Hip pain on the leg press: the pinch in the hip crease, depth, foot position, the groin and swaps

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

You sit or lie back against a pad and push a sled away; as it comes back, your hips and knees bend. On a 45-degree sled, a hip physiotherapist notes, the hip is already bent to 90 degrees with the legs straight and goes towards its end of range at the bottom, and most machines take and release the load at the deepest point, so each set starts and finishes there. Lying on their backs, 18 experienced lifters bent the hip about 100 degrees before the pelvis began to move. When the neck of the thigh bone meets the rim of the socket, further bend comes from the pelvis tucking under and the lower back rounding, and in a lab study people with a bony bump on the thigh bone (cam shape) couldn't squat as low.

No study has measured the hip in people with hip pain on a leg press, or counted hip injuries on it. The nearest data: in 9 adults on a flywheel machine (one that resists with a spinning wheel), the hip bent about as far in the leg press as in a squat (78 against 81 degrees) and worked a little harder; that is one small study, not the 45-degree sled most gyms have. In 15 trained men, a more reclined backrest moved the hip through more range for the same knee bend; the study didn't report the deepest hip angle.

Sources 1, 2, 3, 4, 5

When it is impingement or a labral tear, and what a scan showsStrong evidence

An international agreement defines femoroacetabular impingement (FAI) syndrome as symptoms, examination signs and imaging together; hip or groin pain linked to movement or position is the symptom. A later consensus groups hip-related pain in active adults into FAI syndrome, a shallow or unstable socket, and labral, cartilage or ligament problems, and says examination and imaging have limited value on their own.

Hip shapes and tears are common in hips that don't hurt: bony bumps (cam) in 37% of pain-free hips (54.8% of athletes), extra socket cover (pincer) in 67% and labral damage in 68% across 2,114 hips, and labral tears in 54% of people without hip pain against 62% with it. So a scan has to match your symptoms. Hip arthritis from 45 is diagnosed without imaging when the pain comes with activity and morning stiffness lasts 30 minutes or less, the National Institute for Health and Care Excellence (NICE) says.

Sources 10, 11, 13, 14, 24

The groin, and the other hip pains on the pressEmerging evidence

An international agreement sorts groin pain in active people into adductor-related (the inner thigh), iliopsoas-related (the hip flexor), inguinal-related (the lower tummy wall), pubic-related and hip-related pain, from the history and examination. The NHS names lifting heavy weights among the causes of a femoral hernia, which needs hospital treatment.

A hip physiotherapist describes deep bend irritating the gluteal tendons on the outside of the hip, and the back of the joint, the deep rotator muscles and the nearby sciatic nerve when the hip is pushed to its end of range, especially with very flexible joints, a shallow socket or after a hip replacement through the back. Rarely, a bony pinch outside the joint at the front of the pelvis causes front-of-hip pain at deep bend, as in one elite weightlifter. The rowing machine's catch bends the hip deeply too, and labral tears in young rowers mostly gave groin pain.

Sources 18, 27, 26, 1, 21, 31

Who gets itEmerging evidence

No figures exist for hip pain on the leg press. The leg press was named in about 1% of US emergency visits for lower-body weightlifting injuries over 10 years (about 2,574 of an estimated 260,704); without figures for how often people use it, that isn't an injury rate. The hip is one of the three commonest injury sites in subelite powerlifters. In our reading, the pinch usually bothers people who press deep (thighs to chest), heavy or often, people whose hip shape brings the end of range sooner, and people with a stiff, arthritic hip.

Sources 22, 23, 3, 1

How it usually goesEmerging evidence

No study follows hip pain from the leg press. The NHS expects home care to help and says see a GP if hip pain hasn't improved after 2 weeks. For hip-related pain, exercise-based treatment runs for at least 3 months, and in the UK trials people improved with physiotherapy as well as with surgery. No one can promise a date.

Sources 25, 12, 15, 16, 21

Depth: the pinch sets your bottom, for nowEmerging evidence

No trial has tested leg press depth against hip pain. A hip physiotherapist advises limiting hip bend first to your own natural range and then less while it's sore, and a squat commentary advises avoiding deep squats with FAI. The rest is indirect: hip shape sets where your end of range falls, and people with a cam shape reached it sooner. So the depth stop goes just above your pinch, including where you rack and unrack, and comes down a notch only after a pinch-free week (our suggestion, as the site's hip squatting guide does with its box).

Sources 1, 2, 3, 9

Stance, foot height and the backrest: our reading of the geometryEmerging evidence

A squat commentary advises a wider stance with the toes turned out for FAI, and the hip physiotherapist suggests setting the hips a little out and turned out to reach more range before the pinch. On the inclined leg press, stance width (hip-width or half as wide again) and turning the feet out 45 degrees changed muscle activity little, and the authors suggest using your preferred stance; feet high or low made no difference to knee forces in 10 lifters, and high feet worked the glutes more in 14 women.

Lower feet on the platform bend the knee more and the hip less at the same sled depth, and the physiotherapist lists them, noting they need enough ankle bend; that trades hip bend for knee load. A more reclined backrest moved the hip through more range in 15 trained men, and whether it eases a pinch hasn't been tested. All of this is our reading of the geometry and one physiotherapist's advice, not a measured result.

Sources 9, 1, 7, 6, 8, 5

Exercise first for hip-related pain, for at least 3 monthsStrong evidence

An international consensus recommends exercise-based treatment for hip-related pain for at least 3 months, with education and staying active, sport included, though strong trial evidence for physiotherapy is lacking. In the UK FASHIoN trial (348 people with FAI syndrome), keyhole surgery scored 6.8 points better than personalised physiotherapy on a 100-point hip quality-of-life score at a year, just over the smallest difference people notice (6.1); adverse events, mostly muscle soreness, were reported by 72% after surgery and 60% after physiotherapy. In the FAIT trial (222 people), surgery scored 10 points better on a daily-activity score at 8 months, where the smallest noticeable difference was 9. A 2025 analysis of 21 trials found small advantages for surgery on two scores and no difference in pain.

Sources 12, 15, 16, 17

The leg press isn't dangerous for hips, including after a replacementEmerging evidence

In 7 people with instrumented hip replacements (measured about a year and a half after surgery), leg presses at half to full body weight and three backrest angles loaded the hip joint no more than walking at 4 km/h. In 60 people after a hip replacement, heavy leg presses (85% to 90% of their maximum, 4 sets of 5, 3 times a week) made them stronger at 3 and 6 months than usual physiotherapy and were well tolerated. The leg press is rarely named in emergency injury data.

But it isn't always kinder to the hip than the squat: in the one flywheel study the hip bent about as far, and a hip physiotherapist calls the 45-degree sled the most provocative form of leg press for hip pain. Use whichever lets you control depth within the pain rule.

Sources 19, 20, 22, 4, 1

Stretching doesn't change the pinchEmerging evidence

Strength training improved range of motion about as much as stretching across 11 trials (452 people). The pinch is bone meeting socket, so stretching into it doesn't change the shape that causes it (our reading), and pushing hard into it only brings the pinch on.

Source 30

Your leg press for now (written steps)

Our 3D figure can't show the machine's settings. No trial has tested any of these changes against hip pain; they come from a squat commentary, a hip physiotherapist's advice and lab studies of healthy lifters, and the foot height and backrest steps are our reading of the geometry.

• 1. Depth: set the safety stops or the sled's start position so the bottom of each rep, and the point where you rack and unrack, sits just above the pinch. Most machines take and release the load at the deepest point, a hip physiotherapist notes. Lower it a notch only after a pinch-free week (our suggestion).
• 2. Stance: feet a little wider than hip-width, toes turned out about 15 to 30 degrees, knees following the toes (a squat commentary's advice for impingement and the physiotherapist's). Stance width changed muscle activity little, so the choice costs nothing.
• 3. Foot height: a little lower on the platform bends the hip less at the same depth, if your knees and ankles allow (our reading of the geometry; the physiotherapist lists it). With kneecap pain, keep the feet in the middle.
• 4. Backrest and machine: choose the backrest setting where you reach your depth without the pinch, and a seated or lying machine over the 45-degree sled if you have one (the physiotherapist's suggestion). That a reclined backrest eases a pinch is untested.
• 5. Load and speed: lighter and slower into the bottom, stopping 2 or 3 reps short (the physiotherapist's load advice; the reps in reserve are editorial).
• 6. One leg at a time, at much less than half your two-leg weight, so each hip sets its own depth (editorial).
• 7. If every press pinches, a hack squat, a Smith machine squat or a squat to a box, where depth is easier to control, or the other way round: no machine has been shown to be kinder to the hip (editorial).
• 8. After a hip replacement, follow the precautions your team gives you; after a replacement through the back, these often limit how far the hip bends for a time. Later on, leg presses up to body weight loaded the hip no more than walking.
• 9. Breathe out as you press, and don't strain against a held breath if you have a groin lump (editorial).

Sources 1, 9, 7, 6, 5, 19

Back to your usual leg day (written steps)

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

• 1. One change at a time: depth, then load, then single-leg presses, then wider or deeper work.
• 2. Add about 2% to 10% at a time, after a session that passed the pain rule.
• 3. Wide-stance presses come back after wide goblet squats pass the rule, as our groin pain in squats guide says.
• 4. Sports that need deep hip bend (rowing, martial arts, ice hockey, squash, a low cycling position) come back after the press passes the rule at a useful depth, in short sessions at first.
• 5. If it flares after a big session, go back a stage for a few days, not to nothing.

Everyday life, the groin and a hernia

The NHS says keep moving without overdoing it, and don't sit in low chairs, which can put extra pressure on your hips. In the car, sit down first and then swing both legs in together, as our hip pain when sitting guide advises.

Groin pain with no lump usually comes from the muscles or the tummy wall, and our groin guides have the plans. A lump that appears when you cough or strain needs a GP, and a painful hernia needs help the same day, as the warning signs say.

Sources 25, 26, 27, 18