When the athlete arrives at the clinic after ACL reconstruction, it may seem too late to implement a primary knee injury prevention plan. However, primary prevention of a similar injury to the contralateral knee is of the utmost importance in addition to secondary prevention of injury to the reconstructed knee. Having a sound understanding of the pathomechanics that resulted in the primary knee injury and any potentially related trunk and lower extremity dysfunction history is essential when designing a post-ACL reconstruction rehabilitation plan. Equally important is understanding the athlete’s expectations in regard to sport competitive level, intensity, and volume. To optimize the likelihood for the patient to effectively re-establish the athlete role and safely return to competitive sport, the therapeutic exercise and movement activity delivery mode may be as important as the selected tasks at each recovery phase. The therapeutic exercise environment should serve as a training and education forum regarding appropriate dynamic postural alignment, movement quality, neuromuscular control and responsiveness, dynamic knee stability, self-efficacy development, fatigue resistance, and coping resilience. The clinician must understand specific movement tasks common to the athlete’s sport, the position played within the sport(s), the team and athlete’s style of play, and the athlete’s role on the team.