RSI is 100 per cent curable with exercise. No surgery needed.

Further advice on stretching and hard massage for RSI

I strongly discourage people from writing to me directly by email. I have just no time to provide personal advice. In this case, however, in response to an email I’ve received,  I’m providing general advice on this blog.

Hi Sanjeev,

I read your blog and facebook page regarding a sure cure for RSI with great enthusiasm. I think I’m experiencing the same, or at least quite similar, pain that you’ve had back at the end of the 1990s. I’m a fanatic, perfectionist student and try to always get the highest grades and best papers. Sometimes I studied up to 10 – 12 hours straight for exams. This, I did, in the worst possible posture (forward head, wrong chair etc.).

After I while I started to develop upper back and neck pain. It first started out after 2 hours, then half a year later, it was after 1 hour of studying, then a year later, after half an hour. Up until now, when I constantly experience pain in the upper back, neck and arms. The tingling, numbing, burning sensation all over both arms is horrible.

Of course I went to physical therapists (5 in total, pain only worsening), neurologists (recommended an MRI, nothing to be found, expensive!), trigger point massage therapist (only worsening of pain), ergo therapist (helps a little, because I now have a good posture, but no reduction of pain), and I read Sarno’s books.. As of three weeks ago I started to follow your regime. I apply self-massage with the foam roller (very hard one), and hard ‘tennislike’ balls. Excruciatingly painful this self-massaging. I also swim now, four times a week. Swimming in general and the backstroke in particular appears to really help. I then started Pilates classes, but this only seems to worsen the pain. The muscles of the upper back are way too overworked now, and I feel as if I’m back at square one (after being so glad I found relief in the massaging and swimming). I’ve experienced more pain than before for more than 3 days now, after I took the Pilates class.

Is it too soon for Pilates? Is it normal to experience more pain? What is the order of applying your ‘cure’? Do the knots need to be gone first, and then you start to stretch and strengthen? Is there no order?

Hope you can help me out a little here.

Much appreciated.

Kind regards,


Once muscles are stressed beyond their coping ability they become really tight/sticky/cramped. Hard as golf balls. Excruciating pain/burning is the consequence, as nerves get cramped badly from all sides.

The solution is manifold and must be done each day in some form or other:

Extreme stretching (not ordinary stretching). This means pulling the tight muscles (unfortuanately I don’t have time to depict all such stretches, but imagine pulling a branch of a tree very hard. Such stretches.

Extreme massage. The roller is great but this is even better – to ease cramped hip muscles. Put the machine to the MAX (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.

And so on.

You get the point: What ever you do – ensure that you break down the muscle spasms/cramps and then STRETCH.

Over time (and this means TIME!) you’ll find incremental improvements and allow you to hand-type up to 10,000 words a day again (as I usually do). But a strong regime of exercises is crucial if you wish to do such intense typing.


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4 thoughts on “Further advice on stretching and hard massage for RSI
  1. Robin

    Hi Sanjeev,

    I don't think the roller is of much use for the smaller muscles between the shoulder blades. That's where it really hurts. The foam roller is good for the big muscles, but these don't hurt as much as the little ones. With a small, hard rubber ball I can get to those muscles, not with the foam roller.

    As I understand you're reply, the massaging comes first and after TIME you can start the stretching? When the muscles don't hurt as much during the massaging? Because when you do the stretching / strengthening before that, it tends to overwork the muscles that are already cramped up? Pilates, yoga, and the gym only worsen the pain at this stage.

    It would be really great if you could find just a few minutes to quickly outline some of the extreme stretches you talk about. Can't find anything other on the internet than just regular upper back stretches. The example you give of a tree branch that is stretches really hard is stricking, but I can't see any practical stretch of the upper back that could do such a thing.

  2. sabhlok

    Use a hard medicine ball, yoga block (made of hard rubber), or a baseball (softball). By contorting yourself suitable (and that is a stretch in itself) you CAN grind almost all muscles through the roller. Focus on the biggest muscles is the key. In fact after the biggest muscles are ground down and stretched, the pain in the smaller muscle usually disappears.

    No, there is no “sequence” massage > stretching.

    BOTH must be done together, many times a day every week. Grind muscles till you can’t bear it any more. Then stretch – extreme stretch – till you can’t bear it any more. The results will start showing very quickly.

    RE: worsening of pain – you’ve got to test out yourself where to draw a line. Progress is usually very slow (but sure). This is not a miracle cure. It WILL take time, depending on how bad you’ve tightened up your body.

    Re: extreme stretch,

    – hang from the top of a strong door or metal stand used for chinups, etc. Find ANYTHING strong – and pull/push your body. Don’t be afraid of any contortion. The contortion that hurst most is the most useful since that’s the area that nedds most stretching.

    There are a lot of “standard” stretches – which are pretty good too. Any standard book on stretching has them.

  3. Carolyn

    Hi Sanjeev, great further advice. I have however two quick questions relating muscle-tension:

    1. After fixing most of the muscles in the upper back, all the tension now seems to concentrate in the upper trapezius muscle. It's burning really bad, and pain radiates through to both the arms. I feel that I've fixed most of the other back muscles. Stretching them hurt like hell in the beginning but feels great now. My question is; how do you 'extreme stretch' the upper trapezius? The stretches I've found online and in books on stretching don't seem to cut it.

    2. I read that stretching a muscle that is really hard, tense, painful and burning can further damage that muscle. This is the case for my upper trapezius. The muscle feels like a steel cable, and hurts upon touching it. How to approach this? Is it true?

    I really appreciate your help. Been struggling with this for years now. I also like how you conclude almost all of your messages with comforting words, like 'its will be oke', 'you're going to be fine!'. Much better than all the crap I've been hearing from the 'professionals'.

  4. sabhlok

    Carolyn, I recommend a combination; (a) loosen tightness through deep massage/grinding and (b) stretching . Neither will work on its own. Both are required. Re: trapezius, the grinding is done through the roller/ medicine ball. Stretch through extreme pulling on relevant gym equipment (basically a range of pulling motions – contortions, etc.). Also standard yoga/pilates postures to strech upper shoulders (plenty of these exist, while lying on the ground). Glad these are working. They will, since they address the cause. Btw, you’ll learn by experimenting. And no, I’ve never accepted any ‘myths’ such as ‘stretching a tight muscle wil damage it’. There is NO damage caused to any muscle. Muscles keep rebuilding themselves. Ask an athlete. The more you loosen them the better they perform.


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