The Key to Athletic Physical Therapy: Finding Balance in a High-Stress World
I am incredibly fortunate to work in the field of athletic physical therapy in Bethesda, Maryland, and McLean, Virginia. The Washington, DC area is home to a remarkable community of driven, highly accomplished individuals who often lead impressive and fast-paced lifestyles. Many of my patients possess “type A” personalities, which is probably why we get along so well. They take a keen interest in their health and are eager to understand the root causes of their injuries, as well as what they can do to address them.
Working with such an informed and proactive population makes my job not only rewarding but enjoyable. I love “talking shop” about clinical topics and helping patients fully grasp their conditions. A well-informed patient is often highly engaged in their rehabilitation, diligently following home exercise programs and making meaningful changes in their daily routines, such as adjusting their workstation setup or refining their posture while sitting, standing, or sleeping.
However, patients with these high-achieving, hard-working personality traits can present unique challenges. Many of them have achieved significant professional success but struggle to manage the relentless stress that comes with demanding jobs—stress that is often compounded by everyday life.
The human body perceives stress as a cumulative load—whether physical, mental, or emotional. This can lead to an overactive sympathetic nervous system, leaving the body in a constant “wound-up” state. While short-term stress is manageable, chronic stress can keep the body in a heightened state of activity, resulting in accelerated heart rates, hormonal imbalances, and a host of other issues. In this state, the body is essentially in overdrive, making it difficult to recover from injuries and adapt to physical therapy.
In athletic physical therapy, one of the first and most important steps toward recovery is teaching the body how to “turn off” and shift into a state of relaxation. Achieving this balance allows the body to recover more efficiently and function at a higher level.
How Do You Turn Things Off?
At Cohen Health and Performance, one of the first techniques I teach my patients is proper breathing. Breathing correctly stimulates the parasympathetic nervous system—the branch responsible for calming the body and promoting relaxation. This helps dial down the overactive sympathetic nervous system, which controls our “fight or flight” response.
Once patients have mastered breathing techniques, we move on to retraining the body to move efficiently. Chronic stress often leads to poor movement patterns, characterized by excessive extension and rigidity in the body. One of the best exercises for counteracting this is the 90-90 Hip Lift, a popular drill from the Postural Restoration Institute.
Here’s how it works:
1. Lie on your back with your hips and knees bent at 90 degrees. Place a small towel or ball between your knees and rest your feet flat against a wall.
2. Inhale through your nose, and as you exhale through your mouth, gently perform a pelvic tilt, lifting your tailbone slightly off the ground.
3. Focus on digging your heels into the wall, engaging the back of your thighs rather than your hip flexors.
4. Hold this position while taking 4-5 deep breaths in through your nose and out through your mouth.
Once this basic activity is mastered, we gradually increase the complexity of exercises to better mimic the functional movements of daily life and athletic performance.
Bringing Balance to Everyday Life
Achieving balance doesn’t stop at the clinic. Incorporating stress-relieving activities into your daily routine is crucial for long-term success. These activities should be enjoyable and help you unwind from the stress of daily life. Whether it’s meditation, a peaceful walk, a hike, or spending quality time with family and friends, finding time to relax is essential for creating balance in your body and improving overall function.
In short, take time to enjoy life outside of work and responsibilities. Your body—and your performance—will thank you for it.
If you’d like more information on these techniques or any other topics related to physical therapy, don’t hesitate to reach out.
