The growth of knowledge in orthopaedic physical therapy practice is on an exponential trajectory. This growth is occurring simultaneously for many aspects of evidence-based practice: diagnosis, prognosis, treatment, and harm – with increasingly more sophisticated basic science and mechanistic studies guiding and supporting the clinical research endeavors. Just how close are we to the day when we can clearly establish the accuracy of our diagnoses, regardless of the model used, and then can confidently inform our patients of the most effective treatment approach and the expected outcomes, as well as any potential harm? This knowledge is being created now, and the ability to assemble and transmit that information effectively to current and future clinicians is evolving. In time, I expect that orthopaedic physical therapy practice will become truly evidence based and standardized around the globe – so that the first line of intervention for a given patient with a specific diagnosis is reasonably agreed upon. Despite the considerable challenges that remain, every day we are getting closer to achieving this vision.