Moving Backward Helps Injured Knees Move Ahead

DENVER – Those recovering from knee injuries might do well to heed research being presented today at the American College of Sports Medicine’s 58th Annual Meeting and 2nd World Congress on Exercise is Medicine®. Those who pedaled backward on treadmills and elliptical machines tended to do better than those who pedaled forward, as measured by muscle strength and cardiovascular fitness.

“The results were very encouraging,” said Elmarie Terblanche, Ph.D., lead author of this study. “Participants who used backward locomotion showed significantly greater gains in quadriceps and hamstring strength. Additionally, they had greater aerobic capacity than the forward-locomotion group.”

Thirty-nine subjects with various knee injuries were randomly divided into forward- and backward-pedaling groups. All completed 24 supervised rehabilitation sessions which included (in addition to the forward- or backward-pedaling cardiovascular exercise) exercises to enhance strength, balance and flexibility.

While the two groups exhibited little difference in balance and flexibility after 24 sessions, those who pedaled backward averaged about nine percent greater aerobic capacity. They also measured higher in improvements in quadriceps and hamstring strength.

“So many people suffer knee injuries, whether through sports participation or activities of daily living,” said Terblanche. “It can be a significant aid in rehabilitation to know how to most efficiently strengthen the joints and muscles after injury. We say, do it backward!”


The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 45,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

The conclusions outlined in this news release are those of the researchers only and should not be construed as an official statement of the American College of Sports Medicine. Research highlighted in this news release has been presented at a professional meeting but has not been peer-reviewed.