One approach to compute the musculotendon forces that underlie human motion is to combine an inverse dynamic analysis with a static optimisation procedure. Although computationally efficient, this classical inverse approach fails to incorporate constraints imposed by muscle physiology. The present paper reports on a physiological inverse approach (PIA) that combines an inverse dynamic analysis with a dynamic optimisation procedure. This allows the incorporation of a full description of muscle activation and contraction dynamics, without loss of computational efficiency. A comparison of muscle excitations and MT-forces predicted by the classical and the PIA is presented for normal and pathological gait. Inclusion of muscle physiology primarily affects the rate of active muscle force build-up and decay and allows the estimation of passive muscle force. Consequently, it influences the onset and cessation of the predicted muscle excitations as well as the level of co-contraction.