Instrument assisted soft tissue mobilization or, Gua Sha, the Traditional Chinese Medicine name, is by far one of my favorite modalities when it comes to releasing tight muscles and relieving pain. Gua Sha is my favorite treatment modality because it does three things really well. Similarly to cupping, the therapy draws stagnated blood from the muscles (not as well as cupping but still well), provides a muscle massage, and releases adhesions in the fascia.
The first two are a little more common place, especially if you read up on cupping therapy. But what is fascia?
Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up and forms adhesions.
Although fascia looks like one sheet of tissue, it’s actually made up of multiple layers with liquid in between called hyaluronan. It’s designed to stretch as you move. But there are certain things that cause fascia to thicken and become sticky. When it dries up and tightens around muscles, it can limit mobility and cause painful knots to develop.
This often times feels like a muscle issue but doesn't always respond to normal therapies for muscle tightness. And because sheets of fascia run in long trains throughout the body, the issue can be far from the source of pain.
Generalized redness is first to appear after treatment begins as blood makes its way to the skin surface. Areas with extra tight muscles, trigger points, and more aggressive fascial adhesions create a brighter, more mottled, appearance on the skin.
The end result may look painful but the therapy is well tolerated and very relieving similar to the sensation of a massage. Some tenderness can occur as with any treatment releasing soft tissue. Tenderness is typically minimal and lessens with consecutive treatments.
This is a wonderful treatment by itself or in conjunction with Chiropractic manipulation to relieve muscle and joint pain and to regain full, pain free range of motion.
After the area of fascial adherence is identified, an emollient is applied to protect the skin from the instrument. A specially designed and contoured Gua Sha tool is used to make small passes "scraping" the skin and pressing down into the underlying muscle.