Social media can be a goldmine for legit, trainer-approved fitness hacks and how-tos that help you step up your workout game. And recently, TikTok users have been promoting walking backward on the treadmill as an exercise that helps relieve knee pain and strengthen your quads. But can simply switching up your walking direction really provide those perks?
Not exactly. Here, a sports performance physical therapist breaks down the common use cases for walking backward on a treadmill — and the benefits the practice actually offers.
The Idea Behind Walking Backward On a Treadmill
Walking backward on a treadmill is a physical therapy technique used primarily by people recovering from knee surgery, says Alyssa Semones, P.T., D.P.T., C.S.C.S., a sports performance physical therapist in Rockville, Maryland. The goal: to practice extending the joint and normalize gait, she says. “A lot of times after a total knee replacement or an ACL injury, people walk with a slight bend in their knee because they’re either afraid to fully straighten it or they’re not used to getting into that full extension,” she explains. But walking backward, in which you reach one leg back, strike the ground with your toes, then roll onto your heel, forces you to completely extend your knee, says Semones. “It gets them used to how it feels to extend the knee again,” she adds.
Physical therapists may also recommend walking backward on a treadmill to folks who are healing from hip or ankle surgery, says Semones. In these cases, the exercise helps patients practice fully extending the hip or the dorsiflexion of the ankle (the ability to pull your toes and feet toward your knee), respectively, she explains. The latter instance "would be used if I'm just trying to get them more comfortable loading into that deep dorsal flexion position," she says.
Regardless of the reason for walking backward on a treadmill, the sessions are typically brief and done only for short time frames, says Semones. A patient coming off a knee surgery might do just two to five minutes on the treadmill for a couple of physical therapy sessions before progressing to functional movements such as walking forward, marching in place, walking over hurdles, or holding a plank with a knee extension, she says. "I don't normally spend a lot of time on it…[before moving onto] other ways to help reinforce that knee extension," she says. "I like to progress to things they're going to be doing in their day-to-day life — most people aren't walking backward on a daily basis."
The Potential Benefits of Walking Backward On the Treadmill
Despite what the TikTokers may tell you, walking backward on the treadmill probably won’t help soothe your run-of-the-mill knee pain, says Semones. A 2012 study found 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 aggravate existing pain around the knee cap — than running forward. The catch? The study group included just 20 healthy participants, and the results weren’t consistent among subjects. That said, taking a backward stroll could be beneficial for folks with diagnosed knee issues. Backward walking may reduce symptoms of patellofemoral pain syndrome (aka runner’s knee) in women and ease pain and improve quad strength in patients with knee osteoarthritis, making it a potentially valuableaddition to rehabilitation programs in both circumstances, research suggests.
Research investigating other potential perks of backward walking for the general population, however, is still limited. In a 2004 study of 27 people, 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, more effective remedies for knee pain are easily available and accessible. To relieve general discomfort in the joint, Semones typically recommends building up strength in the quadriceps. “Your quad muscle is huge with knee pain,” she says. “As you get it stronger, your quad muscle can absorb some of the force when you’re walking, and that can take some of that pressure off [the knee],” she explains. But your best bet for pain relief is to pinpointthe root cause of your discomfort, then adjust your routine as necessary. Knee aches often develop after suddenly increasing your workout volume or intensity (think: going to the gym four times a week instead of one, running three miles a day instead of walking them), says Semones. Scaling these routines back to baseline, and then gradually progressing them up again gives you the opportunity to find the trigger and tweak your activities to prevent the pain — or work with a pro to receive the appropriate treatment, she adds.
That said, there aren't any health risks of walking backward on the treadmill for the average person, says Semones. So if you still want to give the practice a shot just out of curiosity, choose a speed that's a bit slower than your usual walking pace (think: 1.5 to 2.0 miles per hour) and keep the treadmill flat so you can learn the movement safely, she suggests. As you get comfortable, gradually increase the speed to 3.0 to 3.5 miles per hour, making sure to hold onto the handrails for support to avoid falling, she says.
Of course, you should chat with your health care provider or physical therapist before trying backward walking as a recovery method post-knee surgery. If you're given the all-clear, focus on how you're body is moving, remember to squeeze your quad when your foot first hits the ground, and push your heel all the way to the ground to fully extend your knee, says Semones. "Eventually, I want them to have a mind-body connection [so they] don't have to think about how they're walking and their gait mechanics," she adds. (
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Just know that walking backward can be awkward, and you don't have to stick with it if the technique doesn't feel right for you and your body, says Semones. "If you try backward walking and you don't feel comfortable doing it, don't get discouraged," she adds. "There are other ways to work on getting your knee extended, to work on getting your hip extended, to work on dorsiflexion of your ankle — it's not a one-size-fits-all thing."
