“We don’t have replication crisis in exercise science because nobody expects any of the studies to replicate”—paraphrased joke from Eric Trexler. PhD, >30 publications in the field, pro bodybuilder, professional coach
So, a lot studies related to health&fitness are horrible. Without funding they are run on 20 random college students for the duration of a single semester. Measuring what they actually want to measure is usually expensive to impossible, so usually a proxy will be chosen without any formal proof that the proxy is accurate. In general everyone in every health and fitness study is unhealthy and almost any intervention will help them so there are a lot of studies showing that ~miracle training~ works but really it’s because literally anything would have helped.
But if I flail around in the space of possible exercise interventions for my musculoskeletal problems I honestly expect that to go pretty well.
A lot of bone things can’t really be fixed with exercise, only worked around. Most muscle things are made better by getting stronger. People achieve world class deadlifts with scoliosis because they’ve strengthened everything else so much that the scoliosis can be compensated for. Rarely your shoulder bones are in a shape where you’re basically guaranteed to get rotator cuff damage if you work in certain planes. So some bone things are just impossible to fix, that person will never be able to do the volume of overhead work as someone else. But like, when your tendon gets inflamed and starts to hurt you can just stop doing overhead work and avoid injury. Even if you push through it and get a small tear, most people over 40 have scar tissue in their rotator cuff and experience 0 negative symptoms. And the scoliosis dude is better than where he started. Sure he might need some surgery to make it go away for good, but he needed that beforehand too.
So don’t worry about doing the best thing. Cardio probably won’t help any skeletal issue, but is good for general health. Warmups are good but don’t need to be long. A lot of warmups are just a chance for your body to settle back into good form. For muscular issues, you generally want to work on the muscle+synergists+antagonists. The muscle that hurts, the ones that move with it, and the muscle that does the opposite motion all three need to be strengthened to allow that plane of movement to be painless. Lifting with a proper progression scheme is many many times better at strengthening muscles than the next best thing. Yoga type things are nice for old tendon injuries. Just doing movements all through the range of motion can help you learn to compensate. Also sometimes a muscle isn’t activating right causing other muscles to have to compensate for that muscle. That’s a bit harder to explain in a short post (at least, at my current skill level) but it’s worth looking into if you have range of motion issues that isn’t solved with training that area specifically.
Note that this is assuming you have some normal back pain. I used to have lordosis that was bad enough that it hurt to walk >5min. Through the power of deadlifts I have fixed it and now I have medals from powerlifting meets. But for “oh god, I spent a month writhing in agony level” issues please disregard my advice that was aimed at the general public and see a physical therapist who works with athletes and those are usually the best. They will be able to give you advice specific to your situation, including possibly saying “above my paygrade, get surgery”. Also nutrition and medication are harder, this applies more to physical interventions than other types.
“We don’t have replication crisis in exercise science because nobody expects any of the studies to replicate”—paraphrased joke from Eric Trexler. PhD, >30 publications in the field, pro bodybuilder, professional coach
So, a lot studies related to health&fitness are horrible. Without funding they are run on 20 random college students for the duration of a single semester. Measuring what they actually want to measure is usually expensive to impossible, so usually a proxy will be chosen without any formal proof that the proxy is accurate. In general everyone in every health and fitness study is unhealthy and almost any intervention will help them so there are a lot of studies showing that ~miracle training~ works but really it’s because literally anything would have helped.
But if I flail around in the space of possible exercise interventions for my musculoskeletal problems I honestly expect that to go pretty well.
A lot of bone things can’t really be fixed with exercise, only worked around. Most muscle things are made better by getting stronger. People achieve world class deadlifts with scoliosis because they’ve strengthened everything else so much that the scoliosis can be compensated for. Rarely your shoulder bones are in a shape where you’re basically guaranteed to get rotator cuff damage if you work in certain planes. So some bone things are just impossible to fix, that person will never be able to do the volume of overhead work as someone else. But like, when your tendon gets inflamed and starts to hurt you can just stop doing overhead work and avoid injury. Even if you push through it and get a small tear, most people over 40 have scar tissue in their rotator cuff and experience 0 negative symptoms. And the scoliosis dude is better than where he started. Sure he might need some surgery to make it go away for good, but he needed that beforehand too.
So don’t worry about doing the best thing. Cardio probably won’t help any skeletal issue, but is good for general health. Warmups are good but don’t need to be long. A lot of warmups are just a chance for your body to settle back into good form. For muscular issues, you generally want to work on the muscle+synergists+antagonists. The muscle that hurts, the ones that move with it, and the muscle that does the opposite motion all three need to be strengthened to allow that plane of movement to be painless. Lifting with a proper progression scheme is many many times better at strengthening muscles than the next best thing. Yoga type things are nice for old tendon injuries. Just doing movements all through the range of motion can help you learn to compensate. Also sometimes a muscle isn’t activating right causing other muscles to have to compensate for that muscle. That’s a bit harder to explain in a short post (at least, at my current skill level) but it’s worth looking into if you have range of motion issues that isn’t solved with training that area specifically.
Note that this is assuming you have some normal back pain. I used to have lordosis that was bad enough that it hurt to walk >5min. Through the power of deadlifts I have fixed it and now I have medals from powerlifting meets. But for “oh god, I spent a month writhing in agony level” issues please disregard my advice that was aimed at the general public and see a physical therapist who works with athletes and those are usually the best. They will be able to give you advice specific to your situation, including possibly saying “above my paygrade, get surgery”. Also nutrition and medication are harder, this applies more to physical interventions than other types.