What is Backwards Walking? Beyond Just Going in Reverse

Defining the Practice and Its Historical Roots

Backwards walking has been touted as a therapeutic form of exercise for a variety of potential conditions. Ancient Chinese records recommended the practice of backward walking for martial artists. In modern times, backward walking has been used in physical therapy for the treatment of knee injuries and for gait training in patients with neurological conditions such as stroke or cerebral palsy.

Why Does It Differ from Forward Movement

Backwards walking differs from forward walking in both mechanical and cardiovascular requirements. Mechanically, backward walking places less stress on the knee, as the toes (rather than the heel) strike the ground first, shifting stress from the knee to be absorbed by the foot and ankle. When compared to forward walking, backward walking also increases activation of the quadriceps muscles (the muscles on the front of the thigh), which may be beneficial for knee rehabilitation, and the tibialis anterior, the muscle on the front side of the calf, which may help maintain balance while standing.

From a cardiovascular standpoint, backward walking has been found to elicit greater energy expenditure than forward walking at the same speed. Practicing backward walking can be a useful addition to conditioning for activities that require backward movement, such as martial arts or officiating in field sports.   

Key Benefits of Incorporating Backwards Walking

What evidence do we have that backwards walking is an effective therapy? Small sample sizes and short intervention durations limit the majority of clinical trials examining the impact of backward walking. For example, one 4-week intervention found improved balance and gait in healthy subjects after five days/wk of backwards walking practice.

Meta-analyses combine and analyze data from multiple smaller clinical trials to provide a clearer picture of an intervention's effectiveness. Two published meta-analyses, one in 2019 and the other in 2025, concluded that combining backwards walking with conventional physical therapy exercises yielded improved outcomes in terms of reduced pain and disability in patients with knee osteoarthritis. Note that both of these meta-analyses examined backward walking as an adjunct treatment, combined with other strengthening and mobility exercises, to enhance patients' health and function. There is no strong evidence from clinical trials in which backward walking was used as the only treatment.

For patients with neurological disorders (e.g., stroke, Parkinson’s, Multiple Sclerosis, backwards walking is useful as both a rehabilitation exercise and a diagnostic tool. As a diagnostic tool, backwards walking is an excellent predictor of fall risk. As a rehabilitation exercise, backwards walking shows consistent benefits in balance, gait, and functional mobility. However, while a potentially valuable therapy, backwards walking should be approached with caution.

How to Safely Start Backwards Walking

Backwards probably has the greatest potential to help people with mobility impairments due to neurological conditions. However, it presents some substantial dangers. One published report detailed two instances of patients in rehabilitation suffering severe, fall-related injuries from backwards walking. Given this substantial threat, backward walking is probably not worth the risk for frail or elderly folks without appropriate safeguards. Backwards walking for people with compromised mobility should be done only with safety measures to minimize the risk of falls, such as spotters, safety bars, or (ideally) a suspension harness.

Even if you are free of mobility impairments, falling is no fun and potentially dangerous. So the safest practice space for backwards walking is on a treadmill, keeping grasp of the safety rails. Start with a few minutes of backward walking at slow speeds, gradually increasing your time and speed as you gain proficiency. You may enjoy some improvements in balance and knee health – but stay safe!

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3. _{Lin, L. H., Peng, Y. L., Yen, L. W., Tsai, Y. L., & Cheng, C. H. (2025). Effectiveness of backward walking exercises combined with conventional rehabilitation programs on managing pain intensity and disability in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Physiotherapy theory and practice, 1–15. Advance online publication. https://doi.org/10.1080/09593985.2025.2550532}

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