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Comment by ellyagg | Hacker News Reader

Indeed. My wife broke her back in college before we met. Since then she'd had chronic back pain and she figured that's just what she'd have to live with. What fixed it for her was hip thrusters, which are targeted toward the glutes, but also work the lower back to some extent.

To that last, I've wondered how much glute weakness is the factor in back pain. I don't know why it necessarily would be, but a long time ago I saw a study where high school kids with chronic back pain were 100% cured by quadruped hip extensions. Of course, those also work the back to some extent, but it's another exercise that's prescribed for the glutes.

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I have spent a year working on combating my back pain and I can tell you that the musculoskeletal system is exactly that - a system. The joints and muscles all work in concerted effort to move and this idea of isolated muscular contraction is a bit like pure functions in Haskell: ultimately pretty useless without IO.

The core and spine is crazy complex. For starters I've learned a whole bunch of new muscles: glute medius/max, QL, serratus, interior/exterior obliques, multifidus, upper/lower/transverse abs, inner thighs, quads, hamstrings, hip extensors/flexors, lats, spinal extensors/flexors, rhomboids, upper/lower traps, pecs minor/major, levator scapulae...

That sounds like I've just rattled off some anatomy but literally all of those network together to mobilise your spine and any one of those being out of whack can cause cascading and coupling issues of other nodes in the network.

Glute weakness for sure is one of them so could any of the other ones...

This is very well articulated, but very disappointing to see so-called expert in their field orthopedic doctors advise their patients with the exact opposite.

> The joints and muscles all work in concerted effort to move and this idea of isolated muscular contraction is a bit like pure functions in Haskell: ultimately pretty useless without IO.

Great illustration. I'm all about functional strength.

There is a big difference between being able to pick up and throw 50 pound sacks of potatoes and the isolated exercises most of us do on machines.

Total body strength seems far more useful.

Don't do machines, they are really not that good for most uses. The fringe usability I can think of - competition bodybuilders, training around injury of professional athletes. That's probably it. Anything else ain't worth it.

People often do max 1 specific muscle with them, ie biceps or chest to impress and fight low self-esteem, but that's generally not a good way either.

As mentioned, muscles work in complex groups, and having 1 part way stronger than the rest will lead to injuries in real world usage. And injuries mean you will lose it all, and possibly worse.

This.

P.S. Love your username. You'll be pleased that the name of my garage gym is the Gravity Chamber.

Very well said.

I've had trouble knowing where to start, sometimes spending days working on the wrong part of the system, playing wack-a-mole because I hadn't figured out the right root of my pain.

Going to PT helped a whole lot, reading Robin McKenzie and Jim Johnson is great, but I also really like Jeff Cavaliere's technical explanations on his ATHLEAN-X YouTube channel [1]. He's a physical therapy and strength coach that gets crazy on his body with a magic marker and shows you how a chain of issues drives common problems. That deepened my understanding a lot, layering on top of all the other resources.

[1] https://www.youtube.com/channel/UCe0TLA0EsQbE-MjuHXevj2A

I can add one data point to the glute component. I used to see a chiropractor. They are mostly useless for this kind of thing°, but did recommend glute foam rolling, which somehow helps a lot with my lower back pain. I would encourage people to try it even if they're sure the pain is in their lower back. Something about rolling those muscles really well helps me a lot.

° IMO. I'm sure it helps others and is not a point I make very strongly.

quadruped hip extensions have helped me a lot, too

I've tried hip thrusters in the past when I knew less about how weak my glutes were. I'll give them another try. ty for sharing

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