Low Back Disorders

What Hacker News says

1. antogniniAug 2015
   I recently hurt my back and got interested in the anatomy of the lumbar spine and ended up reading the textbook Low Back Disorders by Stuart McGill. McGill is a professor of kinesiology at the University of Waterloo and has spent his ~30 yr research career studying the lower back. It was an informative and surprisingly interesting read!

   He made the point throughout the book that a lot of "common sense" clinical wisdom regarding the low back has little basis in the scientific literature. Among these was that there really is no "correct" sitting posture. All sitting postures are damaging to the low back over long periods of time. Instead he recommends varying the sitting posture at least every ~10 minutes or so, and standing up for a few minutes at least once an hour. Acceptable sitting postures could be anything from sitting up straight as in the illustration in the article, leaning back, sitting cross-legged in the chair, or putting your feet up on the desk. All are fine as long as you change it up every now and again.

   There were a few other bits of wisdom in the book. A few I remember off the top of my head:

   - Don't do sit-ups under any circumstances. They are among the worst exercises you can do for your back. The traditional back extension exercise (e.g., http://lifestyle.beiruting.com/wp-content/uploads/2011/02/su...) also puts the lower back under a huge amount of stress.

   - Muscle strength is not well correlated with having a healthy back. Muscle endurance is much better correlated with back health.

   - Don't do anything to exert your back within an hour or two after waking up (including stretching the back to extreme flexion by, for instance, trying to touch your toes). The hydrostatic pressure in the discs after rising from bed is much greater, which increases the risk of herniation. (This is why one is ~1/2 an inch taller in the morning than in the evening.)

   - If the spine is flexed for a long period of time (e.g., one is sitting slouched over for twenty minutes), the ligaments become lax and remain lax for some time afterwards. Only 50% of the intervertebral joint stiffness remains two minutes later, and even 30 minutes later some residual laxity remained. So if you've been sitting slouched over, don't immediately go and exert your back by lifting a heavy object. Stand up for a few minutes before exertion.

   - Squatting is not necessarily better than stooping when picking up an object. It's most important to keep the spine in a neutral posture.

   - When picking up a light object, it's best to use the golfer's lift if possible (e.g., https://liftingtechniques.files.wordpress.com/2012/12/golf.p...)

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2. jongraehlMay 2009
   Stuart McGill's http://www.amazon.com/Low-Back-Disorders-Evidence-based-Reha... is a good textbook. It's not for the layperson looking for quick recommendations, but he does give some recommendations based on physical and computer models of the spine under various exercises (and traumas).
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3. dkarlMay 2009
   These two books are essential reading for people with back problems and should be reasonably accessible to anyone with both an athletic background and an advanced high school understanding of anatomy and physiology.

   http://www.amazon.com/Low-Back-Disorders-Evidence-based-Reha...

   http://www.amazon.com/Ultimate-Fitness-Performance-Stuart-Mc...

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