The legs contain the largest muscles in the body, and they have a lot of responsibility to provide locomotion, stability, and support. The legs are an important link in the chain of back stability and back health. Many of the leg muscles connect to the pelvis or the spine, and therefore they need to be recruited and trained in response to back injury and/or back surgery. Exercises for the legs can be done with or without weights, but it is important to use all of the muscles involved. A combination of exercises should be done so that gross movement patterns and specific muscular patterns are addressed. Your starting goal can be 1-2 exercises, 1-2 sets, and 15-20 repetitions.

Many leg exercises are done with weight added at the shoulders. For example, popular leg exercises include barbell squats, machine squats, and hack squats. These exercises create an axial load, or a load from the top down, which can compress the spine, and may cause pain for people with back problems. These exercises may also force the back into an excessive forward bend, back bend, or twisting, all of which can further aggravate an injured back.

Leg presses are also used, but they create a lot of internal pressure and may also compress the spine. Often, the hips are elevated off of the machine, and the exerciser feels increased tension on their spine. It is best to avoid being axially loaded with external weights and also to avoid the compressive forces of a leg press.

Squats are great for the leg muscles and they can still be done using body weight only. For additional resistance, hold dumbbells at your sides. Stand up tall with your legs shoulder-width apart. Now think about sitting back in a low chair, initiating the movement by bending at the hips. Ensure that the back is upright, the core muscles are engaged and that you are under control during the movement.

Lunges provide a similar positive response from the leg muscles. They can be done while stationary, with alternating legs, or walking. Stand up tall and reach forward while leading with your heel. Your feet should now be in front/back straddle. Bend the front knee until the thigh is almost parallel to the ground and the back knee bends to almost touch the ground. Return from this position and repeat. As with squats, this can be made more challenging by adding dumbbells.

Every gym has machines for leg extensions where you sit with knees bent and straighten your legs against resistance. These are typically safe exercises. Leg curls for the back of the legs should be done, but perform these on the seated curl machine and not the laying curl machine. Laying face down may add stress to the back. Leg curls and hip extensions (for the glutes) can also be performed with exercise tubing.

Work the leg muscles by walking backwards, sideways, and at an angle. Step up, bringing your knees high, or step up and down onto a riser/stair/platform. Use the stair to perform calf raises as well. Place the balls of your foot on the stair and let your heels hang off. Next, gently rise up on the balls of your feet, so that you feel the calf muscles contracting.

As with cardiovascular and upper body exercises, it is important to try a variety of exercises. Get specific limitations from your therapist or doctor, and then try things that do not contradict their recommendations. You need to experiment to see which exercise will work best for your body and your condition, but you will see that some activity is better than none at all.

Manny Escalante, Jr. MA, ATC, CPT has a Master's Degree in Sports Medicine,

Certified Athletic Trainer, and Certified Personal Trainer.

Disclaimer: The material presented is for informational purposes only. It is not intended to treat, diagnose, or cure any condition or ailment. It does not replace nor supersede guidance from qualified medical professionals. Reader assumes any and all risk if they choose to perform any of the activities presented.