Gua Sha vs IASTM — Rationale, Goals, and Application
How traditional scraping differs from modern instrument-assisted mobilization.
TL;DR
- Rationale: Gua Sha traditionally pursues a visible petechiae ("sha") response; modern IASTM emphasizes comfortable dosing, mobility, and pain modulation.
- Application: different tools, edges, and stroke intents; IASTM typically uses measured pressure and integrates with movement.
- Clinical: choose by goals, preference, and contraindications; bruising is not a marker of success.
Indications and goals
- Gua Sha (traditional): perceived circulation/relief; cultural preference; often shorter‑term symptom easing.
- IASTM: improve ROM/comfort, desensitize tender areas, support graded exposure to movement; better standardized in contemporary rehab.
Technique and dosing
- Gua Sha: light‑to‑moderate strokes along muscle lines; stop if discomfort escalates; avoid over fragile skin.
- IASTM: 30–60s per focal region, slow strokes at 30–60° edge angle; reassess ROM and symptoms; follow with active drills.
Safety and precautions
- Avoid both over: open wounds, acute infection/inflammation, unhealed fractures, anticoagulated areas, sensory loss.
- Extra caution for cervical region, varicosities, and postpartum stages (seek clearance).
FAQs
Is petechiae required?
No. Visible marks are not necessary and may increase downtime or concern. Aim for tolerable pressure and improved movement.
Can I combine Gua Sha and IASTM?
Yes—use gentle strokes first, then integrate IASTM principles and finish with mobility/strength to capture gains.
Reference
- IASTM systematic review (differences noted): https://pmc.ncbi.nlm.nih.gov/articles/PMC5039777/