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It sounds like you're touching on a common misconception in the world of physical therapy and pain management—namely the idea that "gluteal amnesia," or the belief that the glutes are “shut off,” is a primary cause of back pain. Let's unpack that a bit.

The Myth of "Gluteal Amnesia"The theory behind gluteal amnesia is that modern life—especially long hours of sitting—leads to the glutes becoming "inactive," weak, or "shut off," causing compensatory patterns that contribute to pain, particularly in the lower back. As a result, exercises to "wake up" the glutes are often prescribed.

However, the idea that your glutes are literally "shut off" is an oversimplification. The gluteal muscles don’t typically lose their ability to function unless there is significant damage to the nerves or muscles themselves, which is quite rare. The more likely scenario is that inactivity, poor posture, or lack of proper exercise leads to weakness or disuse of the glutes, but this doesn’t mean they’ve completely stopped working. Instead, other muscles might compensate, creating inefficient movement patterns that contribute to pain.

Pain is MultifactorialAs you mentioned, pain is much more complex than simply a lack of gluteal activation. Pain can have physical, psychological, and neurological components, and research has shown that even if an area of the body is structurally impaired or weak, it doesn’t always correlate directly with the pain someone experiences.An infographic by Ben Cormack highlights this complexity—illustrating that pain can be influenced by factors like:Local physiology: This includes tissue damage, muscle weakness, or inflammation.

Distraction: Engaging in a different focus or activity can help reduce the sensation of pain.Cognitive beliefs and emotions: Our perception of pain is also shaped by how we interpret it emotionally and mentally. For example, believing that pain means damage or that one is fragile can increase sensitivity to pain.

Exercises Can Help, But There's No "One Size Fits All"While activating the glutes with specific exercises (such as bridges, clamshells, or hip thrusts) can help improve strength and function, they’re just one part of the equation. Exercise may reduce pain by improving the body’s function (e.g., strengthening muscles, improving posture, increasing blood flow), but it may also help by shifting our attention away from pain, improving mood, or altering beliefs about our bodies' ability to heal.

Furthermore, pain management is holistic, and addressing it often requires a combination of strategies, including:Movement & Exercise – To correct imbalances and improve strength or mobility.Education – Understanding the complexity of pain and how our thoughts and beliefs affect it.Psychological Approaches – Techniques like cognitive behavioral therapy (CBT), mindfulness, or relaxation exercises to help manage pain perception.Manual Therapy – Techniques like massage, dry needling, or myofascial release that may provide short-term relief.

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