Of all the videos I have done over the last 18 years the most popular ones seem to be about knee pain or hip pain. One question I have been regularly asked recently about knee pain is, how good is walking backwards for strengthening your knees? In recent years this type of exercise has grown in popularity on the internet and also among many therapists as an exercise to prescribe their patients with for strengthening of the knees. I can see how it appeals to so many people with knee pain as it requires no equipment, minimal skill, and can be done almost anywhere. The big question is how effective is it really when it comes to strengthening the knees to get rid of pain? While there are some positive benefits to using this, there are several problems I believe are overlooked that would be better resolved with other exercises. In this video, I explain what these are.
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In terms of movement and biomechanical characteristics it differs from forward walking in several key ways that make it quite unique in how your muscles of the foot, knee, and hip interact with each other.

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When you walk normally in a forward direction your leg swings through the air, and your heel lands on the ground first. Then your straight knee bends slightly as you roll from your heel to your toes. As this occurs, your opposite leg rolls from your toes and up into the air. This heeltotoe motion repeats and normal walking occurs.

To control these motions, the quadriceps and hip flexors contract concentrically (shortening) to lift the hip and leg followed by the glutes and hamstrings having to contract eccentrically (lengthening) to control the landing.

Most people have very stiff hips due to sitting too much and lack of movement and this stiffness often leads to weakness in the glutes making it very difficult to control these motions. Combined with poor foot stability, and immobility of the hamstrings these factors eventually lead to instability of the knee causing pain and inflammation.

Reverse walking involves an opposite gait process. Your leg swings through the air and reaches backward with a bent knee. Your toes contact the ground, and your bent knee straightens as you roll from your toes to your heel. Then your heel leaves the ground with your knee straight, and the process is repeated.

By changing the movement sequence and direction you completely change the muscle activation demands. When you walk backwards you are landing on your toe first and then rolling off your heel making it harder to have longer strides. This requires a lot more knee extension to occur during the stance phase and more knee flexion when you reach back to take steps but due to the concentric and eccentric actions being reverse it is easier to control the forces around the knee.

This gives a mechanical advantage to the quadriceps and hip flexors as they lengthen, while simultaneously giving the same advantage to the glutes as they shorten. This can put less stress and compressive force on the knees.

While this appears to be a good thing and it certainly can be it ignores the real problem and what you should be doing instead which is improving your functional movement and strengthening the muscles that provide these.

Factors such as tibial torsion, valgus knee collapse due to poor hip muscle control, poor foot stability creating overpronation, and ankle stiffness inhibiting quadriceps strength need to be addressed if you truly want to stabilize the knee.

The stability of the knee is dependent upon the muscles and joints above and below for providing the perfect position to complete its function. It is pointless in using exercises to strengthen this if you have not addressed those factors first.

Good articles to read with tons of information on this are shown below

How to strengthen a weak vmo
https://www.noregretspt.com.au/index....

What really causes knee pain?
https://www.noregretspt.com.au/index....

How to complete your own knee pain assessment to find the underlying cause of the problem
https://www.noregretspt.com.au/index....