Combating back pain through leg strength

6. July 2025

@iStockphoto: Iona Studio

Runners often suffer from back pain. Surprisingly, strengthening the legs offers more effective pain relief than solely focusing on back exercises, as a study has shown.

Anyone who runs regularly should expect to deal with musculoskeletal issues at some point. Statistically, more than half of all runners injure themselves at least once per year! In order to stay injury-free, it’s essential to find a personal balance in terms of weekly mileage, number of training days, and intensity levels. It should be just enough to be challenged, but not overstrained.

Still, when injury strikes despite precautions, the back is often affected as well. This led researchers from Singapore to conduct a study on those affected. The study investigated whether leg training could be more effective in relieving back pain than the typical back exercises prescribed. The reason behind this unusual approach: In an earlier study, the researchers found that runners with chronic lower back pain had weaker quadriceps muscles. As a result, they benefited less from the shock-absorbing function of the quadriceps while running, which increased strain on the lower back. So, could strengthening these weaker muscles provide relief?

Significant improvement in well-being

84 recreational runners who were on a waiting list for physiotherapy due to back pain were selected for the study. All participants had been suffering from back problems for more than three months and ran two to five times per week. Each was assigned to one of three different eight-week training programs. All programs included two supervised sessions per week; on the other days, participants trained at home without supervision. The programs focused on different areas:

  • Program 1: Leg muscle training (e.g., leg presses, single-leg squats, wall sits)
  • Program 2: Lumbar extensor training (e.g., back extensions, opposite arm and leg raises in a tabletop position)
  • Program 3: Core stabilizer training (e.g., balance exercises, resistance band exercises)

After six months, all three groups showed a reduction in pain levels by about three points on a 10-point scale. This indicates that any kind of strength or stabilization training has a positive effect. Interestingly, the leg training group showed a significantly greater improvement in self-assessed "running ability" (3.8 points compared to 3 or fewer points in the other groups).

According to the researchers, the leg exercises improved quadriceps strength, enhancing their shock-absorbing capacity and thus increasing the score on the running ability scale. There were hardly any differences between the other two groups. It appears that leg muscle exercises can have just as positive an impact on the lower back as back-specific exercises, though the reverse is not true.

So, what can we learn from this?

Leg exercises don’t just strengthen your legs, they also benefit your core and back. A true two-birds-one-stone approach.