far from the truth. Tools of different materials have a different feel when performing gua sha, and it is the vibration created by the tool with the tissue. I have a set of tools made from jade that feels different than tools made of lapis or even steel. Steel tools (also known as Graston blades) were made popular in the physical therapy world a few years ago with custom blades for various parts of the body. The Graston technique was developed in 1994 and shares a lot of similarities to the 2000-plus year old gua sha technique, with similar effects but different rationales for doing it. Like dry needling in physical therapy versus acupuncture: same tools, different rationale and application.

Personally, I have a set of gua sha blades made of jade, which give good results, but recently acquired a set of heated stones made of Himalayan salt. Some of them have more iron to give them a darker color but also retain the heat more than my pink stones. Can you imagine how luxurious it will feel to have gua sha with heated Himalayan salt stones?