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Understanding Gua sha: Why It's Not Suitable for Everyone

Friday, October 27, 2023

The Gua sha Journal - A Blog About Everything Gua sha by Clive Witham/Understanding Gua sha: Why It's Not Suitable for Everyone

Gua sha isn't for everyone and in this episode Clive breaks down exactly why some people either don't like, can't have or need special care with Gua sha. He uses his personal experience to show you what can happen and recounts some of this via the treatment experiences of his life, including the years he treated in a brothel! If you do Gua sha, you need to know what Clive has to say.


Episode Transcript

Why Gua sha isn’t for everyone! Hello and welcome to episode 12 of the Gua sha show.

Why Gua sha Might Not Be For Everyone

Gua sha is a fantastic treatment which you can use for many situations but this week we’re looking at why Gua sha might not be for everyone. And we’re going to start with the fact that sometimes people just don’t like Gua sha. In our clinic over the years there would sometimes people who came in who really didn’t respond well to be touched. They disliked massage or any technique which required manipulation via their skin for any length of time. And invariably there was a level of tension in their connective tissue structures which they’d developed over time through sustained stress or trauma or they might say that they were just always like that. For these people, Gua sha isn’t the perfect fit. As soon as the tool touches the skin and you scrape, the person flinches or complains and then nothing you can do will reverse it. And in fact, it might feel like there’s even more tension afterwards than there was before. Perhaps Gua sha will be great later but at that moment until the underlying pattern is changed, it isn’t so great.

I mentioned this in passing in the first episode of the Gua sha show, and some of you were actually listening carefully (which is nice to hear) and have since asked me about it. So here’s a great time to tell you a bit more about one of the many weird and wonderful experiences I’ve had concerning treating people.

Personal Experiences with Gua sha: Vanessa's Story

So this anecdote involves someone called Vanessa. I’m sure at some point in the future Vanessa will listen to this so thank you Vanessa for giving me lots of great material over the years! So Vanessa is a prime example of someone who just doesn’t respond to Gua sha. She’s just too tense.

And she would tell you straight off bluntly,

‘I don’t like this’.

Or passively aggressively ask things like:

‘Do you know what you’re doing?’

Even with needles, I was afraid of getting kicked in the teeth if I didn’t move away from her legs fast enough.

So the bit about Vanessa which made the experience about treating her a little on the weird side was her profession. I didn’t actually know this at first. She had told me in the clinic but I thought I had misheard her so it came as quite a shock when I turned up the first time. You see Vanessa was madam to a series of brothels. And the reason I was there was that Vanessa had a daughter with a chronic illness and who needed treatment but, due to her disabilities, was unable to come to the clinic. So the only safe place to treat her was at home. And of course home was inside the brothel. I used to go to 2 different addresses depending on the day of week and the more I went, the more surreal and sometimes bizarre it was.

Instead of nice clinical atmosphere with soft music, I treated her on a water bed which made gulping noises every time she made the slightest of movements. It was a very good thing that I didn’t have to do Gua sha because that would have been a logistical feat in itself. If I looked up, I would be able to see the whole treatment event via the ceiling mirror and in the corner there was a large cage with a opened door revealing a selection of leather whips.

After a while these props of a different life, just became mundane furniture like you might have a plant in the corner of the room or a display cabinet against the wall. I didn’t even notice them. If Vanessa wasn’t ready I just used to sit with the manager or working women who by now all knew me and despite the surroundings have mundane conversations about the weather, families and travel. I have to say it was fascinating to be in a particular world but not of it. I was the extraterrestrial on Vanessa’s planet.

I used to carry my equipment in a solid rectangular leather doctor’s case. Which was really heavy. I often wondered what people thought I had in there. So our treatment sessions with Vanessa and her daughter spanned many years but came to end when me and my family moved to our little island in the East China sea but the very day after we had left Heathrow airport, the brothels were simultaneously raided in a coordinated police operation called ‘operation Sail’, everyone was arrested including the janitor and then Vanessa was eventually put on trial and was jailed.

So that’s a quick sum up of what we could call my brothel years! So be aware that for some people, like Vanessa, Gua sha just isn’t an appropriate treatment.

Understanding Gua sha: Beyond a Massage

Right let’s get back on track! Another reason someone might not take to Gua sha is connected to the management of expectations. Gua sha isn’t massage. Sometimes people like to think it is but it isn’t. There’s something you’re doing on a whole different level when you do Gua sha. The sha that might appear on the skin is specific to Gua sha and is a distinctive aspect which elevates Gua sha into a special category of treatments. If you do Gua sha you’re stepping into a world which is important to understand and which is not like other manual treatments. So what happens is that if you usually do relaxing massage treatments and then you do Gua sha, it might not be so relaxing any more! It something that has to be conveyed to the person receiving the treatment. And you have to be clear about what you’re doing too. One of the results of Gua sha is to feel relaxed but it isn’t a relaxation treatment. You can use it in a spa but it isn’t a spa treatment. You can use it for beauty but it isn’t a beauty treatment. You can use it in many ways but it’s still Gua sha! If you’re confused by this, don’t worry, it takes quite a while to understand Gua sha. Just to put it in context. When I teach Gua sha, I don’t talk about tools until about half way through a course. There is so much to understand way before you even pick up a tool! So if you do Gua sha, the receiver has to know it’s Gua sha and that it can be sore and it can leave marks. If not, they might not be happy.

Potential Risks and Limitations of Gua sha Treatment

1. Gua sha and Blood Clotting Disorders

For people suffering from certain conditions it isn’t advisable to have Gua sha. One of them is anyone who has blood clotting limitations. Someone who suffers from haemophilia for example has a condition that affects the blood's ability to clot. When you cut yourself, normally the substances in your blood called clotting factors mix with platelets (blood cells) so that your blood has a more sticky quality to it and forms a clot. This makes the plug which stops the bleeding. But there are problems with this process in haemophilia and there’s a tendency to bleed for longer than usual. So although with Gua sha blood vessels aren’t broken and the blood is coming from the tissue bed, there is a potential for problems and caution is therefore recommended.

And some people have the opposite problem. Instead of having limitations to clotting, they are more susceptible to blood clots. This is the case with people who have heart disease and irregular heart rhythms and who are at risk of blood clots. They take drugs called blood thinners which are antiplatelet and anticoagulant medications to prevent a blood clot. Antiplatelet drugs prevent blood cells from forming clots and include aspirin, clopidogrel (Plavix), dipyridamole (Persantine) and ticlopidine (Ticlid). And common anticoagulant blood thinners include warfarin (Coumadin, Jantoven), enoxaparin (Lovenox) and heparin. So in terms of Gua sha. it’s a similar issue to the one before, in that there is the potential for bleeding more than normal. And this is due to the effect of the medications.

In practice, it’s quite possible to treat with Gua sha but only with training as it’s important to be cautious.

2. Gua sha and Skin Thickness

Another potential issue with Gua sha is the thickness of your skin. If you have problems with thin skin, then Gua sha may not be for you. This might happen with old age but is also a side effect of blood thinners which we just talked about and also corticosteroids which are used for their strong anti-inflammatory effects and in conditions that are related to the immune system function such as arthritis, colitis, asthma, bronchitis and allergies.

The issue with thin skin is an obvious one with Gua sha as sustained friction caused by the normal movement of the tool can easily cause local damage to the surface tissues of the skin. One of the areas with the thinnest skin on your body is below your eyes and I’m sure you know how delicate that area is. The skin thickness is just 0.5 mm compared to an average of 2 mm elsewhere. So if someone has something closer to this thickness over other parts of their body, then it’s important to avoid or be cautious using Gua sha. Again in practice, it’s possible but it’s very important to adjust how you do Gua sha. Age is a factor but not the only factor. Ever since I treated an elderly lady who was so proud of being 90 that she told me each time we met who had pain at her artificial knee. You just presume that something like that will be difficult to help or will take a long time. But not her. She was a nun who liked to stroll and she was back to strolling far quicker than anyone would have thought.

3. Gua sha and Broken Skin or Injuries

Another reason Gua sha may not be for you is if you have any broken skin like a cut, graze or even an ulcer. And that’s an important reason to look at someone’s skin. You’ll be amazed at how many people don’t tell you stuff unless you ask. ‘What’s this on your head?’ ‘Oh Yeah I forgot - I fell down some stairs and sliced it open’ So unless the area to be treated is intact and without any injury, don’t do Gua sha there! This is one of the reasons why you should know holographic gua sha because if the local area you want to treat is not available for any reason, there’s always another area you can go to.

4. Gua sha and Varicose Veins

If you have varicose veins, don’t expect the Gua sha treatment to be anywhere near those veins. What happens is that the veins become enlarged, dilated, and overfilled with blood. And you can see them on the surface of the skin as they might appear swollen and raised.

The reason why varicose veins are an issue with Gua sha is that the problem isn’t a local one but it’s systemic. They happen when veins don’t function properly. The one-way valves that prevent blood from flowing backward stop working so well and blood begins to pool which in turn enlarges the vein. So it’s a problem with the circulation system not just that small area where you can see the vein.

5. Gua sha and Fluid Retention

I did a whole episode on puffiness and edema. If you haven’t listened to that show, go and find it after this one finishes. And this is another reason not to do Gua sha over a particular area. When there’s retention of liquid, you treat around it, not on it.

6. Gua sha and Skin Markings

It’s inevitable that at some point sha will come on to the skin. It may even come on the face. I caused sha to appear on myself only last week right in between the eyebrows at the procerus muscle. And it’s also an area called Yintang. I didn’t even try - it just came out. If sha is going to come to the surface, it’s going to come whether you like it or not. For some people who just don’t want the marks on the skin, it’s a real risk and they won’t be too happy if it does.

The Reality of Gua sha Treatment: Setting Expectations

And lastly for something like Facial Gua sha, expectations are important. If someone comes to you and wants something that only a scalpel or Botox needle can deliver, you’re only going to disappoint. If there’s no investment of patience or commitment then maybe Gua sha isn’t for you! Gua sha can work wonders but only within the realistic boundaries of understanding how and why it works.

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Hi, It's Clive

Director of Komorebi Institute

Hi, It's Clive

From researching underfunded healthcare in Uganda, to running a thriving chronic illness clinic in North Africa, to collaborating with hospitals in Sri Lanka to train staff and empower communities - My journey has been dedicated to democratizing access to beauty and health.

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