To use the BackSystem3, the user must first straddle the machine in standing position, place the safety strap around both wrists, sit on the seat and place both knees on the roller pads, and finally place both feet in the foot pedals. To begin the first exercise, the user will push backward with the hands, bringing both knees to the chest. As the seat begins to pivot posteriorly, the lumbar spine will be flexed and the knees will approximate the chest.

To return to the seated position the user will contract the erector spinae, gluteals and the upper arms. Upon reaching the last 20 to 30 degrees of movement to the upright position, the upper arms should stiffen and lock at the elbow to allow the lordotic curve of the lumbar spine to return and the firing of the lower abdominals.

Regardless of the relative condition of the user, the first few (10 - 15) repetitions should be performed slowly and rhythmically. BackSystem3 has an upper and a lower set of handle bars. Grasping the upper handle bars provides the user the ability to stretch the dorsal spine and related soft structures.