Sports Gua Sha at PRO Massage

What is Gua Sha?

Gua sha is the practice of using a tool to apply pressure and scrape the skin to relieve pain and tension. This action causes light bruising, which often appears as purple or red spots known as petechiae or sha. The name gua sha — pronounced gwahshah — comes from the Chinese word for scraping.

Gua sha is a natural, alternative therapy that involves scraping your skin with a massage tool to improve your circulation. This ancient Chinese healing technique may offer a unique approach to better health, addressing issues like chronic pain.

In gua sha, a technician scrapes your skin with short or long strokes to stimulate microcirculation of the soft tissue, which increases blood flow. They make these strokes with a smooth-edged instrument known as a gua massage tool. The technician applies massage oil to your skin and then uses the tool to repeatedly scrape your skin in a downward motion.

Gua sha is intended to address stagnant energy, called chi, in the body that practitioners believe may be responsible for inflammation. Inflammation is the underlying cause of several conditions associated with chronic pain. Rubbing the skin’s surface is thought to help break up this energy, reduce inflammation, and promote healing.

Gua sha is generally performed on a person’s back, buttocks, neck, arms, and legs. A gentle version of it is even used on the face as a facial technique. Your technician may apply mild pressure, and gradually increase the intensity to determine how much force you can handle.

What are the benefits of gua sha?

Gua sha may reduce inflammation, so it’s often used to treat ailments that cause chronic pain, such as arthritis and fibromyalgia, as well as those that trigger muscle and joint pain.

Gua sha may also relieve symptoms of other conditions:

1. Hepatitis B

Hepatitis B is a viral infection that causes liver inflammation, liver damage, and liver scarring. Research suggests that gua sha may reduce chronic liver inflammation.

One case study Trusted Source followed a man with high liver enzymes, an indicator of liver inflammation. He was given gua sha, and after 48 hours of treatment, he experienced a decline in liver enzymes. This leads researchers to believe that gua sha has the ability to improve liver inflammation, thus decreasing the likelihood of liver damage. More research is underway.

2. Migraine headaches

If your migraine headaches don’t respond to over-the-counter medications, gua sha may help. In one study trusted Source, a 72-year-old woman living with chronic headaches received gua sha over a 14-day period. Her migraines improved during this time, suggesting that this ancient healing technique may be an effective remedy for headaches. More research is needed.

3. Breast engorgement

Breast engorgement is a condition experienced by many breastfeeding women. This is when the breasts overfill with milk. It usually occurs in the first weeks of breastfeeding or if the mother is away from the infant for any reason. Breasts become swollen and painful, making it difficult for babies to latch. This is usually a temporary condition.

In one study trusted Source, women were given gua sha from the second day after giving birth up until leaving the hospital. The hospital followed up with these women in the weeks after giving birth and found that many had fewer reports of engorgement, breast fullness, and discomfort. This made it easier for them to breastfeed.

4. Neck pain

The Gua sha technique may also prove effective for remedying chronic neck pain. To determine the effectiveness of this therapy, 48 study participants trusted sources were split into two groups. One group was given gua sha and the other used a thermal heating pad to treat neck pain. After one week, participants who received gua sha reported less pain compared to the group that didn’t receive gua sha.

5. Tourette syndrome

Tourette syndrome involves involuntary movements such as facial tics, throat clearing, and vocal outbursts. According to a single case study trusted Source, gua sha combined with other therapies may have helped to reduce symptoms of Tourette syndrome in the study participant.

The study involved a 33-year-old male who had Tourette syndrome since the age of 9. He received acupuncture, herbs, gua sha, and modified his lifestyle. After 35 once-a-week treatments, his symptoms improved by 70 percent. Even though this man had positive results, further research is needed.

6. Perimenopausal syndrome

Perimenopause occurs as women move closer to menopause. Symptoms include:

  • insomnia
  • irregular periods
  • anxiety
  • fatigue
  • hot flashes

One study trusted Source, however, found that gua sha may reduce symptoms of perimenopause in some women.

The study examined 80 women with perimenopausal symptoms. The intervention group received 15-minute gua sha treatments once a week in conjunction with conventional therapy for eight weeks. The control group only received conventional therapy.

Upon completion of the study, the intervention group reported a greater reduction of symptoms such as insomnia, anxiety, fatigue, headaches, and hot flashes compared to the control group. Researchers believe gua sha therapy might be a safe, effective remedy for this syndrome.

Sports Gua Sha

There are a lot of methods a strength athlete can utilize to help them recover. Besides your typical eat well and get a good night’s rest, there are methods that involve soft tissue massage. In the strength and conditioning world, we’re beginning to see older methods (thanks to Instagram) become more Westernized such as cupping and Gua Sha.

More than likely you’ve seen pictures of athletes with the cup imprints and what look like bruised scrapes throughout their body. These scrapes are a result of what’s known as Gua Sha (pronounced Gwah Shah). It’s a form of Traditional East Asian Medicine (TEAM) that involves softly scraping soft tissue with the aid of a tool for recovery purposes, but does Gua Sha have benefits?

How Can Strength Athletes Benefit From This Form of Soft Tissue Therapy?

“When you look at any type of soft tissue modality or manipulation and you look at two windows where it can be beneficial,” states Dr. Rusin. “The first window would be an actual therapeutic benefit, so you have pain alleviation, movement enhancement, and performance enhancement. Those things happen in the pre-training routine, so if you’re working on something like a mobility deficit, then this could play a role in enhancing your mobility, and that’s just one example,” explains Dr. Rusin.

“A more intriguing second window, especially for the fitness population is Gua Sha’s role in recovery. I use it sparingly now, but it’s a way to manipulate bigger musculature, so something like ART or manual manipulation soft tissue therapy is hard to go through something as big and thick as the quad, so Gua Sha allows you to use a tool that literally coerces the muscle and the dermatome over that muscle more importantly. It’s something you can get a little bit more of a quick result from by using broader stroke, so to say,” says Dr. Rusin.


“Healing needs to take place after treatment in order to see the therapy gains. A recommended time-lapse is a minimum two days between Gua Sha therapy sessions, or until the slight bruising has subsided,” states Dr. Peloquin. “Continually damaging a tissue without letting it repair will eventually weaken the tissue and lead to further complications or injury.”

Can Some Strength Athletes Benefit More from Gua Sha Than Others?

Gua Sha could be a useful therapy for pre-workout purposes and recovery. I was curious if certain strength athletes could tell if they’d benefit more with Gua Sha than other therapies. “No, I’m a big believer in everyone’s going to respond differently to different stuff. It’s figuring out which modality you respond best to,” says Dr. Rusin.

“Personally in my practice, I’ve helped multiple groups of strength athletes,” Peloquin explains that whether your focus is heavy lifting or endurance work, then you may benefit from Gua Sha. “The heavy lifters always seem to have grip strength problems due to the static load being endured on their forearms/hands. As opposed to strength athletes who endure repetitive endurance exercises that lead to poor biomechanics as they fatigue. This can create a myriad of biomechanical stressors thus leading to conditions mentioned above.”

Is Gua Sha Safe For Strength Athletes?

The bruising you frequently see on athletes via Instagram videos and photos getting Gua Sha done often looks alarming. My next question involved the Gua Sha side effects that illicit these bruises and if it’s actually normal/safe.

Are Those Red Marks Side Effects of Gua Sha?

Sports Gua Sha
Sports Gua Sha

Dr. Peloquin pointed out that these marks can be a side effect of Gua Sha and it can be normal for some athletes. “There may be some degree of discomfort during the procedure that should resolve spontaneously – within a few days. Some patients may develop mild bruising, which is normal and resolves on its own.”

Dr. Rusin pointed out that a lot of bruising may not be ideal for this style of therapy. “A lot of people don’t know how to use Gua Sha’s tools, because in ancient China they used to use it as a systemic health method. They would literally scrape to the point of bruising through the tissue (red blood cells coming to the surface). They would think that the bruising was what caused systemic recovery.”

“The more science and more research that’s out there show this is not a mechanical process. If you’re going to get Gua Sha done on you, or any form of tool-assisted work and you’re bruising, then there’s a serious problem. That’s not something that’s warranted. People go super hard, way too heavy, and they traumatize the tissue they’re trying to target.”.

“You’re always looking for a result, but if the result is you being purple up and down your IT band, then that’s not what you’re looking for. Softer is often better because we’re trying to elicit a neurological adaptation. There’s no breaking of scar tissue or realigning of sarcomeres, there’s no mechanical processes happening, which a lot of people wrongly state,” explains Dr. Rusin.

What are the Benefits of Gua Sha?

The real benefits of Gua Sha revolve around what’s actually happening with this soft tissue therapy. “What’s happening is a neurological adaptation that occurs from the sensory feedback from the tool going over your dermatomal patterning. There are different nerve roots that come out to the skin, and they control sensory feedback on the skin and the underlying tissues. All Gua Sha is really doing is going over dermatomes and areas with correlations to nerve roots to elicit a relaxed and recovered parasympathetic response from the underlying tissue,” says Rusin.

Dr. Rusin also pointed out the misconceptions people have with Gua Sha. “People think, ‘we’re breaking up scar tissue,’ but in reality, you’re not doing that whatsoever. For example, look at the layers of the skin and how deep those are. You have your cutaneous tissue, subcutaneous, adipose tissue, and then you have the muscle belly. In reality, you’re an inch or two away from the stuff you think you’re breaking up scar tissue on.”

So What’s the Call on Gua Sha Therapy?

Gua Sha has been used as a therapeutic modality for thousands of years, and only recently has it become more popular in the fitness industry. Much like other forms of soft tissue therapy, there’s always an inherent risk with its practice. The risk, as Dr. Rusin states, often comes from those who lack the experience or knowledge to utilize Gua Sha therapy properly.


Sports Gua Sha
Sports Gua Sha


Does gua sha have side effects?

As a natural healing remedy, gua sha is safe. It’s not supposed to be painful, but the procedure may change the appearance of your skin. Because it involves rubbing or scraping the skin with a massage tool, tiny blood vessels known as capillaries near the surface of your skin can burst. This can result in skin bruising and minor bleeding. Bruising usually disappears within a couple of days.

Some people also experience temporary indentation of their skin after a gua sha treatment.

If any bleeding occurs, there’s also the risk of transferring blood-borne illnesses with gua sha therapy, so it’s important for technicians to disinfect their tools after each person.

Avoid this technique if you’ve had any surgery in the last six weeks.

People who are taking blood thinners or have clotting disorders aren’t good candidates for gua sha.

When conventional therapies don’t improve your symptoms, research suggests that gua sha may be able to provide relief.

This technique may appear straightforward and simple, but it should only be performed by a licensed acupuncturist or practitioner of Chinese medicine. This ensures a safe, proper treatment. More research is needed, but there are a few risks associated with this massage technique.


Gua sha is most often used to relieve muscle and joint pain. Conditions of the muscles and bones are known as musculoskeletal disorders. Some examples include back pain, tendon strain, and carpal tunnel syndrome.

Practitioners claim that gua sha can also benefit the immune system and reduce inflammation. Sometimes, gua sha is used to treat a cold, fever, or problems with the lungs.

Small injuries to the body, such as the bruises caused by gua sha, are sometimes known as microtrauma. These create a response in the body that may help to break up scar tissue.

Microtrauma may also help with fibrosis, which is a buildup of too much connective tissue when the body heals.

Physiotherapists may use IASTM on connective tissue that is not working to move joints as it should. This problem may be due to a repetitive strain injury or another condition. Gua sha is used alongside other treatments, such as stretching and strengthening exercises.


Gua sha is a technique in traditional East Asian medicine. Some people use it to treat muscle pain and tension, but there is limited research into how well it works.

Gua sha aims to move energy, known as qi or chi, around the body. The treatment involves using a tool to rub the skin in long strokes, applying enough pressure to create minor bruising.

Gua sha may help to break down scar tissue and connective tissue, improving movement in the joints. The treatment does not have any serious side effects but is not suitable for those with certain medical conditions.

We find out more about whether gua sha is effective, and if it has any side effects.

What is gua sha?

Gua sha may be used to treat muscle pain and can break down scar tissue.

Gua sha is the practice of using a tool to apply pressure and scrape the skin to relieve pain and tension. This action causes light bruising, which often appears as purple or red spots known as petechiae or sha.

The name gua sha — pronounced gwahshah — comes from the Chinese word for scraping. It may also be called skin scraping, spooning, or coining.

According to traditional Chinese medicine, qi or chi is energy that flows through the body. Many people believe that a person’s qi must be balanced and flowing freely to ensure their health and well-being.

People also believe that qi can become blocked, causing pain or tension in the muscles and joints. Gua sha aims to move this blocked energy to relieve aches or stiffness.

Traditional East Asian medicine also views blood stasis or stagnation as a cause of pain and illness. Another aim of gua sha is to move pooled or stagnated blood to relieve symptoms.

Some physiotherapists use a version of the technique known as instrument-assisted soft tissue mobilization (IASTM). Using a tool instead of the hands during a massage allows a physiotherapist to apply more pressure.


Other Resources:

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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