“…Galen is recognized as the father of “Exercise in Medicine”[ 10 , 19 ] with over 500 medical Treatises[ 20 ] that provide potential documentation for the use of rope walking for rehabilitation and prehabilitation purposes. The texts considered[ 21 - 23 ] do not mention rope walking specifically as an activity, but such an activity or exercise is highly likely to have been used and can be insinuated from the following knowledge: rope walking was, as mentioned, an accepted and integral activity within Imperial Roman Society[ 4 , 6 ]; Galen is considered the “father of rehabilitation” who advocated the importance of exercise, his texts and teaching were the recognized authority for almost 1600 years[ 24 ], particularly for exercise and health[ 22 , 25 ]. Galen wrote extensively on knee injuries including loss of function and balance in athletes and Gladiators, noting that knee muscle control required considerable time to regain due to loss of muscle activation, with “wasting in the absence of local muscle or nerve damage ” [ 24 ], a reference to arthrogenic muscle inhibition (AMI)[ 6 , 11 , 14 , 18 ].…”