Social media can be a treasure trove for legitimate, trainer-approved fitness tricks and tutorials that aid in enhancing your workout routine. And recently, TikTok users have been endorsing the act of walking backward on a treadmill as an exercise that alleviates knee discomfort and enhances your quadriceps. However, can a simple change in walking direction truly provide these benefits?
Not entirely. Here, a sports performance physical therapist breaks down the typical scenarios in which walking backward on a treadmill is used — and the actual advantages it offers.
The Concept Behind Walking Backward On a Treadmill
Walking backward on a treadmill is a physical therapy method primarily utilized by individuals recuperating from knee surgery, states Alyssa Semones, P.T., D.P.T., C.S.C.S., a sports performance physical therapist in Rockville, Maryland. The objective is to practice extending the joint and restore normal walking pattern, she explains. “Often after a complete knee replacement or an ACL injury, individuals walk with a slight bend in their knee because they either fear fully straightening it or they are not accustomed to reaching that full extension,” she elaborates. However, walking backward, where you step one leg back, touch the ground with your toes, and then roll onto your heel, compels you to fully extend your knee. “It gets them accustomed to the feeling of knee extension once again,” she adds.
Physical therapists may also advise walking backward on a treadmill to individuals recovering from hip or ankle surgery, notes Semones. In these instances, the exercise helps patients practice complete extension of the hip or dorsiflexion of the ankle (the ability to pull your toes and feet towards your knee), respectively. The latter scenario “would be utilized if I’m simply attempting to make them more comfortable loading into that deep dorsiflexion position,” she states.
Irrespective of the reason for walking backward on a treadmill, the sessions are typically short and only done for brief periods of time, according to Semones. A patient who has undergone knee surgery might only spend two to five minutes on the treadmill during a few physical therapy sessions before progressing to functional movements like walking forward, marching in place, walking over hurdles, or holding a plank with a knee extension. “I don’t usually spend much time on it… [before moving onto] other ways to reinforce that knee extension,” she asserts. “I prefer to progress to activities they will engage in on a daily basis — because most people aren’t walking backward on a daily basis.”
The Potential Advantages of Walking Backward On the Treadmill
Despite what the TikTokers may inform you, moving in the opposite direction on the treadmill probably won’t help alleviate your ordinary knee pain, says Semones. A 2012 study discovered that running backward does put less compressive force on the patellofemoral joint (where the back of the kneecap and femur meet at the front of the knee) — which may exacerbate existing pain around the knee cap — than running forward. The catch? The study group included just 20 healthy participants, and the results were not consistent among subjects. That said, taking a backward stroll could be advantageous for individuals with diagnosed knee issues. Backward walking may reduce symptoms of patellofemoral pain syndrome (aka runner’s knee) in women and alleviate pain and enhance quad strength in patients with knee osteoarthritis, making it a potentially valuable addition to rehabilitation programs in both circumstances, research suggests.
Research investigating other potential advantages of backward walking for the general population, however, is still limited. In a 2004 study of 27 individuals, researchers found that walking backward on a treadmill at a speed of 2.5 mph at various inclines improved VO₂ max (the maximum amount of oxygen your body can utilize during intense exercise) more than forward walking under the same conditions. And results from another small study, published in the International Journal of Sports Medicine, showed that participants who ran and walked backward for six weeks improved their predicted VO₂ max (which is based on the assumption that heart rate and power output are linked with oxygen consumption) by 5.2 percent. Given the size of the studies, the results may not be applicable to the population at large, but the findings are promising: The higher your VO2 max, the more energy your body can use, and the longer you can exercise, according to UC Davis Health.
Should You Walk Backward On the Treadmill?
Unless you’re recovering from surgery or working on your ability to extend or flex certain joints, you don’t need to incorporate walking backward on the treadmill into your wellness routine, says Semones. “I don’t really think I would ever prescribe someone walk backward on a treadmill unless they were lacking some knee extension or hip extension to help reinforce that,” she adds.
Plus, additional effective remedies for knee pain are readily available and accessible. To alleviate general discomfort in the joint, Semones typically suggests strengthening the quadriceps. “Your quad muscle is immense in the presence of knee pain,” she states. “As you enhance its strength, the quad muscle can absorb some of the impact when you walk, which can alleviate some pressure on the knee,” she explains. However, the best course of action for pain relief is to identify the underlying cause of your discomfort and make necessary adjustments to your routine. Knee aches often arise after a sudden escalation in workout volume or intensity (for example, going to the gym four times a week instead of once, or running three miles instead of walking them), says Semones. Scaling back these routines to their baseline and then gradually progressing them again gives you the opportunity to identify triggers and modify your activities to prevent the pain—or consult a professional for appropriate treatment, she adds.
That being said, there are no health risks associated with walking backward on a treadmill for the average person, according to Semones. So if you are curious and still want to try it out, select a speed slightly slower than your usual walking pace (approximately 1.5 to 2.0 miles per hour) and keep the treadmill flat to ensure safe movement, she suggests. As you become more comfortable, gradually increase the speed to 3.0 to 3.5 miles per hour, while holding onto the handrails for support to avoid falling, she advises.
Of course, it is important to consult your healthcare provider or physical therapist before attempting backward walking as a recovery method post-knee surgery. If given the green light, focus on the movement of your body, remember to contract your quad when your foot first makes contact with the ground, and fully extend your knee by pushing your heel all the way down, says Semones. “Ultimately, I want individuals to establish a mind-body connection so that they no longer have to consciously think about their walking and gait mechanics,” she adds.
Keep in mind that walking backward may feel awkward, and if the technique doesn’t feel right for you and your body, you don’t have to stick with it, says Semones. “If you try backward walking and it doesn’t feel comfortable, don’t get disheartened,” she suggests. “There are other ways to focus on knee extension, hip extension, and ankle dorsiflexion—it’s not a one-size-fits-all approach.