Pain guide · Back pain

Lower back pain on the leg press: the pelvis lifting off the pad, depth, seat, feet and what helps

Lower back pain on the leg press usually comes from going deeper than your hips allow: as your knees come towards your chest, your pelvis rolls up off the seat and your lower back rounds under the load. No study has measured the lower back on a leg press, so that explanation comes from coaching advice and squat studies. Setting the depth stop just above that point, keeping your back and tailbone on the pad, going lighter and breathing out as you press usually ease it. The leg press isn't shown to be bad for your back: it is rarely named in gym injury data, and trials have used it in people with back pain, though it still loads the spine (about as much as a squat, in one computer model). Pain down a leg is a nerve, pain at the tailbone is the seat, and a pinch at the front of the hip is the hip.

This guide starts with the signs that need help, from a 999 call for numbness around your genitals or bottom, new bladder or bowel trouble, weakness in both legs or a sudden, extremely painful headache during a heavy lift, to a same-day check through the National Health Service's 111 line (NHS 111) or a general practitioner (GP) for back pain with a fever, after a fall or with a leg that's getting weaker. It then maps the causes by where it hurts, explains what the studies show (and don't) about depth, the seat, your feet, discs and breathing, shows how to change your leg press today, and gives a three-stage plan with a 3D demo of every move, back to your usual leg day.

3-stage exercise plan When to get help 47 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Call 999 or go to A&E: back pain with chest pain, or back pain that started after a serious accident, such as a car crash.
Call 999: a sudden headache that is extremely painful and doesn't go away, during or after a heavy lift or at any other time, or weakness or numbness in one arm or down one side of the body. A bleed on the brain may be more likely when lifting something heavy.
Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Same day (NHS 111): back pain after a new, significant injury in the last 7 days, such as a fall from a height (off a box, a bar or rings) or a direct blow to the back.
Same day: leg weakness that is getting worse; new leg pain with a history of cancer, HIV, TB or inflammatory arthritis; or leg pain with a fever, feeling unwell, loss of appetite, unexplained weight loss or night sweats.
Same day (urgent GP appointment or NHS 111): new difficulty lifting the front of your foot or toes (foot drop), or a foot that slaps down or catches as you walk, especially if it is getting worse. Weakness in both legs, or with numbness around the genitals or bottom or bladder or bowel changes, is the 999 emergency above.
Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of your thigh, in your groin) and very bad tummy pain, you feel sick or you're being sick, you cannot fart or poo, you have a high temperature or you feel hot, cold or shivery, or you've suddenly become confused. Do not drive to A&E. With any other hernia and pain in or around it, a bloated tummy, feeling or being sick, vomiting blood or vomit that looks like coffee grounds, constipation, a high temperature or feeling hot, cold or shivery, or sudden confusion, get help from NHS 111.
Same day: you have or have had cancer, and new back pain that is severe and doesn't let up, is getting steadily worse, is worse at night and disturbs your sleep, is worse when you cough, sneeze or strain, or comes with tenderness over the spine. Contact your cancer team or GP urgently. With cancer, new weakness, difficulty walking, numbness or bladder or bowel problems are an emergency.
Call 999: sudden, severe pain in the tummy or back, which can come with breathlessness, pale or grey skin, or collapse. It can be a burst abdominal aortic aneurysm, most common in men aged 65 or over and in people who smoke or used to smoke.
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of squats, sit-ups, back extensions or burpees, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.

See a doctor or physiotherapist if

Back pain that hasn't improved after a few weeks of looking after it at home, stops you doing day-to-day activities, worries you, or you're struggling to cope.
Pain that doesn't improve with rest or is worse at night, or pain that is worse when you sneeze, cough or poo.
Unexplained weight loss, or a lump, swelling or change in the shape of your back.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
A lump in the groin, upper thigh or tummy, especially one that appears when you cough or strain and goes when you lie down: see a GP, as it may be a true hernia. A femoral hernia (a small lump at the top of the thigh, mainly in women over 50, though it can happen to anyone) needs treating in hospital.
Sudden new back pain after a minor fall, lift, cough or sneeze, from 50 or past the menopause, or if you take long-term steroid tablets; or height loss, a curved spine or a change in posture: see a GP. It can be a spinal fracture.
A teenager or young adult whose low back pain is worse arching backwards and hasn't settled after a couple of weeks: stop the lifts that arch the back and get it checked by a GP or a sports medicine doctor or physiotherapist. It can be a stress fracture of the spine (spondylolysis), which usually does well without surgery when it's found.
Back pain that started before 45 and has lasted more than 3 months, especially if it started before 35, wakes you in the second half of the night, comes with buttock pain, gets better with movement or within 48 hours of anti-inflammatory painkillers, or you have or have had arthritis, pain where a tendon attaches to bone (enthesitis) or psoriasis, or a parent, brother, sister or child with spondyloarthritis. These can point to inflammatory back pain (axial spondyloarthritis, such as ankylosing spondylitis). The National Institute for Health and Care Excellence (NICE) asks GPs to refer people with 4 or more of these 9 features to a rheumatologist, and to do a blood test for the HLA-B27 gene marker if exactly 3 are present, referring if it is positive.
Pain right at the base of your spine that is worse while you sit, when you sit down or stand up, when you bend forward or when you have a poo, and hasn't improved after a few weeks of a coccyx cushion and shorter spells of sitting: see a GP or physiotherapist. Our tailbone pain guide has the full list.
A strain that is getting worse, or isn't feeling better after looking after it yourself: see a GP or physiotherapist. In many areas you can refer yourself to physiotherapy.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

An ache across the lower back, on one or both sides, at the bottom of a deep or heavy press as your pelvis lifts

Usually ordinary low back pain, often a strain: by far the commonest pattern. A shallower depth stop, a lighter load and walking usually ease it.

Read: Back pain →A sudden catch or sharp pain during one rep, with the muscles locking up

A strained muscle or back spasm: common, and it settles over days to weeks.

Read: Back spasm and pulled back muscle →An even ache across both sides a day or two after a hard leg day, not during the press

Usually muscle soreness; our after-workout guide tells soreness from a strain.

Read: Back pain after a workout →Down one leg past the knee, with tingling, numbness or weakness

Sciatica, usually from a disc: less common, and slower to settle. A leg that is getting weaker needs a same-day check, as the warning signs say.

Read: Sciatica →A scan report says a bulging or herniated disc

Disc changes are common in people without pain, and herniated discs often shrink on their own.

Read: Herniated or bulging disc →Low on one side, by the dimple at the back of the pelvis, worse when one leg pushes harder

Possibly the sacroiliac joint. Even pressure through both feet, or single-leg presses, may suit it better.

Read: SI joint pain →Right at the base of the spine (the tailbone), as your pelvis rolls under on the seat, and when you sit

Tailbone (coccyx) pain. The link to the leg press is our reading; no study has looked at it.

Read: Tailbone pain →A pinch at the front of the hip at the bottom of the press

Usually the hip running out of bend (our reading). Stop higher, or try your feet a little wider.

Read: Hip pain when squatting →A lump or bulge in the groin, the top of the thigh or the tummy, bigger when you strain on heavy presses

A possible hernia: read the warning signs first.

Read: Groin pain →A teenager or young adult whose back hurts more arching backwards, building over weeks

Possibly a stress fracture of the spine, which was found in 47 of 100 young athletes with back pain in one clinic. Get it checked, as the warning signs say.

Read: Spondylolisthesis →Sudden pain with a crack during a heavy press, from 50, past the menopause or on long-term steroid tablets

Possibly a spinal fracture from thinning bones (osteoporosis): rare, but it is the only leg press back injury on record. Get it checked.

Read: Spinal compression fracture →The knees on the leg press

Our knee guide.

Read: Knee pain on the leg press →

Understand it

What the leg press asks of the back, and what no study has measuredEmerging evidence

You sit or lie back against a pad and push a platform away with your feet. The pad supports your back as long as your pelvis stays down. As the platform comes towards you, your hips and knees bend; when the hips run out of bend, the pelvis rolls up off the seat and the lower back rounds under the load (gym slang calls it the butt wink). The American Council on Exercise (ACE) coaches keeping your back and tailbone flat against the backrest, not lifting your bottom off the seat or rounding your lower back, and not letting your thighs press into your ribcage.

No study has measured the lower back or pelvis on any leg press, or counted back pain or injuries caused by it, so that explanation is coaching advice, not a measured fact. The nearest data are stand-ins from squats: in a barbell back squat, all 18 expert lifters' lower backs and pelvises bent a little at the bottom (18.4 degrees on average), and in 30 trained lifters the lower back rounded as soon as the bar went on their shoulders. One computer model of 8 trained lifters on a flywheel leg press (a machine that resists with a spinning wheel), read only as an abstract, put the squeeze on the lower spine about as high as in a back squat at the same effort. The one leg press study of the backrest measured only the pressure against the pad (15 people).

Sources 1, 2, 3, 4, 5

Gym back injuries: common, mostly minor, and the leg press is rarely namedEmerging evidence

In US emergency departments, the leg press was named in about 1% of lower-body and lower-trunk weightlifting injuries (an estimated 2,574 of 260,704 visits over 10 years), against 2% to 7% for squats and 1% to 9% for deadlifts. There are no figures for how often people do each lift, so these aren't injury rates. Across 345,254 New Zealand gym injury claims, about a quarter were the lower back or spine and 96% were soft tissue injuries such as strains, and the weight-training sports have low injury rates overall.

The only report of a back injury on a leg press is a 69-year-old woman with osteoporosis nobody knew about. On a failed maximal attempt of 109 kg with her lower back slightly rounded, she felt a soft crack; a fracture of a lower spine bone was found two and a half weeks later. She had first taken it for ordinary back pain, and she was free of symptoms at six and a half weeks.

Sources 6, 7, 8, 9, 10

Discs, rounding and back painMixed evidence

Discs can be made to bulge out in the lab: pig spines did so under compression with highly repetitive bending (up to 86,400 cycles), and 6 of 52 human cadaver discs prolapsed gradually under repeated bending and squeezing. Neither is living tissue that adapts, or a gym session. In people, rounding the lower back more while lifting wasn't a risk factor for starting or keeping back pain (11 studies, 9 finding no difference; low-quality evidence), and a review of 41 reviews found no agreement that posture or physical load causes back pain.

Scans often show disc changes in people without pain: across 3,110 people without back pain, disc bulges showed in 30% of 20-year-olds and 84% of 80-year-olds. Herniated discs often shrink on their own: across 31 studies, in 96% of the largest kind (sequestrations), 70% of extrusions, 41% of protrusions and 13% of bulges.

Sources 11, 12, 13, 14, 15, 16

When a scan or test mattersStrong evidence

Not usually. The National Institute for Health and Care Excellence (NICE) says don't routinely offer imaging for low back pain, with or without sciatica, outside specialist care, and disc bulges are common in people with no pain. The NHS slipped disc page says you may be referred for a magnetic resonance imaging (MRI) scan if your symptoms don't get better.

Tests do matter with the warning signs; after sudden back pain with a crack in an older adult or someone with osteoporosis, when a fracture needs ruling out; and for a teenager or young adult whose pain is worse arching backwards and lasts more than a couple of weeks. In one clinic, 47 of 100 young athletes with back pain had a stress fracture of the spine, against 5 of 100 adults.

Sources 17, 15, 18, 10, 19, 20

How it usually goesStrong evidence

No study follows back pain from the leg press. Across 33 groups of people with new back pain (11,166 people), average pain fell from 52 to 23 out of 100 in 6 weeks, then more slowly (12 at 26 weeks and 6 at a year); people whose pain had already lasted months improved less. An NHS trust says most new back pain improves within 6 to 8 weeks, NHS inform suggests talking to a professional if a back problem hasn't improved within 6 weeks, and sciatica is slower: 55% of 609 UK patients had improved at 12 months.

The NHS says back pain is very common, usually improves within a few weeks, and is very rarely a sign of a broken bone, cancer or an infection. No one can promise a date.

Sources 21, 22, 23, 24, 25

What helps, and how strong the evidence is

Depth and the pelvis: coaching advice and squat stand-insEmerging evidence

ACE says keep your back and tailbone flat against the backrest, avoid lifting your bottom off the seat or rounding your lower back, and don't let your thighs press into your ribcage; the National Academy of Sports Medicine (NASM) lists going far beyond 90 degrees of knee bend and letting the hips shift as common mistakes. That is coaching practice, not tested against pain or injury.

In the squat study used as a stand-in, depth didn't track how much the lower back bent, and hip range, including a stand-in measure of hamstring length, didn't predict it; lying down, the hip bent about 100 degrees before the pelvis moved. So the depth stop is set by watching your own pelvis, not by a number. Machines differ, too: in 15 trained men on an inclined leg press, a backrest reclined to 125 degrees from the seat let the hip bend further for the same knee bend than an upright one at 90 degrees. The back wasn't measured, so whether that is kinder to a sore back hasn't been tested, and no study has tested foot position against any back measure.

Sources 1, 26, 2, 27

How much the leg press loads the spine: one modelEmerging evidence

Only one study has estimated the squeeze on the lower spine during a leg press: a computer model of 8 trained lifters on a flywheel leg press, read only as an abstract. It put the peak compression between the lowest two lumbar bones (L4 and L5) about as high as in a barbell back squat at the same effort, with more shearing force than a flywheel squat. No one has measured it on the plate-loaded sled most gyms have. In a separate study of 15 people, the shape of the backrest changed the pressure against the lower back by up to 26% at half body weight. So the leg press isn't spine-free: depth and load still matter.

Sources 4, 5

Breathe out as you pressEmerging evidence

Heavy double-leg presses push blood pressure very high: in 5 bodybuilders pressing to failure it averaged 320/250 millimetres of mercury (mmHg), and in one it went above 480/350. In 10 athletes on a maximal double-leg press, breathing out slowly as they pressed cut the peak from 311/284 to 198/175 mmHg, against holding the breath. A brief held breath near a maximum is hard to avoid, and a review says its harms in healthy lifters remain unconfirmed.

Pressure inside the tummy was lower on heavy leg presses (about 161 mmHg) than in squats (more than 200) across 16 small studies. The NHS says a bleed on the brain may be more likely when lifting something heavy, which is why a sudden, extremely painful headache during a press is a 999 call. With a hernia, high blood pressure, heart disease or glaucoma, keep loads moderate and keep breathing (our suggestion).

Sources 28, 29, 30, 31, 32

Exercise helps back pain, and the leg press has been used without harmStrong evidence

Exercise eases long-lasting back pain by about 15 points out of 100 against no treatment (249 trials, moderate certainty), and the harms were mostly minor soreness; across 89 studies, resistance training ranked among the best for function, though the evidence is low quality. Heavy deadlift training did as well as gentle motor control exercise over 2 years in 70 people. NICE says keep up normal activities and consider group exercise of any kind, and doesn't offer belts or corsets as a treatment.

Two trials used the leg press in people with back pain, without adverse events. In 45 adults (32 analysed), adding a weekly machine circuit that included the leg press (56% of the most you could lift once, your one-repetition maximum or 1RM, for 20 reps in 60 seconds, twice) to group exercise was well attended but eased pain no more than group exercise alone. In 73 rehabilitation patients, 30 of them with back pain, horizontal leg presses of 4 sets of 4 at about 90% of 1RM raised strength by 43%; pain wasn't reported. No trial has tested a programme for back pain brought on by the leg press.

Sources 33, 34, 35, 17, 36, 37

Osteoporosis is the exception to "rounding is fine"Emerging evidence

The UK consensus on exercise with osteoporosis advises avoiding a high degree of spinal bending in exercise and daily life, notes spinal fractures reported with end-range, sustained, repeated or loaded bending exercises, and suggests strength training at the most you can lift 8 to 12 times, building up to 3 sets. In an old, non-randomised study of 59 women with spinal osteoporosis, new fractures followed a bending programme in 89%, against 16% with back-extension exercises. The one leg press back injury on record was in a woman with undiagnosed osteoporosis, on a failed maximal attempt with her back rounding. With osteoporosis or a high risk of it, keep your pelvis down and your loads at 8 to 12 reps.

Sources 19, 38, 10

How much pain is OK while you exercise?

Up to 5 out of 10, settled within an hour or so, and no worse the next morningEmerging evidence

This guide uses the back hub's rule, as our other back movement guides do. Some discomfort during exercise is fine, and it does not mean you are doing damage. Aim for pain you would call mild to moderate, no more than about 5 out of 10. It should settle within an hour or so, and your back should be no worse the next morning. If it is worse, do less next time (fewer reps, a smaller range, a lighter load), not nothing. Leg symptoms are the exception: stop or shrink any movement that sends pain, pins and needles or numbness further down a leg. NHS inform's back exercises use the same bands (0 to 3 minimal pain, 4 to 5 acceptable, 6 to 10 excessive) and ask for no worse the morning after; an NHS trust's back leaflet allows discomfort that eases within 2 hours; the NHS back pain page is stricter about specific exercises, saying stop if your pain gets worse and see a GP. In long-lasting muscle and joint pain, exercise into some pain did no worse than pain-free exercise (7 trials, 385 people).

For the leg press (our suggestion, built on the same rule): set the depth stop and the load so the last reps of each set stay at 5 out of 10 or less with your pelvis on the seat, and your back is no worse the next morning. If it isn't, raise the stop or lighten the load, not both at once. A sudden sharp catch mid-rep means end the set. Pain down a leg, numbness, a bulge in the groin or a sudden severe headache isn't a pain-rule question: see the warning signs.

Sources 23, 39, 25, 40

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep moving, take the depth out

About the first 2 weeks, walking daily and the gym 2 or 3 times a week: settle the pain without resting in bed, find out whether bending forward or arching back eases it, and keep your legs training with a press that passes the pain rule. With a diagnosed condition (sciatica or a disc, a hernia or a hernia repair, a stress fracture of the spine, osteoporosis with a fracture, or a back operation), that guide's plan or your team's comes first.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

5 to 10 minutes, several times a day · As in our squat and deadlift guides (editorial); walking outdoors counts the same. The NHS says stay active and don't stay in bed for long periods

Harder: Treadmill jogging

3D demoCat-cowBeginner · No equipment

8 waves, slower than feels natural, in a comfortable range · The move page's dose

Harder: Half lord of the fishes (Ardha Matsyendrasana)

Single knee-to-chest stretch demonstrated on the 3D figure

3D demoSingle knee-to-chest stretchBeginner · No equipment

Hold 20 to 30 s, 2 to 4 times each side · The move page's dose (editorial). Keep it only if bending forward eases your pain, and leave it out if it sends pain down a leg, as the move page says

Harder: 90/90 hip lift-off

Prone press-up (McKenzie press-up) demonstrated on the 3D figure

3D demoProne press-up (McKenzie press-up)Beginner · No equipment

10 slow repetitions, 3 to 5 times a day, while it helps · The move page's dose (editorial). Keep it only if arching eases your pain; skip it with spinal stenosis, if arching brings on leg symptoms, or if you're a young lifter whose pain is worse arching back

Easier: Sphinx pose (Salamba Bhujangasana)

3D demoLeg pressBeginner · Strength machine

2 sets of 12 to 15 with a light load, the depth stop well above where your pelvis lifts, breathing out as you press; leave it out for now if every rep hurts · Editorial, from ACE's depth cue and the breathing study on the leg press

Harder: Bodyweight squat

Lying sciatic nerve slider (nerve glide) demonstrated on the 3D figure

3D demoLying sciatic nerve slider (nerve glide)Beginner · No equipment

Only with leg symptoms: 10 repetitions with a 1-second pause, 2 to 3 times a day; try it for 2 weeks · The move page's dose (an NHS musculoskeletal service's). Keep it only if it eases your leg

Harder: Seated sciatic nerve slider (nerve glide)

Move on when: You can walk for 10 to 15 minutes and get in and out of bed and the car without catching pain, the light presses pass the pain rule, and the pain is easing day by day (as in our deadlift and squat guides).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Rebuild the press and the hinge

About weeks 2 to 6, 2 or 3 sessions a week: the leg press back at a moderate load in a range where your pelvis stays down, with the hips and trunk trained around it.

3D demoLeg pressBeginner · Strength machine

3 sets of 10 to 12, stopping 2 or 3 reps short, with the depth stop just above your pelvis-lift point; lower it a notch at a time only while the pelvis stays down and the pain rule holds · Editorial. For comparison, a back pain trial used 56% of 1RM for 20 reps in 60 s, twice, once a week, without adverse events

Harder: Bodyweight squat

Hip-hinge practice demonstrated on the 3D figure

3D demoHip-hinge practiceBeginner · No equipment

2 to 3 sets of 10 · As in our deadlift and squat guides (editorial)

Harder: Kettlebell deadlift

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

3 sets of 12 · As in our knee leg press and squatting guides (editorial)

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

3D demoBird dogBeginner · No equipment

2 to 3 sets of 6 to 8 each side, with 3 to 5 s holds · As in our squat and back pain guides (editorial). Make fists if your wrists complain, as the move page says

Easier: Bird dog, one limb at a time · Harder: Bear crawl

Dumbbell squat to a bench demonstrated on the 3D figure

3D demoDumbbell squat to a benchIntermediate · A dumbbell + A bench or box

2 to 3 sets of 8 to 12, stopping with 2 or 3 reps in reserve · The move page's dose, to a bench at the depth where your lower back stays put

Easier: Bodyweight squat · Harder: Back squat with bands

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

3 holds of 15 to 20 s each side · As in our squat and deadlift guides (editorial)

Harder: Side plank

Move on when: 3 sets of 10 to 12 leg presses at a moderate load pass the pain rule with your pelvis down, and your back is no worse the next morning, for a week (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to your usual leg day

From about week 3 to 6, later after sciatica: your usual depth, stance and load, one change at a time by the written steps below. No trial has tested a return to the leg press after back pain, so the order is editorial.

3D demoLeg pressBeginner · Strength machine

Your usual sets at your usual depth, as long as your pelvis stays down: start at about half your old working weight and add about 5% to 10% a week while the pain rule holds, with heavy sets of 4 to 6 last · Editorial, as in our squat guide. With osteoporosis or a high risk of it, stay at loads you could lift 8 to 12 times, as the UK consensus advises

Harder: Bodyweight squat

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

3 sets of 8 to 10 · As in our squat guide (editorial), only as deep as your lower back stays put

Easier: Bodyweight squat · Harder: Barbell front squat

Kettlebell deadlift demonstrated on the 3D figure

3D demoKettlebell deadliftBeginner · A kettlebell

3 sets of 10, 3 or 4 times a week at most, with at least a day between · The dose an NHS trust's back leaflet uses for loaded hinges (Romanian deadlifts with a moderate weight); the leaflet is past its expiry date

Easier: Hip-hinge practice · Harder: Dumbbell Romanian deadlift

Machine hack squat demonstrated on the 3D figure

3D demoMachine hack squatBeginner · Strength machine

2 to 3 sets of 8 to 12, stopping with 2 or 3 reps in reserve · The move page's dose (an editorial starting point). The same depth rule as the leg press

Easier: Bodyweight squat · Harder: Narrow-stance machine hack squat

Back extension on a 45-degree bench demonstrated on the 3D figure

3D demoBack extension on a 45-degree benchIntermediate · A bench or box

2 to 3 sets of 8 to 12 · As in our deadlift and squat guides (editorial). Move slowly and never fling into the top, as the move page says

Easier: Ball back extension · Harder: Horizontal back extension (hyperextension, Roman chair)

Farmer's carry demonstrated on the 3D figure

3D demoFarmer's carryIntermediate · A dumbbell + A kettlebell

3 walks of 20 to 30 m · As in our deadlift guide (editorial)

Harder: Suitcase carry

Move on when: Your usual leg day passes the pain rule for 2 weeks. Keep two strength sessions a week with a squat or press and a hinge after the pain has gone, and if it flares after a big session, go back a stage for a few days, not to nothing (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your leg press for now (written steps)

Our 3D figure can't show the machine's settings. These steps come from coaching sources, lab studies and a UK consensus; where a step is our suggestion, it says so. No trial has tested a change to the leg press for back pain.

1. Depth: set the safety stops, or the sled's start position, so each rep ends just above the point where your pelvis starts to lift off the seat (ACE's cue). Check it with a light set, and lower it a notch at a time over the weeks, only while the pelvis stays down and the pain rule holds (editorial).
2. Back and tailbone flat on the pad before the first rep, and your thighs never pressing into your ribs (ACE). If the pelvis lifts, the depth was too great; it isn't a sign that your core is too weak (editorial).
3. Backrest: if your machine adjusts, choose the setting where you reach your depth with the pelvis down. A more reclined backrest lets the hip bend further for the same knee bend, but whether that is kinder to a sore back hasn't been tested (the choice is editorial).
4. Feet: the whole foot on the platform, heels down, about hip-width or slightly wider, and a little higher if that keeps your pelvis down (editorial; no study has tested foot position against any back measure).
5. Load: lighter, stopping 2 or 3 reps short, with no maximal attempts or sets to failure while it's sore (editorial). With osteoporosis, keep to loads you could lift 8 to 12 times, as the UK consensus advises, and never round under a maximal load.
6. Breathing: breathe out as you press. On a maximal leg press, breathing out cut peak blood pressure by about a third against a held breath.
7. One leg at a time if one side hurts, at much less than half your two-leg weight (editorial).
8. If every leg press hurts, a hack squat or a squat to a bench may suit you better, or the other way round: no machine has been shown to be kinder to the back (editorial).
9. Getting on and off: put the safety catches back on before you take your feet off the platform, and don't twist out of the seat under load (editorial).

Sources 1, 27, 19, 29, 4

Back to your usual leg day (written steps)

No trial has tested a return to the leg press after back pain, so these steps are our suggestion.

1. One change at a time: depth, then load, then sets, then single-leg presses and heavy sets.
2. Add about 5% to 10% at a time after a session that passed the pain rule, as in our squat guide.
3. Keep a hinge and a squat or press in your week for a few months after the pain has gone.
4. If it flares after a big session, go back a stage for a few days, not to nothing.

Sciatica, a disc, a hernia and everyday life

With sciatica or a herniated disc, the NHS says the type of exercise isn't important as long as it doesn't cause pain or make your back pain worse, and that even if moving hurts, it's not harmful. Stop or shorten anything that sends pain further down your leg, and follow your clinician's advice if you have weakness or numbness.

The NHS femoral hernia page names lifting heavy weights among the causes. After a groin hernia repair, the NHS says no heavy lifting for at least 4 to 6 weeks; Danish surgeons suggest 2 to 4 weeks and say the evidence is limited, so follow your surgeon.

Everyday life comes back alongside the plan: walking first; sitting in shorter spells, with a coccyx cushion if your tailbone is sore, as the NHS suggests; and lifting at work with the load close to your body (in one volunteer, pressure inside a disc was about half as high with a 20 kg load held close as when lifting it with a rounded back). Sleep in whatever position is comfortable (editorial).

Sources 18, 41, 42, 43, 44, 45, 46, 47

Positions to swap, and why

Habit or position	Why it matters	Instead
Deep presses with your thighs into your chest	Your pelvis lifts and your lower back rounds under the load; ACE says avoid it.	A depth stop just above your pelvis-lift point.
Maximal attempts or grinding sets to failure while it's sore, or with osteoporosis	The only leg press back injury on record was a fracture on a failed maximal attempt with the back rounding, and the UK consensus advises loads of 8 to 12 reps with osteoporosis.	Sets of 8 to 12 with 2 or 3 reps in reserve.
Holding your breath on every rep	A maximal leg press with a held breath peaked at 311/284 mmHg, against 198/175 breathing out.	Breathe out as you press.
Lifting your bottom off the seat to get more range	Coaching sources say keep your back and tailbone on the pad.	A shorter range with your pelvis down.
Pushing through pain or tingling down a leg	That is a nerve, and the back hub's rule says stop or shrink the movement.	A shorter range or a different exercise, and our sciatica guide.Try: Lying sciatic nerve slider (nerve glide)
Resting in bed or stopping all leg training	The NHS says stay active and don't stay in bed for long periods, and an NHS trust doesn't recommend complete rest.	Walking and the stage 1 moves.Try: Treadmill walking
Counting on a belt to protect a sore back	NICE doesn't offer belts or corsets for managing low back pain.	Build back gradually; a belt is optional kit later.Try: Bird dog
Heavy pressing within weeks of a hernia repair	The NHS says no heavy lifting for at least 4 to 6 weeks, and surgeons vary.	Your surgeon's timeline, with walking first.
Long sits on a hard seat with a sore tailbone	The NHS says don't sit for a long time, and suggests a coccyx cushion.	Shorter sits, a cushion and a shallower press.

Routines to follow

Machine leg workout: leg press, leg extension, leg curl and calves

A 45-minute leg day on machines only: the leg press, then leg extensions and seated leg curls for the muscles it misses, hip abduction and calf presses.

45 minBeginner10 movesCardio machine, Strength machine

Leg day workout (gym)

A gym leg day: back squats, leg press, leg curls, Bulgarian split squats, leg extensions and calf raises.

55 minIntermediate9 movesA wall, A barbell

Hip hinge workout: learn to hinge in 15 minutes, no equipment

Learn the hip hinge at home: the wall tap, the dowel drill and a held hinge, then single-leg hinges and bird dogs, with an optional kettlebell deadlift.

15 minBeginner9 movesA wall, A dumbbell

McGill big 3 core routine

The McGill big three for the core: curl-ups, side planks and bird dogs, each held for 10 seconds at a time in falling sets of 5, 3 and 1 reps.

12 minBeginner3 movesNo equipment

Lower back strengthening workout: bird dogs to supermans, no equipment

A 20-minute floor workout for your back muscles: bird dogs and bridges, then a face-down ladder from the locust to the superman, with side planks and dead bugs.

20 minBeginner13 movesNo equipment

Lower back stretch routine

Seven gentle stretches and mobility moves for a stiff lower back, done lying and kneeling.

12 minBeginner7 movesA wall

More moves for this area

Questions people ask

Why does my lower back hurt on the leg press?

The usual explanation, from coaching advice rather than any study of the leg press, is that the press goes deep enough for your pelvis to lift off the seat, so your lower back rounds under the load at the bottom. Set the depth stop just above that point, go lighter and breathe out as you press. Pain or tingling down a leg is a nerve: see the warning signs.

Is the leg press bad for your lower back?

Not as far as the evidence shows: it is rarely named in gym injury data, and trials have used it in people with back pain without problems. It still loads your spine (about as much as a squat, in one computer model), so depth and load matter.

Can I do leg press if I have lower back pain?

Usually, yes, in a shorter range and with a lighter load that keep the pain at 5 out of 10 or less and your back no worse the next morning. The NHS says stay active. If every rep hurts, leave it out for a few days and walk instead.

How deep should I go on the leg press?

To just above the point where your pelvis starts to lift off the seat, and never so deep that your thighs press into your ribs. For many people that is around a right angle at the knee, as coaching sources suggest, but it varies with your hips and the machine.

Can the leg press cause a herniated disc?

No study shows that it does. Lab discs bulged out after tens of thousands of loaded bends, far beyond a gym session, and rounding while lifting hasn't been shown to cause back pain. The NHS lists exercising too hard among causes of a slipped disc in general, so keep the depth and load where your pelvis stays down.

Can I leg press with a herniated disc or sciatica?

Often, once it's settling: the NHS says the type of exercise matters less than whether it makes your pain worse. Stop or shorten anything that sends pain further down your leg. With weakness or numbness, follow your clinician's advice first.

Why does my tailbone hurt on the leg press?

Probably pressure on it as your pelvis rolls under at depth, though that is our reading and no study has looked. Stop higher, use a cushion when you sit, and see a GP if it hasn't improved after a few weeks.

What seat angle and foot position are best for a sore back?

No study has tested either for back pain. A more reclined backrest lets your hips bend further, so choose the backrest and a slightly higher foot position that let you reach your depth with your pelvis down.

Is the hack squat or the leg press better for a sore lower back?

Neither has been shown to be kinder. Both load the lower spine, and the same depth rule applies to each: stop before your pelvis tucks under. Use whichever lets you train within the pain rule.

Should I wear a belt on the leg press?

It's optional kit, not a treatment: NICE doesn't offer belts or corsets for back pain. Breathing out as you press and a sensible load matter more.

Do I need a scan, and how long will it take?

Usually no scan: NICE says don't routinely image back pain, and disc bulges are common in people without pain. Sudden pain with a crack, if you have or might have osteoporosis, needs checking instead. No one can promise a date, but most new back pain eases a lot within 6 weeks, and sciatica takes longer.

When should I see a doctor?

Call 999 for numbness around your genitals or bottom, new bladder or bowel trouble, weakness in both legs or a sudden, extremely painful headache during a lift. Get a same-day check for back pain with a fever or after a fall. See a GP if it isn't better after a few weeks; in the US, call 911 where this page says 999.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.