What is Gua Sha?

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  • Written By: Devon Pryor
  • Edited By: O. Wallace
  • Last Modified Date: 06 October 2019
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Gua Sha is a significant technique in the practice of Traditional Chinese Medicine. The name is comprised of the two Chinese characters Gua, meaning to scrape or rub, and Sha meaning sand. This name indicates both the action and the visual result of the practice. Gua Sha includes scraping the skin with the rounded edge of an instrument to encourage the formation of petechiae, red spots on the surface of the skin that resemble sand.

The Gua Sha technique is used medically among practitioners of Traditional Chinese Medicine, as well as domestically among many people from Asia and Indonesia. The technique can be performed using the back of a spoon, the edge of a coin, the rounded edge of a metal cap, or other instruments fashioned specifically for the administration of Gua Sha.

The surface of the skin is lubricated with massage oil, and the instrument is pressed firmly down onto the skin above a muscle. The instrument is then used to rub or scrape firmly along the length of the muscle, or along the acupuncture meridians of the body, in quick strokes of about 5 inches (12.7 cm) in length. The objective is to create friction through the rubbing motion, causing blood to evacuate the capillaries. This causes the appearance of Sha, or petechiae, which fade within a few days.


The markings of Gua Sha do not indicate injury to the body. This appearance on Sha should not be confused with rupture of the capillaries, as in bruising. Rather, the appearance of the Sha marks on the skin indicates that there had been a stasis in blood in that location of the body. In fact, the color of the Sha marks may indicate the nature and severity of blood stasis within the body. For example, darker Sha indicates a more long-standing congestion of blood and energy.

The Gua Sha technique is designed to promote free flow within the body, and is often associated with the concept of Qi, the Chinese word indicating energy or circulating life force. When stagnant blood evacuates the capillaries due to Gua Sha, new blood must replace it. The old blood, once it has exited the capillaries, must be re-assimilated by the body, resulting in metabolic filtration. In other words, the area of the body which was experiencing stagnation is delivered a fresh supply of blood, and the old blood is cleaned up, and recycled by the body.

Since Gua Sha is essentially a treatment designed to correct stagnation and promote the free flow of Qi and blood throughout the body, its indications vary widely. Gua Sha is used to treat fever, fatigue, poor circulation, respiratory afflictions, muscle and tendon injury or soreness, digestive disorders, even gynecological and urinary disorders.

Gua Sha, like most techniques in Traditional Chinese Medicine, has been used for decades to treat and prevent illness and discomfort. Unfortunately, like other techniques in Traditional Chinese Medicine such as Cupping, Gua Sha is widely misunderstood in the West. Both Gua Sha and Cupping result in markings resembling rash or bruising. These marks are often mistaken as a sign of physical abuse, as they are clearly visible, and appear to be painful. The marks from Gua Sha, however, are completely painless. Unlike bruising, Sha fades quickly and does not indicate that the Gua has caused bodily injury. If anything, Sha markings on the body should indicate that the individual was previously experiencing illness or discomfort, and is feeling much better.


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Can cardio exercise help to prevent blood stasis within the body?

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