Leg Press and Lower Back Rehab

Leg Press and Lower Back Rehab

When working with patients recovering from lower back injuries, particularly bulging or herniated discs, I mentioned in previous posts that my goal is to improve function while minimizing irritation to the lower back.  For people rehabilitating from bulging or herniated discs, I avoid spinal flexion activities, as this may cause further disc protrusion.  I do not usually use the leg press machine, as in my opinion there are more functional lower extremity activities that I would rather spend time performing.  However, if for whatever reason you are using the leg press with your "lower back client," you can minimize the strain placed on the lower back by performing single leg presses rather than bilateral presses.  Here, the non-working leg remains on the floor during the press. 

Image 1

Image 2

In image 1, you can see that at the deepest part of the motion, where the knees are up against the chest, the lower back is extremely flexed.  This may lead to further posterior "disc creep."  In image 2, keeping the non-working leg on the floor helps to maintain a more neutral pelvis and lumbar spine, decreasing disc protrusion.  This places much less stress on the spine and intervertebral discs.