Gua Sha vs. Foam Roller - Which is better?

If you are an athlete you have probably experienced firsthand the pain and frustration that comes from being sidelined with an injury. We’ve all been there and know that there’s only so much you can accomplish with rest and Advil before you start looking for something drug-free that will get you back in the game. Two such techniques: gua sha and foam roller therapy, are rapidly gaining in popularity among injured athletes as well as anyone seeking relief from chronic muscle and joint pain.

The practice of foam rolling was introduced in the 1980s by Moshe Feldenkrais, who developed a method of reducing pain and improving mobility through increased body awareness. Foam rolling has gradually gained popularity as a form of self myofascial release and many athletes have gravitated to foam rollers as a way to alleviate muscular aches and pains.

The science on foam roller therapy reveals that it offers some significant benefits. If you consider yourself flexibility-challenged foam rolling may offer the benefits of static stretching without requiring you to twist, bend and fold. A single session of foam rolling was shown to increase hamstring flexibility by an average of 4% – about 3/4 inch – in one study. In fact, the practice may be as effective as traditional stretching for some people.

In addition to promoting flexibility and increasing joint mobility, it is thought that foam rolling may be useful as a way to break up scar tissue and release myofascial adhesions. In so doing, it might improve strength, balance muscular forces around joints and reduce your risk for repetitive stress joint injuries.

Studies on foam rolling have demonstrated good range of motion results. The technique produced measurable increases in knee joint range of motion within two minutes and improved knee joint range of motion by as much as 12% in 10-minute sessions, in one study. Foam rolling has also been found to be as effective as deep heating and static stretching combined.

Gua sha offers similar benefits to foam rolling with some added advantages. In a side-by-side comparison study of hip and knee range of motion in athletes, both therapies produced significant gains; however, gua sha resulted in up to twice as much improvement in range of motion, with benefits lasting longer than those obtained from foam rolling. The reasons for this may have to do with gua sha’s versatility.

From a practical standpoint, because it uses a tool that fits in the palm of your hand gua sha enables you to treat areas of larger joints, such as the hips, that might not be easily accessible with a foam roller as well as treating smaller joints such as those of the hands and wrists. And, in situations where injury leads to prolonged immobilization, such as a frozen shoulder or sprained ankle, gua sha can be performed without having to move the injured area.

If you are treating an active injury or a longstanding, chronic condition, or, if you simply wish to speed up your post-workout recovery period gua sha can be applied using a variety of stroke techniques. This allows you to tailor your treatment for a particular structure or condition to accomplish each of these goals, i.e. long or short strokes, light or deep pressure and across or parallel to muscle fibers.

The mechanical action of gua sha obviously differs from that of a foam roller. By its scraping action on the skin surface, gua sha compresses and stretches underlying connective tissue cells. This effect, known as mechanotransduction, causes a form of controlled microtrauma. Collagen producing cells become activated and produce healthy connective tissue fibers to replace the tangled knots of connective tissue that occur when scar tissue forms.

At the nervous system level gua sha works via multiple routes to reduce pain and improve function. When gua sha is administered using a deep pressure technique it suppresses pain signals, preventing them from reaching the brain. The same technique also triggers release of endorphins, your body’s natural pain-relieving chemicals. Gua sha has also been found to increase the speed of nerve transmission and improve proprioception – the body’s position sensing system. The consequences of better proprioception, which are all good, include greater accuracy and precision, increased speed – your brain can propel your body faster if it knows where all your parts are at any given instant – and, most importantly, significantly greater potential for preventing injuries.

To summarize:

Both techniques have been found to improve flexibility and range of motion, with some studies showing gua sha outperforming foam rolling. It is possible that the scraping action of gua sha results in a greater degree of stretch than does foam rolling, which applies mostly compression, although the answer to this is not fully known at this time. More definitive evidence will emerge as further studies are carried out.
Both techniques break down scar tissue and release myofascial adhesions. However, the use of mechanotransduction in gua sha introduces an added component of shear that foam rolling lacks and that may induce a greater degree of healing microtrauma compared to foam rolling.
Both conditions suppress pain signals. Pain relief may vary significantly from person to person.
Gua sha offers greater versatility than foam rolling since it is conveniently applied using handheld tools. This makes it a better choice for those who might have difficulty positioning themselves or controlling their movement across a foam roller.
Still trying to choose between foam rolling and gua sha? Both techniques are convenient, cost-effective, can be learned quickly and are easily practiced at home by most people. So, why not use both?