RSI is curable – and does not need surgery to fix it

The Sure Cure for RSI

Why RSI?

Muscles operate best when they are flexible and supple. All RSI is caused by excessively tight (hence weak) muscles, with sticky fasciaTest for tightness in these muscles. As a general rule, people with supple and flexible muscles, particularly of the upper body – but basically all muscles – won't get RSI.

Re: sticky fascia, I found this excellent youtube video on 11 Feb. 2015:

The crucial thing to understand is this: Your hands bear about 10% of the load of typing. 90% of the load is borne by your forearm/upper arm/upper back/ pectorals/ lats/middle back/ lower back and even glutes. The 'hands' and wrists can't be "fixed" without without fixing the entire upper body – including remote areas like the gluteal muscles. Yes. The body works as a whole. And doctors DON'T have a clue about this basic concept of bio-kinetics.

THE ONLY EFFECTIVE CURE OF RSI

40% of the cure: EXTREME MASSAGE

Break the spasms/ tightness in muscles with myotherapy or other very hard (deep tissue) massage. This will include massage not merely (indeed almost not even) massage of the arms, but (a) upper back, (b) neck (c) lats, (d) lower back, (e) abdominal muscles – and arms including hands.If you don't (actually) scream with pain for at least half the time during the massage, your massage "therapist" is USELESS. Find another one

One great way to massage YOUR muscles on your own is through a foam roller (see this blog post).  

 

 

Added on 22 May 2014: Use a leg press machine:

Put the machine to the MAXIMUM (in terms of weight) and push the legs, while pushing the hips into the back of the machine, one hip at a time.

And use a hard medicine ball to grind the back muscles:

 

 

40% of the cure: EXTREME STRETCHING

Recover normal range of motion and length of muscle. This must be EXTREME and not a simple massage. But it is important to undertake a comprehensive stretching regime. Imagine pulling a branch of a tree very hard. Initiially, with severe RSI, stretching will also be very painful. But this is a crucial part of the package.

I used clinical Pilates and yoga as well. But I find these too mild now. I would have used more extreme streches had I known about them in the past 

Perhaps hte most important yoga postures are the shoulder stand and backward flip of the legs, shown below. 

5% of the cure: STRENGTHEN

NOTE: I've downgraded my strenghtening recommendation. It is actully NOT the key. It can help but only very marginally. 

Swim to strengthen your back muscles. Backstroke is particularly important. And use a range of weightlifting and other strenghtening exercises [some of these shown here]

5% of the cure: PACE YOURSELF

Pause before doing anything – relax the body as much as possible (Alexander technique, psychiatry MAY help, but in the end, this is a VERY SMALL part of the solution)

5% of the cure: SPEECH RECOGNITION

Use Dragon Naturally Speaking Ver. 9.0 or better to minimise typing.

[Update 22 May 2014: I've mostly give up using Dragon over the past few years, typing up to 10,000 words a day from morning to night, almost without a break. My solution to RSI works. But I have to keep up a very active stretching and massage regime] 

5% of the cure: ERGONOMICS

Good ergonomics will help, eg. a split keyboard. I also sat on a 65 cm fit ball at work from December 2006 – July 2010, after which I reverted to an ergonomic chair. The key is to have the arms hanging LOOSELY from the shoulders, looking at the screen without slouching forward. 

THE KEY THING IS TO NOT DESPAIR

It WILL get OK! May take time but IT WILL DEFINITELY BECOME OK NO MATTER HOW BAD IT IS. but you must not waste time on "solutions" that don't work.  A bunch of utterly USELESS "professionals" and "experts" make a living by selling BOGUS "solutions".

First thing – don't rely on your doctor or physiotherapist unless you want your problem to get worse. Either they'll give pain killers, or do some useless and expensive 'tests' including MRI, or give you useless therapies like ultrasound, or may even recommend surgery . Better spend all that money on the myotherapist, gym, swimming pool, and yoga classes.

The ignorance within the medical profession of the biokinetics and physiology of the muskulo-skeletal system is mind-boggling!

Instead or running after totally useless 'experts', just put in the effort outlined above. That will fix it. The solution is actually quite logical, as well. It makes physical sense. I'll explain the logic some day when I find the time, through a detailed book.

Get well!

Sanjeev Sabhlok

http://sabhlokcity.com/

Melbourne

Addendum, 21 June 2012

I'm working on a hypothesis that Vitamin D deficiency could exacerbate RSI. If you wish, you can check these blog posts:

http://sabhlokcity.com/2012/06/are-dark-skinned-computer-workers-more-susceptible-to-muscle-fatigue-rsi-eyestrain/

and

http://sabhlokcity.com/2012/06/the-worlds-greatest-doctor-alive-dr-holick-vitamin-d-guru/

Update 22 May 2014: I don't think Vitamin D is a vital factor in RSI.


NOTE: If my advice to you has worked then please consider donating to (a) help me recoup a tiny part of the tens of thousands of dollars I've wasted through bad professional advice from ignorant doctors and other nitwits, and, (b) more importantly, to help me spread the message of freedom across the world, particularly in India (working night and day on bringing liberty and good governance to India was the thing that drove me to the excessive typing that led to RSI). Write to me at sabhlok AT gmail DOT com.

sabhlok

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30 thoughts on “The Sure Cure for RSI
  1. sabhlok

    Dear Leela

    I didn’t use a foot mouse so can’t comment on that. Yes I did buy and read Sarno’s book. Found it totally irrelevant to my case and hence I strongly discourage it for cases where the physical cause (excessive typing, for instance, using a bad posture, without adequate stretching and rest) is obvious.

    Clearly you type a bit, since you are talking about using Dragon and the mouse. I would suggest you find a deep tissue massage therapist pronto. You’ve likely got your muscles in knots all over your upper body particularly neck area, shoulders, and lats. Pectorals as well. Once the big muscles are fixed only then you’ll experience significant relief. That will mean stretching them dramatically, through pilates and yoga, as well. Please also definitely include a strengthening regime. Try out Iron Cross: http://www.5min.com/Video/The-Gym-Workouts—Iron-Cross-58309225

    Basically go to a gym. And swim. You’ll need to invest at least 10 hours a week initially on recovery, else this won’t go away easily! Anyway that’s my experience. I currently spend at least 5 hours a week on RSI related exercises. The moment I reduce this focus, the thing flares up again, given that I type up to 12 hours in an average day, 7 days a week.

     
  2. judith

    dear sabhlok, please excuse the lack of capitals and brevity of this message.  severe rsi makes typing very difficult.  am i right in thinking that you had 7 years of regular myotherapy?  I have spent 9 months on regular physio, osteopathy and acupuncture to no effect.  i am feeling quite despondent.  i am prepared to try myotherapy, but have the feeling that i would need numerous sessions.  my muscles just keep tightening, as if that is their default setting now.  you really seem to have suffered with rsi, and it's encouraging to hear that you have found a cure.  how soon after starting myotherapy did you notice an improvement? 

     
  3. sabhlok

    Dear Judith

    The RSI problem is perhaps caused because muscles tend to have a kind of memory, and will revert to their “learned” position – like the humpback’s muscles are almost permanently twisted.

    If you do some yoga and muscle stretching you’ll know how quickly lose flexibility (flexibility is the best sign of muscle health).

    So the problem is that your muscles have tightened up very badly (particularly back and even thigh muscles – which hold up the arm) and need to be broken up and then loosened (made flexible). That is not going to be easy. And the breakthroughs will be slow.

    Treatments that you cite are totally useless. These people don’t know a THING about muscles. So a good myotherapist (muscle specialist) is crucial.

    The more you do the entire package that I have recommended – simultaneously, i.e. everything every week – the greater the chance you’ll experience quicker relief.

    Be prepared to spend a lot of money. And after all, what’s money for if not to help you in your time of need?

    The initial loosening is the hardest (and most painful). Once you are there, the rest gets easier. I experienced relief fairly quickly (in just about six months of intensive myotherapy – one or more sessions per week) but I did not do other things then – stretching/ backstroke, etc. Had I known the entire package then, my recovery would have been much sooner.

    Regards
    Sanjeev

     
  4. judith

    dear sanjeev
    thanks for your prompt reply.  i have managed to locate a myotherapist in the uk, where i live, and where they are virtually unknown.  i am seeing her on monday.  i am prepared for the long haul. i used to enjoy yoga and swimming in my youth, and am looking forward to resuming them as part of my recovery.
    i chuckled when i read your comments about the practitioners i'd seen.  the physio was ok, but ineffective.  however the acupuncturist kept saying that my pulse was 'forceless' and insisted on saying how well his other patients were doing.  the osteopath said that his other patients got well quickly.  he thought that i might have cadmium poisoning, despite the fact that i have never spent time near sites of cadmium dumping.
    thanks very much for your reply and the site in general.  i am looking forward to starting the project.
    best wishes, judith

     
  5. Heather

    Hello,
    I have been suffering with RSI for over 2 years now and like yourselves have been treated with acupuncture, physio, numerous medications, pain clinic sessions, brain diversion therapy and have just had a nerve conduction study  as the pain has now developed into my elbows but the test revealed nothing. I really do find stretching and yoga helps but only temporarily, while doing it. My physio has also said I have over flexible muscles (hyperactive is the term I think she used) to the point I can not dislocate my shoulder so I'm not sure if I agree with the above theory of people with flexible/supple musicles never getting rsi as I also dance alot so am quite flexible. I have only just heard of Myotherapy which sounds interesting but I cannot find one in the south of UK, only in London. Can anybody recommend a Myotherapist in Hampshire? 
    Thanks,
    Heather

     
  6. sabhlok

    Thanks, Heather

    Re: “My physio has also said I have over flexible muscle”. I’m not quite sure this applies to ALL muscles, for if it does then that’s a different problem to RSI. Dislocation is an altogether different issue, not related to “flexibility” as I think of it.

    For most of us, the following applies: Of the HUNDREDS of muscles in the body, some muscles, related to repeated exercises, get over-used, then get tired and tight. The key is to identify such muscles and break the “knots” and make them flexible.

    Anyway, you are welcome to pursue this line of thought and suggest a better theory that works for everyone. Happy to learn.

    Do post your question also on the Facebook group of this website – there might be someone from UK there.

    Regards
    Sanjeev

     
  7. sins

    hi,

    i have been suffering for two years now, i have done neary everything but Doctors and medicine seem useless I think the best way in recovering is helping yourself.
    I have found that when my upper back pain is bad my rsi is very bad vice versa.
    I am sure it has also to do with my neck and back pain been the causes. I can now use the mouse and keyboard and am getting better but is there and back stretch and exercises you can recommended or how to I fix this neck/shoulder and back pain?

     
  8. sabhlok

    As indicated, the entire package I’ve outlined is necessary. Yoga and Pilates are particularly good for the back. I have found that taking group classes under different instructors is useful since each person has a different style. But just yoga/pilates won’t help. Appropriate myotherapy/ deep massage is crucial. You can massage yourself in many ways as well (using a foam roller, for instance), but this requires actively seeking different techniques/methods. Avoid any single ‘solution’ provider, and try out a good number of combinations.

    Wish you the best.

    S

     
  9. Sanjeev Sabhlok

    Dear Friend
    I empathise with your pain at a deep, emotional level. RSI is no trivial problem. Its effects are devastating. But few, if any, of the members of the medical professions understand it. 
    It took me over three years to discover the basics of the cure – through reading tens of journal articles, hundreds of websites, and trying out tens of treatments. Only with myotherapy did the momentum of recovery pick up pace. All other treatments were weak and ineffective.
    The combined package that I suggest above is definitely more effective than just myothearpy. I'd recommend intensive treatments in the first six months – e.g. myotherapy twice a week, pilates once a week, yoga at least thrice a week, swimming backstroke at least twice a week, and some basic strenghtening of muscles at the gym.
    The first six months will be painful, but relief should be significant. Thereafter the treatment frequency can be reduced to suit your needs. You'll know by then what works, and how. 
    S

     
  10. sabhlok

     

    Dear Friend

    Sorry to hear about this continuing actute problem. I'm (personally speaking – and my myotherapist would agree too) 100% sure that this is all about tight muscle spasms that trap the nerves and create agonising problems. The whole of body needs to be treated, and the package of care that I've outlined does work. I use it – and it always works when things start getting bad.

    You have mentioned yoga, but yoga is 10 per cent of the cure. There are a  number of physical activities and massage (particularly in the acute stage) that are crucial. If you have tried everything I've suggested and still things didn't improve, then I don't know what to say, but if you have done everything (including regular backstroke swimming, extensive stretching of the body including key pilates postures (book openings they are called, but many others), and specialist massage) and things haven't worked, then I'd say do the surgery. 

    I'm not convinced, though, that surgery is appropriate, since the symptoms you describe are so close to the ones I have had, and managed to cure (or, rather, manage) without surgery. Maybe we should talk over phone – so I can explain to you what I do (or did), in more detail.

    sanjeev sabhlok

    Blog: http://sabhlokcity.com/

    MESSAGE RECEIVED

    HI Sanjeev,

    I am writing to you too ask your advice. I still struggle with rsi but now I have to make a decision to have carpal tunnel surgery.I was diagnosed with tendonitis of mainly my two thumbs,thoracic outlet syndrome (moderate) and carpal tunnel(mild) recently by a hand surgeon.I took you advice on the various things that you.said.However after a second bout of rsi in 2010 i could not do the heavy yoga poses using the hands and only recently i have started strenthening using resistance tubes for the arms and back.Only recently i can type for about 5 minutes before i get numbness.The foot mouse helped for bit and then I got foot pain which was minor and would discontinue after a while.I was able to help my upper back but my hands remain a problem.Voice helps to certain extent. I employed a part time typist and I dont drive anymore.Swimming helps too,especially the back stroke.In fact a number strokes combined helps too.

    So now since my test came back positive as compared to before, do you think I should in for the carpal tunnel operation.My thumb tendonitis and thoracic outlet is improving but every time i type i feel my wrists get stiiff and my index and middle fingers go numb.

    Greatly appreciate your views.

    Cheers 

    XX

     
  11. Sam Rommer

    Dear Sanjeev,
    I am a professional bass player in the UK. I have been suffering with RSI for a couple of months ever since playing a 2 week show on double bass, an instrument I have only ever played for a couple of hours a week (not the 2 hours a day this show required). Near the end of the two weeks I started to suffer with symptoms. 
    I went to see my chyropractor who diagnosed the tendonitis in both forearms and recommended rest after doing some deep tissue massage. 
    However, while the problem sometimes improves I am still seriously limited in how much playing I can do.  Since it has started I have been stretching every morning and night (both upper and lower body) as well as having a strict warm up involving stretching and using a powerball before playing. However, I have not been able to give my arms considerable rest (which seems to be widely recommended) until next month when I can give it a few weeks off.
    I would really appreciate some advice on how you think it best I get through this trying period as at the moment I cannot be at all creative as i have to save my arms for playing gigs.
    Kind Regards,
    Sam

     
  12. sabhlok

    Dear Sam

    Sorry, I saw this msg only now. From my experience, once this problem starts it is very hard to come back to normal quickly. Stretching will help, but the key is deep tissue massage at the early stage. And note that such massage is unlikely to help if it only covers the arms. The problem invariably is tight neck and upper back muscles, and often the pectorals and lats.

    Rest is generally pointless, since the spasms in the muscles won’t break through rest.

    S

     
  13. sabhlok

     

    Hi Sanjeev, I read with interest your website on RSi. I have struggled with it for several years. Have you ever read suparna damany's book? I am being treated by her now and am curious what you think. Sorry for the typos, written with voice activated technology. Also I hope it's okay that I friended you. Amy

    Sanjeev Sabhlok

      • xx, haven't read Damany's book. Essentially if it offers a combined basket of techniques (as at rsicure.sabhlokcity.com) it should work. There's no quick and dirty solution to this problem, but a battle to unlock muscle spasms in the upper body, then stretch the muscles and strengthen them. Sounds easy but this takes a lot of time (and money!) to fix. The better the massage therapist, the better the yoga/pilates instructors, the better the gym instructors, the better for RSI.

       

      Yes, she proposes a protocol that is very similar to what you recommend on your site. Thanks again for sharing your story, your site is very well-written. I'm glad your condition has improved, it's very encouraging.

       

      Sanjeev Sabhlok

        • Best of luck on your recovery. I'm able to type up to 14 hours a day now, again, after finding it difficult (impossible is the right word) to type even 2 minutes. I still do use Dragon where possible to minimise unnecessary typing, for each time I overdo the typing, I get back some of the symptoms and have to spend hours to fix the body again.
         
      • Natalie Brown

        Dear Sanjeev,
        Thank you for your website I have found it a most enlightening read.  I wanted to ask you urgent advice.  I think I have developed an RSI injury.  My arm has become progressively weaker over the last few  months to the poin that I battle to brush my teeth.  Three neurologists have ruled out motor neuron disease,  Can an RSI injury be so bad that the weakness is to the extent that I cannot pick up a salad bowl.  I would be most grateful to hear from you.  Kind Regards Natalie Brown

         
      • sabhlok

        Natalie, there was a time when I could not open a door handle, turn a screwdriver, lift a 2 kilo plastic bag of groceries, or put a (clothes)clip on a clothesline. Each of these experiences led to sheer exhaustion and pain.

        In that sense, the relevant muscles had reached the stage of total weakness and fatigue, which meant ordinary actions were extremely difficult.

        In each case, the key was exhaustion (and pain) moments after starting the relevant activity.

        If that is you, then yes, you perhaps have acute RSI. If you have a different set of “weakness” symptoms then don’t know.

        You can QUICKLY check if it is RSI by going to a myotherapist and asking him to check your upper body (generally neck/upper back) for seriously tight trigger points. If you scream when he/she touches (mildly!) then you have RSI.

        S

         
      • sabhlok

         

        Hi Sanjeev, can you have RSI without pain?  I did have a lot of pain in my right hand initially.  A lot of tightness in the forearm etc but weakness is in upper arm.  Do you think that is possible?

        MY RESPONSE

        RSI pain (and other symptoms) is essentially referred pain from nerves that are feeling trapped inside tight muscles. In peak RSI days (which lasted nearly 4 years) I experienced not just pain but burning skin, numbness, and extreme muscle exhaustion/tiredness (weakness). And typing became impossible due to extreme pain/burning sensations upon touching the keyboard.

        Releasing the tight muscles (primarily the back and upper body, including pectorals) slowly got rid of all symptoms (I still have some, but very mild, and that is because I continue to type a huge amount each day). 

        I can't readily visualise painless RSI. All I can suggest is that you get your upper body (including pecs and lats, upper back and all neck muscles) checked for tightness. If these are tight then get these released and you'll know fairly quickly (4-5 sessions) whether your upper arm weakness is being relieved. 

        If your upper body muscles are not very tight then from my experience and reading it is unlikely to be RSI. Even then, I'd suggest that a well trained myotherapist might have some idea about the cause.

        Best of luck. Wish you the best for a quick recovery

        PATIENT

        Thanks Sanjeev that gives me a little hope til I can see my neuro on Monday.  I have the burning, numbness and tingling and extreme weakness.  I am battling to find a myotherapist in XX but will get things checked out that you have suggested.  Thank you again I am most grateful for your time and feedback.

         
      • allwyn

        even i have these probs from long time now but yes i stretch and all and doctors are so stupid. i was already following these tips but still spent 3-4k for "professional "  treatment and it dint help anything at all – the bastard dint have time to even listen, its just routine for him and mechanical – write the same meds, send to some physiotherapy(and get a cut perhaps).

         
      • sabhlok

        COMMENT BY EMAIL:

        Dear Mr Sabhlok, 

        I am a person who usually dismisses medical information which diverts from mainstream medical theory. 

        Surprisingly, your website caught my attention and I am starting to get convinced by your content. 

        However, if RSI is simply a muscular tension/weakness, can you still explain why cold weather aggravates the condition?


        (PS: Do include this explanation in your upcoming book for skeptics like me) 

        MY RESPONSE:
        I've not noticed any such issue. In my case the strain has been directly linked with the amount of pounding I do on the computer, sitting stationary at the desk.

        There was a theory re: Vitamin D but after personal experimentation I discount it as a key factor. By all means have good amounts of Vitamin D but if the cause is PURELY computer typing related, then sunlight is a tertiary issue.

        Sanjeev

         
      • Sumit

        Yoga/Myotherapy specialists: Hello Sanjeev,

        Any recommendations for yoga/myotherapy specialists in India or US who understand RSI.Any particular attributes to look for in a yoga instructor who understands RSI?

         
      • sabhlok

        No yoga instructor I have met understood RSI – since it is well beyond anyone’s level of knowledge/training (including doctors’).

        The key is to undertake extreme stretches. Yoga is merely a form of stretching, but it is not extreme. You need extreme massage and extreme stretching.

         

         
      • Shane

        How long did you have to continue with treatment (stretching, massage, etc.) before you could get back to fully functioning without pain? Also once you have resolved RSI does it come back or relapse?

         
      • sabhlok

        Since I did not give up any typing tasks, it is a constant battle to incrementally loosen tight muscles. It is a work of years, and as the years have passed, I’ve become more efficient and effective in fixing the tightness. It has never entirely gone away, and if I were to not undertake regular stretching, etc., I’d be in pretty bad pain very soon. 

        But if someone were to reduce typing AND undertake these types of stretches, I’d expect they’d almost entirely recover to normalcy. I doubt whether there can be a 100 per cent recovery, though. The tightness spreads so dramatially across the key muscles (and smaller muscles) of the upper body (and even some to the mid/lower) with typing RSI that it will always remain a constant effort to stretch and recover full normalcy. But pain/burning should be largely history within 2 years of solid work, as outlined in this blog. 

         
      • Mauricio

        thank you very much for telling in your group about the new group i started recently.
        i have to ask you a last thing.
        since people no longer enter your group to see what you posted, could you make an event inviting all members and in the event tell the members of your group about the new one?
        this will be greatly aprreciated and will ensure that the members of your group get notice. Otherwise not all your members will know that there is a new group that is very active.

         
      • sabhlok

        Mauricio, the group is public ie anyone can see its posts, members, etc. So people who are interested will get the message.

         
      • Mauricio

        but i mane, if you look even the post you made on january was seen only by 30 people of the 80 in your group. It’s not an interest issue, it’s a how facebook works issue. So i’d like all your members to receive a notification, and an event is the only way i guess it is possible.
        thank you very much.

         
      • sabhlok

        Mauricio

        Pl. don’t make things too hard. I don’t know anything about your and your work or your group, nor have time to find out.

        I appreciate your effort but cannot in any way endorse your work. This is an open, free world. If your work is good, people will find out.

        Let’s leave this here.

        s

         

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