Therapeutic Techniques
Gua sha explained: what it is, how it works, and what the marks mean
If you've seen photos of someone's back after gua sha — those dramatic red streaks — you might assume it's painful or extreme. In practice, gua sha ("gwah shah") is one of the gentler-feeling tools in Traditional Chinese Medicine, and one of the most immediately satisfying for tight, overworked tissue.
What happens in a gua sha treatment
Massage oil is applied to the area being treated. Then a smooth-edged instrument — traditionally stone or horn, today often stainless steel — is drawn across the skin in short or long strokes, typically over the painful area or along the back parallel to the spine. The pressure is firm but shouldn't be painful; most people describe it as intense in the satisfying way a deep massage stroke is.
About those marks
The strokes create raised redness or bruise-like marks called sha. They aren't true bruises — the technique is drawing blood flow to the surface, not injuring tissue. In the traditional framework, the color and density of the sha tells the practitioner something about the condition of the underlying area. The marks typically fade within two to four days.
Gua sha vs. cupping
The two are cousins: both are TCM techniques for moving blood and releasing tissue, both leave temporary marks, and both feel like variations on deep tissue work. Cupping uses suction to pull tissue upward and works deeper into muscle and fascia; gua sha works across the surface with directional strokes. Which one suits you depends on the area, the condition, and honestly, personal preference — many treatments use both.
Aftercare
Stay warm and dry after your session — traditional practice considers the treated area temporarily vulnerable to cold and wind.
Skip the shower for about 12 hours.
Drink water, take it easy, and let the marks fade on their own schedule.
Gua sha is available as part of acupuncture sessions and bodywork at Resolution. If you're curious whether it fits your situation, ask when you book — or start with an acupuncture consultation and we'll build a plan together.
William Black
Licensed Acupuncturist, MAc
William Black is a nationally certified acupuncturist with a Master's in Acupuncture from Pacific Rim College and a background in psychology. He was first drawn to Chinese medicine as a teenager after a severe concussion left him with lingering brain fog, cystic acne, and other challenges that conventional medicine couldn't fully address. Through changes in diet, acupuncture, and other supportive treatments, he experienced a profound shift in how he understood and related to his own body — an experience that opened the door to a lifetime of study. His clinical focus is on restoring the body's internal balance: releasing obstructions, regulating circulation, and supporting the body's innate capacity to heal. His practice draws from a range of time-honored tools, including acupuncture, gua sha, cupping, acupressure, moxibustion, and tuina bodywork. He also weaves in mindfulness-based practices rooted in Taoism, qigong, yoga, and creative exploration, grounded in ongoing study of the Huang Di Nei Jing and the subtle rhythms connecting body, mind, and season. Will specializes in chronic pain, stress, anxiety, neurological conditions, and digestive health. He works best with people who are ready to slow down, reconnect with their bodies, and move toward a more embodied and intentional way of living.
