The Dragontree

Since at least several hundred years B.C., people in Greece, India, China, and elsewhere have used a technique of applying friction to the skin in order to resolve pain and treat deeper medical disorders, and it’s recently attracted the attention of mainstream medicine. The Greeks called it “frictioning.” The Chinese call it Gua Sha.

The technique involves using the hands, a piece of coarse cloth, or, more commonly, a ceramic spoon, a coin, a dull, thick blade, or the edge of a jar lid, to repeatedly stroke the skin until it becomes red. Nearly everyone in China (and much of greater East Asia) is familiar with Gua Sha, and parents routinely perform it on their children for colds and flus. Practitioners of Chinese medicine usually employ it to treat communicable diseases, conditions of internal toxicity, and to release tight tissues to alleviate pain and stiffness. Gua sha also has an extensive history of successfully treating cholera, a form of epidemic diarrhea.

When you receive Gua Sha, the practitioner usually oils your skin first, and then begins stroking the treatment area repeatedly with the blunt edge of their tool (I like a ceramic spoon or piece of water buffalo horn best). Often, dots begin to appear under the skin, ranging from bright red to deep purple, and with continued stroking, they multiply and fill in the area, until the whole region develops a diffuse bruise-like look. Actually, the marks left by Gua Sha have caused some problems in the U.S., where teachers who are unfamiliar with the technique have noticed the marks on some of their Asian students and alerted authorities of suspected child abuse!

To look at it, someone might think you were tortured, but it’s not a painful process. Many people enjoy the sensation, though it can occasionally feel a bit tickly or mildly sore. The marks disappear within a few days. When these dots arise quickly, and especially when they’re dark in color, we consider this to indicate poor circulation and/or a build-up of toxins in the area, which is a sign that the treatment was needed and should produce an improvement in health and a loosening of the muscles.

Frictioning techniques were initially understood by the Greeks as counteracting an existing condition – shifting the body’s attention by causing irritation (called “counter-irritation”) or a healing crisis elsewhere in the body. The minor trauma the technique caused was thought to elicit a broader healing response by the body, which would frequently resolve whatever other issue a person was grappling with.

The Chinese understand the technique as releasing something (pathogenic factors, such cold, dampness, stagnant blood, and toxins) through the surface of the body, and invigorating local circulation.  Gua means “to scrape or scratch.”  Sha means a sickness or evil that is retained in the body and also the rash-like expression when Gua Sha is performed. That is, Gua Sha is the process of intentionally bringing Sha to the surface. Other terms, such as Pak Sha (“pak” means “to slap”) and Xian Sha (“xian” means “to pinch”), describe different ways of eliciting Sha.

It has been said that, “Gua Sha is to an Asian family what chicken soup is to a family in the West.” Because this practice is so ubiquitous, and so humble, it’s especially funny that opportunists in the West have reframed this method as a brand new, cutting edge medical technique, dubbing it the Graston Technique and Astym (among other monikers). What’s more, I know people who have paid large sums to receive these techniques, under the impression that they are culmination of modern Western scientific research.

For instance, the Astym website features the question, “Can’t I just do this myself?” and the response: “You can only get the results ASTYM treatment delivers from a certified ASTYM therapist…. The ASTYM system’s outstanding results can not be achieved by picking up something you have at home and rubbing it along your skin. If this worked, there wouldn’t have been any need to spend years on the research and development process.” Millions of acupuncturists and Chinese lay people would beg to differ!

Don’t get me wrong. I do think it’s worth paying a trained medical professional to help you deal with your pain. And while I’ve never received The Graston Technique or Astym from a professional, I wouldn’t be surprised if they work – because I know Gua Sha works. My purpose is not to disparage these Western spin-offs, but to illuminate the true historical context and persistence of this technique. Medicines don’t usually stick around for over 2000 years if they don’t work! If you’re interested in learning more, ask an acupuncturist, or check out the authoritative book on the subject by my colleague Arya Neilsen, called simply Gua Sha.

Be well,

Dr. Peter Borten