According to , the best workout you’re not doing is backward walking. Mass-market publications are always looking for the buzziest fitness hack they can sell to their readers. Their authors are almost never scientists; they interview a few “experts” who believe in the very preliminary evidence trickling in through the academic literature; and the entire thing is treated as fashion, as the author of The Gospel of Wellness, Rina Raphael, once told me. Bone broths are out. It’s now time to embrace walking backward, until the next Big Thing in fitness rolls in.
The alleged health benefits of adding a bit of backward walking to your workout (either on a road or on a treadmill) are abundant, while the scientific evidence is thin on the ground. It’s important to recognize this dichotomy: the glossiness of how these interventions are sold to readers of magazines and blogs, versus the dull, disappointing reality of the deficient studies behind them.
Here is how backward walking fails to live up to the hype.
A hot potato
The idea of training people to walk backward in order to derive some sort of benefit is not entirely without merit. For some, this skill is a necessity: boxing and other martial arts often involve moving in multiple directions while keeping your balance, and soccer referees have been measured as spending  during matches walking backward. But even if you don’t need to adopt this strange means of locomotion, a casual moonwalk triggers your muscles differently from walking forward. Your very balance is tested in a way you may not be accustomed to. It makes sense to think that training like this might be advantageous.
Journalists certainly have not run out of medals to hand out to retro-walking, as it is sometimes called. It strengthens your legs. It improves pain. It boosts your mental health and straightens your posture. And it burns a lot more calories than simply walking forward. That last claim does have evidence behind it: back in , a team from New Jersey measured heart rate and oxygen uptake in 17 adult volunteers who walked either forward or backward, and sure enough they exerted themselves significantly more when doing it backward. Maybe the fear of tripping over and falling had something to do with the higher heart rate (more on that later). But it confirmed findings from two other groups: walking backward is indeed more strenuous, which is why it has been positioned in the media as a way to lose weight—ignoring the facts that burning fat by exercise alone is hard to do, that weight loss is difficult to sustain, and that there are more enjoyable ways of working up a sweat.
Retro-walking has its origins in physical therapy—unless you want to go all the way back to Ancient China, which some reporters do to add a touch of irrelevant exoticism and venerability. Just because distant ancestors did something, like revere the sun or use toxic lead to treat a baby’s colic, does not mean they were onto something. But many physical therapists have touted the benefits of integrating backward walking in rehabilitating patients with knee osteoarthritis, Parkinson’s disease, cerebral palsy, or a stroke, and it is in their field that we find the most papers on the topic. Quantity, however meager, should definitely not be confused with quality.
Scientists are known to play a game of “hot potato” when it comes to larger studies. They all want them to be done, but they don’t want to be the ones to do them—or at least they recognize that getting the money to conduct them is really hard to get, so they cross their fingers and hope someone else gets to do them. A  summarizing the evidence for backward walking training for cerebral palsy put it thusly: “It was disappointing that most recent trials were not of high methodological quality and did not include larger samples,” they wrote. “That is, limitations identified in a previous systematic review [published four years prior] were not rectified by recent trials.” Meaning: we all knew we needed to up our game, but nobody’s done it yet.
Hence, the studies that do exist tend to involve few participants and the follow-up is almost always non-existent, so that we have no idea if any benefit being reported is sustained long term. One crucial problem with many of these studies is that backward walking was tacked on a regular physical therapy regimen. This means that participants were randomly allocated to either be in the control group (normal training) or in the experimental group (normal training plus backward walking). Basically, they got a longer intervention than their peers in the control group. Any benefit detected could be due to backward walking… but it could also be due to simply exercising for a longer period of time. Those studies can’t disentangle these two explanations.
And because the studies are very small, they are noisy. The findings are easily influenced by chance and can go one way or the other. A  published last year looking at studies that tested backward walking to improve the speed at which stroke victims can walk came to a surprising conclusion. When backward walking was tested head-to-head against forward walking, it was superior in terms of allowing people to walk faster afterwards; but when scientists had instead given backward walking training in addition to forward walking training, the benefit disappeared. How could something work on its own but not when added to normal training? The answer is likely to be that small studies are just noisy and unreliable.
The size of the literature on retro-walking initially appears to be substantial, but when we start to read these papers, we quickly realize that some of them are simply protocols describing what researchers promise to do, as well as studies that use backward walking speed as an outcome measure, not an intervention. There are potential diagnostic and predictive applications for this. For example, a  wanted to know if a slow backward walking speed on a flat surface in someone with multiple sclerosis would predict an increased risk of falling, and the results they published pointed in that direction. While this study is interesting, its massive limitations stand in the way of generalizations. Falls had to be reported by the participants, and many never returned their fall diaries for analysis. Other important variables known to influence the risk of falls, like spasticity and fatigue, were not even measured. Once again, a promising hypothesis is let down by the limitations of the study itself.
Knowing the risks backwards and forwards
Two years ago, Nick Tiller, who has a doctorate in applied physiology, looked at the evidence behind retro-walking and, having surveyed the literature myself, I agree with : “A generous interpretation of the sparse literature would be that incorporating backward walking into a physiotherapy-led program, alongside conventional treatment, may confer various benefits for people with preexisting knee issues.” The word “may” is an important fulcrum here. For anyone without a knee condition, the evidence is simply too flimsy to infer anything.
Before you invite your geriatric mom to take up backward walking on the gym’s treadmill, though, I need to point to . I covered effectiveness, but what about safety? The doctors who co-authored this warning mention two patients who underwent backward walking training and suffered the consequences: an elderly man fell down from the beam he was walking on and sustained a hip fracture, while an older woman tripped over a treadmill during training, fell down, and worsened her condition. The authors point out that having a single physical therapist on hand to supervise is inadequate: once the patient trips, it’s too late. They recommend at least two therapists or the use of parallel bars or a suspension device, and that training to walk backward only makes sense if you have a specific need to walk backward. See martial artists and soccer referees.
The fanfare over retro-walking delivered by outlets such as the ,Ěý, and  can drown out a much more important voice: that of actual experts screaming at the top of their lungs that we are not exercising enough.  are not meeting the target of at least two-and-a-half hours of moderate-to-vigorous physical activity per week. And if you think you are, you may be overestimating how much you move around: a  found that, on average, Canadian adults reported 49 minutes of physical activity a day, but an accelerometer they were wearing clocked only 23 minutes.
We need to move more. Focusing on exotic regimens like walking backward—and going so far as to trace their ancestry to old Chinese sages—is probably not terribly productive.
Pick something you love. Work up a sweat.
Don’t turn your back on basic physical exercise.
Take-home message:
- Media outlets have claimed that adding backward walking to your workout regimen will strengthen your legs, reduce your pain, and help you burn calories
- The evidence for backward walking training mostly comes from the world of physical therapy, where very small studies show that this type of training may help people with knee issues when added to a regular physical therapy program
- The media’s fascination with exotic and trendy workout routines often obscures the simple fact that most people need to move more and that there are better (and safer) ways to work up a sweat than walking backward on a treadmill
