What is Backward Walking? Beyond Just Going in Reverse
Defining the Practice and Its Historical Roots
Backward walking has been touted as a therapeutic exercise for a variety of conditions. Ancient Chinese records recommended backward walking for martial artists. In modern times, backward walking has been used in physical therapy to treat knee injuries and to provide gait training for patients with neurological conditions such as stroke or cerebral palsy.
Why Does It Differ from Forward Movement
Backward walking differs from forward walking in both mechanical and cardiovascular requirements. Mechanically, backward walking places less stress on the knee because the toes (rather than the heel) strike the ground first, shifting stress from the knee to 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 Backward Walking
What evidence do we have that backward walking is an effective therapy? Small sample sizes and short intervention durations limit most 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 backward 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 backward walking with conventional physical therapy exercises improved outcomes, including reductions in 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, backward walking is useful as both a rehabilitation exercise and a diagnostic tool. As a diagnostic tool, backward walking is an excellent predictor of fall risk. As a rehabilitation exercise, backward walking consistently improves balance, gait, and functional mobility. However, while potentially valuable, backward walking should be approached with caution.
How to Safely Start Backward Walking
Backward probably has the greatest potential to help people with mobility impairments due to neurological conditions. However, it poses substantial risks. One published report detailed two instances of patients in rehabilitation suffering severe, fall-related injuries from backward walking. Given this substantial threat, backward walking is probably not worth the risk for frail or elderly folks without appropriate safeguards. Backward 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 backward walking is on a treadmill, keeping a 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!
FAQs
Is backward walking better than regular walking?
Backward walking is not necessarily better than forward walking, but it offers different benefits. Research suggests that backward walking may increase muscle activation, challenge balance, and require greater energy expenditure than forward walking at the same speed. It is often used as a complement to traditional exercise rather than a replacement.
Can backward walking help with knee pain?
Some studies suggest that backward walking, when combined with conventional physical therapy and strengthening exercises, may help reduce pain and improve function in individuals with knee osteoarthritis. However, backward walking should be viewed as part of a comprehensive rehabilitation program rather than a standalone treatment.
How many calories does backward walking burn?
Because backward walking typically requires more energy than forward walking at the same pace, it may increase calorie expenditure. The exact number of calories burned depends on factors such as walking speed, body weight, fitness level, and duration of exercise.
Is backward walking safe for everyone?
No. Backward walking increases the risk of falls because it limits your ability to see obstacles and changes in terrain. Individuals with balance difficulties, mobility impairments, neurological conditions, or a history of falls should consult a healthcare provider or physical therapist before attempting backward walking and should use appropriate safety measures when practicing.
What is the safest way to start backward walking?
Beginners should start slowly in a safe, controlled environment. A treadmill with safety rails or an open area free of obstacles can help reduce fall risk. Begin with short sessions at a comfortable pace and gradually increase time and speed as your confidence and coordination improve. Stop immediately if you experience dizziness, pain, or loss of balance.
References
1Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. *Gait & Posture*. https://doi.org/10.1016/j.gaitpost.2018.06.168
2Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. *Journal of Physical Therapy Science*. https://doi.org/10.1589/jpts.28.1901
3Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2018). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. *Clinical Rehabilitation*. https://doi.org/10.1177/0269215518801430
4Lin, 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*. https://doi.org/10.1080/09593985.2025.2550532
5VanNostrand, M., Monaghan, P. G., Wu, W., & Fritz, N. E. (2026). Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review. Gait & Posture. https://doi.org/10.1016/j.gaitpost.2025.110048
6Thomas, M. A., & Fast, A. (2000). One Step Forward and Two Steps Back. American Journal of Physical Medicine & Rehabilitation. https://doi.org/10.1097/00002060-200009000-00011
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