The risk of knee injury in sport may be related to deviations in lower-limb alignment. An example of biomechanical deviation is dynamic knee valgus, considered by many to be one of the most important predictors of serious knee injury; however, the predictive validity of commonly used screening tests for dynamic knee valgus has recently been questioned. In this Viewpoint, the authors argue that assessing the risk of knee injury is complex and endeavor to present pelvic pronation and system tension as a 3-D construct to consider during physical assessments and exercise design, and to recognize dynamic knee valgus as a normal and necessary response to ground reaction forces. J Orthop Sports Phys Ther 2019;49(4):216-218. doi:10.2519/jospt.2019.0606.

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