Chinese medicine has used a form of tissue massage with spoons or other small instruments. In chiropractic work this is known as instrument assisted soft tissue massage (IAST). At the first hearing of skin scraping, as its sometimes known, many people shy away from this modality but after trying it for the first time have enjoyed the feeling and benefits. Because the body has different levels, Gua Sha is done at different depths depending on the illness. Most often Gua Sha is used for musculoskeletal injury and does not need to be very deep however some illnesses will need a deeper sort of pressure. After the treatment there may be redness or even a sort of bruising on the skin. Like cupping therapy, this is the desired result of a successful therapy and completely normal. Note that this discoloration will recede after a few days but ask your practitioner about and concerns you may have before and/or after the treatment.