If you’ve spent time in a gym or around physical therapists, you’ve likely heard the advice:
“Never let your knees go over your toes!”
This myth has been around for years, but the reality is—your knees should go over your toes—especially during physical therapy and rehab.
Think about it: You can’t walk, run, or even rise from a chair without your knees naturally moving forward. For athletes, movements like deceleration, cutting, and landing demand the tibia (shin bone) to angle forward, known as forward inclination.
Yet, many people recovering from ACL injuries fear this knee movement. After an ACL reconstruction, it’s common for patients to hesitate when allowing their knee to pass over their toes. Unfortunately, avoiding this necessary motion can slow down rehabilitation and leave the patient unprepared for real-world physical activity.
Why Knees Over Toes is Essential in Physical Therapy for ACL Rehab
One of the main goals of physical therapy following an ACL injury is restoring movement confidence. As rehab progresses, patients work on drills that allow for controlled knee translation. This begins with slow, straight-line movements and gradually introduces more speed and direction changes to mimic real-world activities.
Athletes don’t just move in a straight line. They cut, pivot, and absorb forces from multiple angles. This is why physical therapy for ACL recovery involves exercises that recreate these unpredictable movements—giving the knee the chance to regain its strength, stability, and range of motion.
Preparing Athletes for the Stressors of Sports with Physical Therapy
The last thing an athlete recovering from ACL surgery should face is their knee being tested in high-stress situations for the first time during a game. That’s why physical therapy should simulate sport-specific movements in a controlled and progressive environment. This prepares the body for the unique demands of each sport and builds up knee resiliency.
In many cases, the goal is not only to return the ACL-repaired knee to its pre-injury strength but to make it even stronger than before to prevent reinjury.
Rehab That Mirrors Performance Training
This is why end-stage rehab should look like performance training. Athletes need to be ready to perform at their peak—prepared for the physical demands of their sport—before returning to competitive play. Physical therapy should not just focus on recovery but also on preparing athletes for the challenges they’ll face once back on the field or court.
If you’re recovering from an ACL injury or looking for a sports-specific physical therapy approach, we can help you get back to peak performance. Contact us today to learn more about how we tailor physical therapy to meet your rehab and athletic goals!
