Osteoarthritis of the Knee→

Osteoarthritis of the knee (knee OA) is the inflammation and wearing away of the cartilage on the bones that form the knee joint (osteo=bone, arthro=joint, itis=inflammation). The diagnosis of knee OA is based on 2 primary findings: radiographic evidence of changes in bone health (through medical images such as X-ray and magnetic resonance imaging [MRI]), and an individual’s symptoms (how you feel). Approximately 14 million people in the United States have symptomatic knee OA. Although more common in older adults, 2 million of the 14 million people with symptomatic knee OA were younger than 45 when diagnosed, and more than half were younger than 65.

What is Osteoarthritis of Knee?

Knee osteoarthritis (knee OA) is a progressive disease caused by inflammation and degeneration of the knee joint that worsens over time. It affects the entire joint, including bone, cartilage, ligaments, and muscles. Its progression is influenced by age, body mass index (BMI), bone structure, genetics, muscular strength, and activity level. Knee OA also may develop as a secondary condition following a traumatic knee injury. Depending on the stage of the disease and whether there are associated injuries or conditions, knee OA can be managed with physical therapy. More severe or advanced cases may require surgery.

How Does it Feel?

Individuals who develop knee OA may experience a wide range of symptoms and limitations based on the progression of the disease. Pain occurs when the cartilage covering the bones of the knee joint wears down. Areas where the cartilage is worn down or damaged exposes the underlying bone. The exposure of the bone allows increased stress and compression to the cartilage, and at times bone-on-bone contact during movement, which can cause pain. Because the knee is a weight-bearing joint, your activity level, and the type and duration of your activities usually have a direct impact on your symptoms. Symptoms may be worse with weight-bearing activity, such as walking while carrying a heavy object.

Symptoms of knee OA may include:

• Worsening pain during or following activity, particularly with walking, climbing, or descending stairs, or moving from a sitting to standing position

• Pain or stiffness after sitting with the knee bent or straight for a prolonged period of time

• A feeling of popping, cracking, or grinding when moving the knee

• Swelling following activity

• Tenderness to touch along the knee joint

Typically these symptoms do not occur suddenly or all at once, but instead develop gradually over time. Sometimes individuals do not recognize they have osteoarthritis because they cannot remember a specific time or injury that caused their symptoms. If you have had worsening knee pain for several months that is not responding to rest or a change in activity, it is best to seek the advice of a medical provider.

How Is It Diagnosed?

Knee OA is diagnosed by 2 primary processes. The first is based on your report of your symptoms and a clinical examination. Your physical therapist will ask you questions about your medical history and activity. The therapist will perform a physical exam to measure your knee's movement (range of motion), strength, mobility, and flexibility. You might also be asked to perform various movements to see if they increase or decrease the pain you are experiencing.

The second tool used to diagnose knee OA is diagnostic imaging. Your physical therapist may refer you to a physician, who will order X-rays of the knee in a variety of positions to check for damage to the bone and cartilage of your knee joint. If more severe joint damage is suspected, an MRI may be ordered to look more closely at the overall status of the joint and surrounding tissues. Blood tests also may be ordered to help rule out other conditions that can cause symptoms similar to knee OA.

How Can a Physical Therapist Help?

Once you have received a diagnosis of knee OA, your physical therapist will design an individualized treatment program specific to the exact nature of your condition and your goals. Your treatment program may include:

Range-of-motion exercises. Abnormal motion of the knee joint can lead to a worsening of OA symptoms when there is additional stress on the joint. Your physical therapist will assess your knee’s range of motion compared with expected normal motion and the motion of the knee on your uninvolved leg. Your range-of-motion exercises will focus on improving your ability to bend and straighten your knee, as well as improve your flexibility to allow for increased motion.

Muscle strengthening. Strengthening the muscles around your knee will be an essential part of your rehabilitation program. Individuals with knee OA who adhere to strengthening programs have been shown to have less pain and an improved overall quality of life. There are several factors that influence the health of a joint: the quality of the cartilage that lines the bones, the tissue within and around the joints, and the associated muscles. Due to the wear and tear on cartilage associated with knee OA, maintaining strength in the muscles near the joint is crucial to preserve joint health. For example, as the muscles along the front and back of your thigh (quadriceps and hamstrings) cross the knee joint, they help control the motion and forces that are applied to the bones.

Strengthening the hip and core muscles also can help balance the amount of force on the knee joint, particularly during walking or running. The “core” refers to the muscles of the abdomen, low back, and pelvis. A strong core will increase stability throughout your body as you move your arms and legs. Your physical therapist will assess these different muscle groups, compare the strength in each limb, and prescribe specific exercises to target your areas of weakness.

Manual therapy. Physical therapists are trained in manual (hands-on) therapy. Your physical therapist will gently move your muscles and joints to improve their motion, flexibility, and strength. These techniques can target areas that are difficult to treat on your own. The addition of manual therapy techniques to exercise plans has been shown to decrease pain and increase function in people with knee OA.

Bracing. Compressive sleeves placed around the knee may help reduce pain and swelling. Devices such as realignment and off-loading braces are used to modify the forces placed on the knee. These braces can help "unload" certain areas of your knee and move contact to less painful areas of the joint during weight-bearing activities. Depending on your symptoms and impairments, your physical therapist will help determine which brace may be best for you.

Activity recommendations. Physical therapists are trained to understand how to prescribe exercises to individuals with injuries or pain. Since knee OA is a progressive disease, it is important to develop a specific plan to perform enough activity to address the problem, while avoiding excessive stress on the knee joint. Activity must be prescribed and monitored based on the type, frequency, duration, and intensity of your condition, with adequate time allotted for rest and recovery. Research has shown that individuals with knee OA who walked more steps per day were less likely to develop functional problems in the future. Your physical therapist will consider the stage and extent of your knee OA and prescribe an individualized exercise program to address your needs and maximize the function of your knee.

Modalities. Your physical therapist may recommend therapeutic modalities, such as ice and heat, to aid in pain management.

If Surgery Is Required

The meniscus (the shock absorber of the knee) may be involved in some cases of knee OA. In the past, surgery (arthroscopy) to repair or remove parts or all of this cartilage was common. Current research, however, has shown that—in a group of patients who were deemed surgical candidates for knee OA with involvement of the meniscus—60% to 70% of those who first participated in a physical therapy program did not go on to have surgery. One year later, those results were unchanged. This study suggests that physical therapy may be an effective alternative for people with knee OA, who would prefer to avoid surgery.

Sometimes, however, surgical intervention, such as arthroscopy or a total knee replacement, may be recommended. There are many factors to consider when determining the appropriate surgical treatment, including the nature of your condition, your age, activity level, and overall health. Your physical therapist will refer you to an orthopedic surgeon to discuss your surgical options.

Should you choose to have surgery, your physical therapist can assist you prior to and following your surgery. The treatment you require following surgery will depend on a variety of factors such as the type of surgery performed, your level of function, and fitness prior to surgery. Contrary to popular belief, surgery is not the easy choice; you will still require treatment following your surgery to maximize your level of function.

Can this Injury or Condition be Prevented?

Many conditions, including knee OA, can be prevented with the right fitness and exercise program. Physical therapists are experts in movement. Some ways that a physical therapist can help you prevent knee OA include:

• Developing an appropriate exercise program. Inactivity is a significant contributor to many problems that affect individuals, including knee OA. Strengthening the muscles around the knee, as well as surrounding joints, can help decrease stress to the knee joint. Exercises to improve flexibility can help you maintain motion in the knee joint, which helps keep the cartilage healthy. Your physical therapist can design an individualized treatment program to boost your strength and flexibility, based on your specific condition.

• Weight loss. Excessive weight can increase stress to the knee joint, which in turn can contribute to the wearing away of the protective cartilage, leading to knee OA. Your physical therapist can assess your weight, perform testing to determine your fitness level, establish an exercise program, and recommend lifestyle changes. The therapist also may refer you to another health care provider, such as a dietician, for further guidance.

• Activity modification. Individuals often move or perform activities in a way that is unhealthy or inefficient, or that places excessive stress on the body, including the knee joint. Your physical therapist can teach you better ways to move in order to ease stress on your body and your knees.

• Taking a “whole body” approach to movement. Lack of strength, mobility, and flexibility in surrounding areas of the body such as the ankle, hip, and spine also can affect the knee. Taking these body regions into consideration is important to help prevent knee OA. Your physical therapist will work with you to help ensure your whole body is moving correctly, as you perform your daily activities.

Real Life Experiences

Luke is a 50-year-old businessman who has just moved his family to the city so he can start a new job. For the last 2 months, Luke has been working hard to fix up his family’s new home, carrying heavy boxes and moving furniture up and down stairs. He also has worked late into the night installing appliances.

After starting his new job last week, sitting through numerous orientation sessions and meetings, Luke notices that his right knee is really hurting. He is used to occasional knee discomfort, but this is the worst it has felt in a long time. During his junior year at college, Luke suffered a significant knee injury while playing basketball, which required surgery.

These days, Luke coaches his son’s Little League team, exercises several times each week, and plays pickup basketball with his friends. But occasionally, particularly after long road trips, his knee pain flares up, and he has to resort to medication, icing, and rest. These bouts are starting to occur more regularly. Luke decides it's time to seek a consultation with a physical therapist.

During Luke’s first appointment, his physical therapist asks him questions regarding his medical history, prior injuries, current symptoms and complaints, and goals for physical therapy. She examines his knee motion, strength, balance, and walking mechanics. She also uses special tests and measures to determine the nature of Luke’s pain, ruling out any other possible conditions.

Based on her findings, Luke's physical therapist determines that his current knee pain is a result of posttraumatic osteoarthritis. She diagnoses knee OA. She explains that his history of significant knee injury in college put him at risk of developing knee OA at a young age. The recent increased demand on his knee joint during his move is likely responsible for the current flare-up of pain and swelling.

Over the next 6 weeks, Luke works with his physical therapist to decrease his joint pain and improve his knee motion and full-body flexibility. She uses manual therapy techniques to improve the mobility of his knee joint. She prescribes a progressive exercise program to strengthen the muscles of his hip, knee, and core. She tailors this program so that Luke can complete it daily, based on the equipment available at his office gym facility.

Six weeks later, Luke is able to climb and descend stairs, squat, and jog without pain. He can sit through a full day of meetings without noticing stiffness or swelling in his knee. On his last day of therapy, Luke’s physical therapist provides him with a detailed home-exercise program and suggestions for maintaining the improvements he has made. With the summer approaching, he's preparing to coach his son's baseball tournaments—and take his family to the beach!

This story was based on a real-life case. Your case may be different. Your physical therapist will tailor a treatment program to your specific case.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and clinical experience to treat a variety of conditions or injuries. You may want to consider:

• A physical therapist who is experienced in treating people with knee osteoarthritis and after knee replacement surgery. Some physical therapists have a practice with an orthopedic focus.

• A physical therapist who is a board-certified orthopedic clinical specialist. This physical therapist will have advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family and friends or from other health care providers.

• When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people with arthritis.

• During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and report activities that make your symptoms worse.

Further Reading

The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions and also prepare them for their visit with their health care provider.

The following articles provide some of the best scientific evidence related to physical therapy treatment of arthritis. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free full-text, so that you can read it or print out a copy to bring with you to your health care provider.

Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis; part two: strengthening exercise programs. Clin Rehabil. 2017;31:596–611. Article Summary in PubMed.

Deshpande BR, Katz JN, Solomon DH, et al. Number of persons with symptomatic knee osteoarthritis in the US: impact of race and ethnicity, age, sex, and obesity. Arthritis Care Res (Hoboken). 2016;68:1743–1750. Article Summary in PubMed.

Ackerman IN, Bucknill A, Page RS, et al. The substantial personal burden experienced by younger people with hip or knee osteoarthritis. Osteoarthritis Cartilage. 2015;23:1276–1284. Article Summary in PubMed.

Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis [published correction appears in: N Engl J Med. 2013;369:683]. N Engl J Med. 2013;368:1675–1684. Free Article.

Segal NA. Bracing and orthoses: a review of efficacy and mechanical effects for tibiofemoral osteoarthritis. PM R. 2012;4(5 Suppl):S89–S96. Article Summary on PubMed.

Jansen MJ, Viechtbauer W, Lenssen AF, et al. Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review. J Physiother. 2011;57:11–20. Free Article.

Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14:4–9. Article Summary on PubMed.

Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, part II. Arthritis Rheum. 2008;58:26–35. Free Article.

* PubMed is a free online resource developed by the National Center for Biotechnology Information (NCBI). PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database.

Authored by Laura Stanley, PT, DPT, Board-Certified Clinical Specialist in Sports Physical Therapy. Reviewed by the MoveForwardPT.com editorial board.

Guide to Osteoarthritis→

"Arthritis" is a term used to describe inflammation of the joints. Osteoarthritis (OA) is the most common form of arthritis and usually is caused by the deterioration of a joint. Typically, the weight-bearing joints are affected, with the knee and the hip being the most common.

An estimated 27 million Americans have some form of OA. According to the Centers for Disease Control and Prevention, 1 in 2 people in the United States (US) may develop knee OA by age 85, and 1 in 4 may develop hip OA in their lifetime. Until age 50, men and women are equally affected by OA; after age 50, women are affected more than men. Over their lifetimes, 21% of overweight and 31% of obese adults are diagnosed with arthritis.

OA affects daily activity and is the most common cause of disability in the US adult population. Although OA does not always require surgery, such as a joint replacement, it has been estimated that the use of total joint replacement in the US will increase 174% for hips and 673% for knees by the year 2030.

Physical therapists help patients understand OA and its complications, provide treatments to lessen pain and improve movement, and offer education about obesity and healthy lifestyle choices. Research has shown that light to moderate activities such as walking, biking, and swimming can provide more benefits than harm to your joints, and promote weight loss. One study showed that just an 11-pound weight loss reduced the risk of OA in the women studied.

More Information on Osteoarthritis:

• Osteoarthritis of the Hip

• Osteoarthritis of the Knee

• Osteoarthritis of the Shoulder

• Osteoarthritis of the Spine

Other Arthritis Resources:

• Community-Based Physical Activity Programs for People With Arthritis

• Rheumatoid Arthritis

What is Osteoarthritis?

Your bones are connected at joints such as the hip and knee. A rubbery substance called cartilage coats the bones at these joints and helps reduce friction when you move. A protective oily substance called synovial fluid is also contained within the joint, helping to ease movement. When these protective coverings break down, the bones begin to rub together during movement. This can cause pain, and the process itself can lead to more damage in the remaining cartilage and the bones themselves.

The cause of OA is unknown. Current research points to aging as the main cause. Factors that may increase your risk for OA include:

• Age. Growing older increases your risk for developing OA because degeneration and aging of the cartilage and synovial fluid increases over time.

• Genetics. Research indicates that some people's bodies have difficulty forming cartilage. Individuals can pass this problem on to their children.

• Past injury. Individuals with prior injury to a specific joint, especially a weight-bearing joint (such as the hip or knee), are at increased risk for developing OA.

• Occupation. Jobs that require repetitive squatting, bending, and twisting (eg, construction, landscaping, childcare) are risk factors for OA. People who perform jobs that require prolonged kneeling (eg, miners, flooring specialists) also are at high risk.

• Sports. Athletes who repeatedly use a specific joint in extreme ways (eg, pitchers, football linemen, ballet dancers, runners) and those who engage in high-impact joint loading done in a repetitive manner (eg, running, jumping, landing on hard surfaces) may increase their risk for developing OA later in life.

• Obesity. Being overweight causes increased stress to the weight-bearing joints (such as knees), increasing the risk for development of OA.

How Does it Feel?

Typically, OA causes pain and stiffness in the affected joint. Common symptoms include:

• Stiffness in the joint, especially in the morning, which eases in less than 30 minutes

• Stiffness in the joint after sitting or lying down for long periods

• Pain during activity that is relieved by rest

• Cracking, creaking, crunching, or other types of joint noise

• Pain when you press on the joint

• Increased bone growth around the joint that you may be able to feel

Caution: Swelling and warmth around the joint is not usually seen with OA and may indicate a different condition or signs of inflammation. Please consult a doctor if you have swelling, redness, and warmth in or around a joint.

How Is It Diagnosed?

Osteoarthritis is typically diagnosed by your doctor using an X-ray, but there are signs that may lead your physical therapist to suspect you have OA. Joint stiffness; difficulty moving; joint cracking, creaking, or crunching; and pain that is relieved with rest are typical symptoms. Physical therapists often use the American Academy of Rheumatology criteria for diagnosing knee OA, which lists the presence of pain, plus at least 3 of the following 5 criteria:

• Age >50 years

• Stiffness <30 minutes

• Crepitus (a grinding/crunching sound emitted from the joint with movement)

• Bone tenderness

• Bony enlargement

How Can a Physical Therapist Help?

Physical therapist treatment has proven to be an effective treatment for OA, and may help you avoid surgery and use of prescription painkillers. Although the symptoms and progression of OA are different for each person, starting an individualized exercise program and addressing risk factors can help relieve your symptoms and slow the condition's advance.

Your physical therapist may:

• Perform a thorough examination to determine your symptoms.

• Observe what activities are difficult for you.

• Design an individualized exercise program to address your specific needs and improve your movement.

• Use manual (hands-on) physical therapy to improve movement of the affected joint.

• Offer suggestions for adjusting your work area to lessen the strain on your joints.

• Teach you aerobic and strengthening exercises to improve your movement and overall health.

• Design and teach you a home-exercise program to improve your strength and movement.

• Teach you an exercise program for safe weight loss, if you need to lose weight to ease pressure on your joints.

• Recommend simple lifestyle changes that will help keep the weight off.

In cases of severe OA that are not helped by physical therapy alone, surgery, such as a knee or hip replacement, may be necessary. Your physical therapist will refer you to an orthopedic surgeon to discuss the possibility of surgery.

Can this Injury or Condition be Prevented?

The development of OA cannot be completely prevented. The best way to slow the onset or progression of OA is to choose a healthy lifestyle by avoiding obesity and participating in regular physical activity or exercise programs.

Workers or athletes who perform repetitive movements that put pressure on specific joints can seek guidance from a physical therapist on proper movement techniques and muscle strengthening to help lessen joint strain, and prolong joint health.

Workers and athletes, as well as older adults, also should learn proper balance and movement techniques to lower their risk of falling and causing injury to a joint.

Real Life Experiences

Estelle is a 65-year-old executive assistant who sits for long hours at work. In recent months, she has noticed stiffness and pain in her right knee when getting up from her desk. Over the previous few weeks, Estelle has felt more pain in her knee when performing everyday tasks like going up and down stairs, or bending to open a file drawer. Her walks to and from the bus on her commute home have become more challenging due to her knee pain. She now has an increasingly hard time getting up and moving in the morning, due to pain and stiffness. Her friend suggests that she see a physical therapist.

At her first visit, Estelle’s physical therapist reviews her overall medical history, and asks her to describe her current symptoms, when and how they started, and her current level of activities. She notes that Estelle is limited in a number of key daily living activities. She conducts a full physical examination, and notes stiffness and limited range of motion in the right knee, as well as bone tenderness. Considering Estelle’s age and her reported incidence of pain, her physical therapist diagnoses knee OA.

Based on Estelle’s current condition and her personal goals, her physical therapist develops a plan of care to help ease her pain and stiffness and get her moving again. She first works with Estelle to help her gain some lost range of motion in her knee area. She applies manual (hands-on) therapy to gently increase movement in the knee area, and teaches Estelle gentle exercises to strengthen the muscle around her knee without increasing her pain.

Because Estelle’s physical therapist knows the importance of cardiovascular fitness and weight management, she has her ride a stationary bike at her physical therapy sessions, and recommends that she begin a low-impact aerobic or aquatic program at her local gym. She also designs a home-exercise program for Estelle, which she adjusts as Estelle’s strength and movement improve.

Over the next couple of months, Estelle notices an increase in motion and flexibility in the knee area, and reports that she feels much less pain when performing her daily living tasks. She has grown more comfortable and consistent with exercising at her local gym, and with her home-exercise program.

At work, Estelle now finds that she can rise from a chair pain free, and perform her office tasks with much more flexibility. Following her physical therapist’s advice, she makes sure that she gets up from her desk regularly to move about and “stretch her legs.”

Just this week, Estelle decides she’ll walk to a bus stop 2 blocks farther away from work, just for the fun of the added exercise!

This story was based on a real-life case. Your case may be different. Your physical therapist will tailor a treatment program to your specific case.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat OA, regardless of the affected joint. However, you may want to consider:

• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

• A physical therapist who specializes in the treatment of osteoarthritis.

You can find physical therapists with these and other credentials by using Find a PT, the online tool by the American Physical Therapy Association that can help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family and friends or from other health care providers.

• When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people who have osteoarthritis.

Further Reading

The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions and also prepare them for their visit with their health care provider.

The following articles provide some of the best scientific evidence related to physical therapy treatment of hip osteoarthritis and hip replacement. The articles report recent research and give an overview of the standards of practice both in the United States and internationally. The article titles are linked either to a PubMed* abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.

Esser S, Bailey A. Effects of exercise and physical activity on knee osteoarthritis. Curr Pain Headache Rep. 2011;15(6):423–430. Article Summary on PubMed.

Urquhart DM, Tobing JF, Hanna FS, et al. What is the effect of physical activity on the knee joint? A systematic review. Med Sci Sports Exerc. 2011;43(3):432–442. Free Article.

Murphy LB, Helmick CG, Schwartz TA, et al. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010;18:1372–1379. Free Article.

Cibulka MT, White DM, Woehrle J, et al. Hip pain and mobility deficits—hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2009;39:A1–A25. Free Article.

Murphy L, Schwartz TA, Helmick CG, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59:1207–1213. Free Article.

Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–785. Article Summary in PubMed.

Deyle GD, Allison SC, Matekel RL, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85:1301–1317. Free Article.

Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the arthritis, diet, and activity promotion trial.  Arthritis Rheum. 2004;50(5):1501–1510. Free Article.

*PubMed is a free online resource developed by the National Center for Biotechnology Information (NCBI). PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database.

Authored by Christopher Bise, PT, DPT, MS. Reviewed by the MoveForwardPT.com editorial board.