Guasha Indication
Do "learn to spray, the body quack"
State Administration of Traditional Chinese Medicine Vocational Skills Appraisal Guidance Center
Gua Sha diagram
1. Origin
Gua Sha therapy has its origins in the Paleolithic era. When people are sick, out of instinct, they will touch or beat a certain part of the body surface with their hands or stones, which can sometimes relieve the disease. Through long-term practice and accumulation, the method of treating diseases with meteorites was gradually formed, which was also the prototype of scraping therapy.
2. Concept
The scraping health care method is to use a tender bamboo board with smooth edges, the edge of a porcelain piece or a bowl, a small spoon, copper coins, glass, hair or ramie and other utensils that are not easy to damage the skin under the guidance of traditional Chinese medicine theory, and dip them in cooking oil, wine, and water. Or grease, scraping repeatedly from top to bottom and from inside to outside on the surface of human skin until red spots or blood stasis patches appear on the skin, thereby regulating human health.
3. Basic operations
1.Choose utensils
According to the different disease syndromes and scraping parts, select the corresponding scraping board and scraping medium.
2. Select the part
When scraping, select appropriate scraping parts, focusing on meridians and diseased parts. Frequently scraped parts include the head, neck, shoulders, back, waist and limbs. The surgical site should be exposed as much as possible to facilitate operation.
3. Choose a body position
(1) Sitting position
Guests sit sideways on a chair with one hand on the back of the chair; or sit with legs apart, facing the back of the chair, with both hands on the back of the chair; or sit on a stool with both hands on the edge of the table or bed , exposing the head, neck, shoulders, upper limbs and back. It is suitable for gua sha on the head, face, neck, shoulders, back and upper limbs. This position is often chosen when treating sub-health conditions such as headache, nasal congestion, runny nose, neck pain, shoulder pain, etc. (Figure 7-1).
(2) Recline sitting position
Guests sit on a chair with their backs leaning against the back of the chair, exposing the front of their neck and chest. Suitable for gua sha on the face, front of the neck, chest, shoulders and upper limbs. This position is often chosen for scraping for sub-health conditions such as throat discomfort, shoulder pain , whole body scraping, and facial beautification (Figure 7-2).
(3) Support position
The guest leans forward and bends slightly to stand in front of the bed, table or chair, with both hands on the edge of the bed, table or chair back, exposing the back and lower limbs. It is suitable for gua sha on the back, waist, buttocks and lower limbs. This position is often chosen when treating sub-health conditions such as back pain, lumbago, leg pain and discomfort in the lower limbs (Figure 7-3).
(4) Supine position
The guest lies face up on the bed, exposing the face, chest, abdomen and inner sides of the upper limbs. It is suitable for gua sha on the face, chest, abdomen and inner parts of the upper limbs. It is especially suitable for the elderly, women and those who have gua sha all over the body. This position is often used for Gua Sha for sub-health conditions such as diarrhea, abdominal pain, obesity, whole body Gua Sha, facial beauty, and chest Gua Sha for guests with cardiopulmonary discomfort (Figure 7-4).
(5) Prone position
The guest lies face down on the bed, exposing the head, neck, back, buttocks and the back of the lower limbs. It is suitable for scraping the back of the head, neck, shoulders, back, waist, buttocks and the inside, outside and back of the lower limbs. This position is often chosen for neck pain, shoulder pain, back pain, low back pain, fatigue, leg pain, insomnia and other sub-health conditions such as Gua Sha, whole body Gua Sha and back Gua Sha combined with cupping and cupping (Figure 7-5).
(6) Side lying position
The guest lies sideways on the conditioning bed, exposing the side half of the body and the front and back sides of the body. It is suitable for gua sha on the shoulders, buttocks and outside of the lower limbs. This position is often chosen for Gua Sha treatment for shoulder pain, hip pain, and bone and joint pain on one side of the lower limb (Figure 7-6).
4.Environment preparation
The Gua Sha room should be kept clean and tidy, with a moderate temperature so that guests feel comfortable.
5. Disinfection
Clean or disinfect the scraping area and the operator's hands. The scraping board should be disinfected promptly after use.
6. Apply Gua Sha medium
Take an appropriate amount of scraping oil or scraping lotion, place it on the disinfected area to be scraped, and apply it evenly with a scraping board.
(2) Basic methods
1. How to hold the scraping board
Generally, the scraper is held with one hand, and the scraper is placed in the palm of the hand. The thumb, index finger, and middle finger hold the scraper. The ring finger and little finger are close to the corners of the scraper. Fix the scraper from three angles on both sides and the bottom of the scraper. When scraping, use finger strength and wrist strength to make the angle between the scraping board and the skin about 45°, with the elbow joint as the axis and the forearm moving regularly (Figure 7-7).
2. The order of scraping
The general principle of choosing the order of scraping parts is: first the head and face, then the hands and feet, first the back and waist, then the chest and abdomen, first the upper limbs, then the lower limbs, and gradually scrape in sequence. For whole body scraping, the sequence is head, neck, shoulders, back and waist, upper limbs, chest and abdomen and lower limbs; for local scraping, for example, the sequence for neck scraping is head, neck, shoulders, and upper limbs; for shoulders, the sequence is head, neck, and shoulders. Upper, front of shoulders, behind shoulders, upper limbs; back and waist scraping sequence is the middle of the back and waist, both sides of the spine, and both lower limbs.
3. Gua Sha direction
The general principle of scraping is from top to bottom, from inside to outside, scraping in one direction and extending the distance as much as possible. The head is generally combed from the front to the back, or the scattering method is used, from the center of the top of the head to the surroundings; the face is generally scraped from the center to both sides, and the lower jaw is outward and upward; the neck, shoulders, back, waist, and the middle and both sides are scraped from top to bottom. , the shoulders should be from inside to outside, the front of the shoulders, the outside of the shoulders, and the back of the shoulders from top to bottom; the middle of the chest should be from top to bottom, and the intercostal space should be from inside to outside; the abdomen should be from top to bottom, and gradually expand from the inside to the outside; the limbs should be expanded from the inside to the outside. It is advisable to scrape in the direction of the tip.
4. Gua Sha time
(1) Each part is generally scraped 20 to 30 times, and usually a guest chooses 3 to 5 parts; local scraping usually takes 10 to 20 minutes, and full body scraping is suitable for 20 to 30 minutes.
(2) There should be an interval of 3 to 6 days between two scrapings, or when the scraping on the skin has subsided and there is no pain when pressing the skin with the hand. If the scraping spots on the scraping area have not receded, it is not advisable to scrape at the original site.
5. Degree of scraping
(1) When scraping, the force should be even, from light to heavy, and as much as the guest can bear.
(2) Generally, the skin will be scraped until color changes such as flushing and purple-red appear, or morphological changes such as miliary, papule-like spots, or flaky or cord-like plaques will appear, accompanied by local heat or slight pain. Do not force it on some guests who are not prone to or have fewer cases of Sha.
(3) Gua Sha technique
1. Classification according to strength
(1) When scraping with the light scraping method, the scraping blade contacts the skin and the scraping force is small, so the person being scraped does not feel any pain or other discomfort. After light scraping, the skin only appears slightly red and has no ecchymosis. This method is suitable for the elderly and infirm and guests with deficiency syndrome.
(2) When the heavy scraping method is used, the scraping blade contacts the skin and the scraping force is greater, which should be as strong as the guest can bear. This method is suitable for use on both sides of the spine in the lower back, areas with rich soft tissues in the lower limbs, young and middle-aged people with strong constitutions, and guests with chronic syndrome or heat syndrome.
2. Classification by moving speed
(1) The frequency of quick scraping is more than 30 times per minute. This method is suitable for people with strong physiques, and is mainly used to scrape the back, limbs, and guests with acute or exogenous diseases.
(2) The frequency of slow scraping should be within 30 times per minute. This method is suitable for people with weak constitutions, and is mainly used to scrape the head, face, chest, abdomen, inner lower limbs and other parts of the body, as well as guests with chronic, weak internal injuries.
(3) Vibrating scraping method: Use the corners of the scraping board to contact the body surface, press down, and make rapid and rhythmic vibrations, more than 100 times per minute; or gradually move the scraping board while vibrating. This method is suitable for sub-health conditions with spasmodic pain, such as hypochondriac pain, stomach pain, lower abdominal pain and calf cramps.
3. Classify according to scraping direction
(1) Straight line scraping method
Also known as the straight scraping method. Use a gua sha board to scrape the human body surface in a straight line of a certain length. This method should be used on relatively flat parts of the body, such as the back, chest and abdomen, and limbs (Figure 7-8).
(2) Arc scraping method
The scraping direction is in an arc shape. After scraping, arc-shaped sha marks will appear on the body surface. During the operation, the scraping direction mostly follows the muscles or is determined according to the characteristics of the bone structure. This method should be used on the chest and back, in the intercostal space, around shoulder joints and knee joints (Figure 7-9).
(3) Reverse scraping method
It means that the direction of wiping is opposite to the conventional wiping direction, starting from the distal end and wiping in the direction of the proximal end. This method is suitable for patients with varicose veins of the lower limbs, edema of the lower limbs, or areas where the results of scraping in conventional directions are not satisfactory (Figure 7-10).
(4) Rotation method
When scraping, do regular scraping in clockwise and counterclockwise directions, with moderate force, neither fast nor slow, and with a sense of rhythm. This method should be used around the abdomen, breasts, and patella of the knee joint (Figure 7-11).
(5) Push and scrape method
When scraping, the scraping direction is opposite to the operator's standing position. If the operator is in front of and on the right side of the guest, this method should be used when shaving the guest’s left neck and shoulder (Figure 7-12).
4. Classification according to the parts of the body surface where the scraping board contacts
(1) Friction method
Put the gua sha board directly against the skin, or make regular rotational movements with the gauze cloth, or move it back and forth in a straight line to create a feeling of heat on the skin. This method should be used on areas with numbness, coldness or lingering pain, such as the inside of the shoulder blades, waist and abdomen; it can also be used before scraping to relax the guest (Figure 7-13).
(2) Combing and scraping method
Use a scraping board or scraping comb to scrape regularly in one direction from the hairline on the forehead and temples to the back hairline. The scraping board or scraping comb is at a 45° angle to the scalp. The movements should be gentle and gentle, like combing your hair. , hence the name combing and scraping method. This method is suitable for sub-health conditions such as headache, dizziness, fatigue, insomnia and mental stress (Figure 7-14).
(3) Point pressure method
Also known as acupoint technique. Use the corner of the gua sha board to directly press the acupuncture points. Gradually increase the force to the level that the guest can bear. Hold it for a few seconds and then lift it up quickly. Repeat the operation 5 to 10 times. This method should be used on acupoints in areas with full muscles, or on the depressed areas of bones and joints where the scraping power cannot reach deeply, or where it is not suitable to directly scrape, such as Huantiao, Weizhong, calf nose, ditch, and between the spinous processes of the spine on the back, etc. ( Figure 7-15).
(4) Massage and kneading method
Use the gua sha board to massage the meridians and acupoints on the body surface, then move back and forth or rotate forward and backward. During operation, the scraping board should be close to the skin without moving, and massage 50 to 100 times per minute. This method should be used on Taiyang, Quchi, Zusanli, Neiguan, Taichong, Yongquan, Sanyinjiao and other acupoints (Figure 7-16).
(5) Corner-cutting method
Use an angular scraping board or make the edges of the scraping board contact the skin at a 45° angle to the body surface, and scrape from top to bottom or from the inside out. The technique should be flexible and not harsh to avoid damaging the skin due to excessive force. This method should be used on the joints of the limbs, the meridians on both sides of the spine, around bony prominences, and on shoulder acupoints, such as Fengchi, Neiguan, Hegu, Zhongfu, etc. (Figure 7-17)
(6) Edge scraping method
Place the long edge of the scraping board in contact with the body surface at a 45° angle for scraping. This method is suitable for scraping large areas, such as the abdomen, back and lower limbs (Figure 7-18).
5. Common facial techniques
(1) Flat wiping method
The flat surface of the scraping board contacts the skin, and you can use your wrist to scrape in one direction, or you can hold the scraping board with both hands to scrape from both sides. Pay attention to steady technique, even force, smooth movement and large contact area. This method should be used on the forehead, cheekbones and neck of the face (Figure 7-19).
(2) Flat push method
The scraping board forms an angle of 5°~15° with the body surface, pushing the skin in one direction. You can hold the board in your hand and use the other hand to fix the skin being pushed during the pushing process, or you can hold the board with both hands and use the other board to press the skin to prevent pulling the skin. Pay attention to gentle technique and consistent strength. This method should be used on the forehead and neck of the face, such as crow's feet (Figure 7-20).
(3) Flat pressing method
Use the end surface or flat surface of the board to contact the skin and press it to loosen it. It is recommended to press it 4 to 6 times continuously. The characteristics of this method are that the force is applied immediately, the pressure is not firm, and the force is stopped when the force is reached, which is different from the point pressure method. This method should be used in acupoint areas that are small and not suitable for scraping, such as around Yingxiang, Sibai and other acupoints (Figure 7-21).
6. Special scraping techniques
(1) Plucking method
Use the corners of the gua sha board to press and massage the muscles, legs, meridian attachments or specific acupuncture points in a regular manner using your wrist force, and then quickly pluck outwards, like a plucked piano string, hence the name plucking method. During operation, the technique should be gentle, the strength is moderate, and the speed is fast. Each part should be played 3-5 times. This method is suitable for regulating pain in bones, joints, ligaments, etc. (Figure 7-22).
(2) Slapping method
Also known as hitting method and tapping method. Hold one end of the scraping board and use wrist strength or elbow joint movement to hit the flat surface of the other end of the scraping board on the body surface regularly with even speed and gentle force. This method should be used on the lower back, forearms, popliteal fossa and the following parts (Figure 7-23).
(3) Double scraping method
Also known as the double-board scraping method. Hold a plate in each hand and scrape the same area alternately with both hands, or scrape two areas at the same time. Use both hands evenly and operate smoothly. This method should be used on both sides of the spine and both lower limbs (Figure 7-24).
(4) Pulling method
Also known as the Sha pulling method and the Sha squeezing method. Flex the five fingers, use the second knuckle of the index finger and middle finger or the index finger and thumb to hold the surgical site, pull up the skin and muscles, or tear the specific part, slide it outward quickly and then release it, pull and release until Purple red or petechiae appear on the skin. This method should be used on the Yintang of the head and face, Tiantu on the neck, and Jiaji points on the back (Figure 7-25).
7. Gua Sha combination method
(1) Gua Sha and Cupping Method: Gua Sha is used in conjunction with cupping. First scrape, then leave or remove the cup in the scraped area. This method is suitable for diseases in the back and lower limbs, such as neck and shoulder pain, low back pain, insomnia, acne, fatigue, etc.
(2) Gua Sha massage method. Gua Sha therapy is used in conjunction with massage therapy. You can massage first and then scrape, or you can scrape first and then massage. This method should be used on the neck, back, waist and limbs. Scraping after massage can enhance the effect of massage; massaging after scraping can promote blood circulation and absorption of blemishes, and improve the effect of scraping.
8. Postoperative treatment
After scraping, use clean paper towels, towels or sterilized cotton balls to wipe the scraping area clean with the scraping medium.
4. Indications for scraping
Gua Sha therapy is widely used in practice. Before the Ming and Qing Dynasties, it was mainly used to treat various types of Sha diseases. Sha syndrome refers to a type of disease that occurs in summer and autumn due to the evil qi of wind, cold, heat, dampness, dryness, and fire, or the turbidity of epidemic diseases. The indications for scraping therapy involve internal medicine, surgery, gynecology, and pediatrics. It has relatively good health care effects especially on exogenous diseases, painful bone and joint lesions, neuromuscular vascular lesions, and post-illness rehabilitation.
5. Contraindications to Gua Sha
(1) People with severe cardiovascular and cerebrovascular diseases, liver and kidney insufficiency, general edema, etc. are not allowed to use scraping.
(2) Gua Sha is prohibited on the abdomen and lumbosacral area of pregnant women.
(3) Gua Sha is prohibited on the eyes, lips, tongue, ear holes, nostrils, nipples, navel, front and back vagina and other parts of the human body.
(4) Scraping is prohibited wherever there are boils, ulcers, sores, moles, rashes and unexplained masses on the body surface.
(5) Gua sha is not allowed on the painful parts of acute sprains, trauma or fractures.
(6) People with contact skin infectious diseases should avoid using this method or pay attention to strict disinfection before use.
(7) People with bleeding tendency should use this method with caution. Such as late stage diabetes, severe anemia, leukemia, aplastic anemia and thrombocytopenia.
(8) People who are overly hungry, tired, or drunk should not use gravity to scrape large areas at that time. In special cases, light techniques or tapping can be used.
(9) Gua Sha is prohibited for guests who suffer from certain mental illnesses and cannot cooperate with the therapist.
6. Precautions for scraping
(1) According to the applicable scope of traditional Chinese medicine scraping, select guests who are suitable for traditional Chinese medicine scraping and should not exceed the corresponding range.
(2) Whether the guest's posture is appropriate has a great impact on the correct scraping operation, preventing dizziness and achieving good results. You must choose the appropriate posture when scraping.
(3) According to the guest’s physique, select the appropriate scraping area and try to expose it as much as possible; if the scraping area is not clean, use disinfectant products such as hot towels, sanitary towels or alcohol cotton balls to scrub clean to prevent infection.
(4) For guests who are undergoing Gua Sha for the first time, necessary explanations should be made to eliminate the guests’ nervousness.
(5) When scraping, you should maintain a suitable indoor temperature, especially in winter, you should avoid colds and colds; in summer, you should avoid direct blowing from fans, hall drafts and air conditioners to the scraping area.
(6) After scraping, guests can rest for a while and drink an appropriate amount of warm water. It is not advisable to eat raw or cold food immediately or take cold showers.
(7) When scraping, the force should be even and the technique should be from light to heavy, as much as the guest can bear, until the area becomes flushed or spots or spots appear.
(8) Some guests are not likely to develop sha after scraping. Do not scrape vigorously or for a long time.
(9) Guests who are elderly, infirm, children, or those who are sensitive to pain should use gentle scraping techniques, and pay attention to the guest's facial expression and general condition, and adjust the scraping regimen at any time.
(10) If the sha spots have not receded after scraping, it is not advisable to scrape them in place again. Generally, the interval is 3 to 5 days. After the sha subsides, the original area can be scraped again.
(11) Those with varicose veins in the lower limbs or those who are prone to swelling of the lower limbs should scrape from bottom to top using the reverse scraping method. Be careful not to scrape from top to bottom.
7. How Gua Sha works
1. Strengthen blood circulation and promote metabolism
The human body is constantly undergoing metabolic activities every day, and the waste generated during the metabolic process must be excreted in time. Gua Sha can regulate the contraction and relaxation of muscles, strengthen local circulation, make local tissues highly hyperemic, increase temperature, accelerate blood flow and lymph circulation, strengthen phagocytosis and transport force, increase tissue flow, and regulate inter-tissue pressure. Promote metabolism, eliminate toxins, scrape the metabolic "garbage" in the body to the body surface in a timely manner, and deposit it into the pores under the skin to smooth the blood flow in the body and restore natural metabolic vitality, thereby promoting blood circulation and removing stasis, removing stasis and promoting health. new effects, thereby improving the body's resistance.
2. Relax the muscles and unblock meridians, and increase the pain threshold of local tissues.
Modern life is fast-paced and stressful. More and more people are suffering from cervical spondylosis, frozen shoulder, low back pain, etc. This is because when the human body's muscle attachment points and "soft tissues" (joint capsules, ligaments, fascia) are injured, the muscles will be in a state of tension, contraction or even spasm, causing symptoms of pain. If not corrected in time, adhesion, fibrosis or scarring will form to varying degrees, causing harmful impulses to continue to be released, aggravating pain, tenderness and muscle contraction and tension, and then causing secondary pain lesions in surrounding tissues, forming Metabolic disorders further aggravate the pathological changes of "blockage leads to pain", thus aggravating the condition. Tense or spasmodic muscles can be stretched under the action of Gua Sha, which strengthens local microcirculation, thereby relaxing muscles and unblocking meridians, relieving tension and spasm, and eliminating pain. Gua Sha can relax the tendons and unblock meridians, eliminate painful lesions, relieve muscle tension, and improve the pain of local tissues; while significantly reducing pain symptoms, it is also conducive to the recovery of lesions.
3. Adjust yin and yang and improve organ function
"The secret of yin and yang is that the spirit is the cure." Traditional Chinese medicine places great emphasis on the balance of the relationship between yin and yang in the body. The regulatory effect of Gua Sha can reach all organs of the body through the meridian system, making the Qi flow unobstructed and the yin and yang Qi and blood balanced. Gua Sha has a two-way regulating effect on human body functions. For example, for people with hyperactive intestinal peristalsis, using scraping techniques on the abdomen and back can control the hypermotility and return it to normal. On the contrary, for those whose intestinal peristalsis function is reduced, it can promote their peristalsis to return to normal. Therefore, scraping can improve and adjust the functions of the organs and restore the balance of yin and yang in the body.
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