Author: Zachary Cohen

Dr. Zac began his career working in professional sports. He noticed a large discrepancy between the quality of care that elite athletes receive when compared to the normal active public. This inspired him to create Cohen Health and Performance, a place that treats everyone as if they are a professional athlete! He graduated summa cum laude from Northeastern University in 2011 with his Doctorate in Physical Therapy, and also became a Certified Strength and Conditioning Specialist (CSCS). While at Northeastern he worked as a Physical Therapy Graduate Assistant for the New England Patriots, and served as a strength and conditioning coach for Northeastern University athletics. Prior to moving to Maryland, Zac was a Performance Physical Therapist with EXOS (formerly known as Athletes' Performance) in Dallas, TX where he treated and trained the world's most gifted athletes from throughout the NFL, MLB, NBA, MLS, and various Olympic teams.

Knee Pain Physical Therapy: How to Prepare Your Body for Ski and Snowboard Season

Winter is here, and with it comes ski and snowboard season. After a fresh snowfall and a morning spent shoveling the driveway, I was reminded how quickly winter sports sneak up on us. I also thought back to a trip I took out west last year. It was an amazing experience, but I remember feeling more sore afterward than I had in years past.

As I approach 40, I have realized something many skiers and snowboarders experience. You cannot get away with the same preparation you once did.

If you ski or snowboard and deal with knee pain, or want to avoid it altogether, a little intentional preparation can make a significant difference. This is where knee pain physical therapy becomes especially valuable.

Why Skiing and Snowboarding Stress the Knees

Both skiing and snowboarding place repeated, high-load demands on the knees. Every turn, landing, edge change, and deceleration sends force through the knee joint. By the end of the day, fatigue sets in, technique changes, and the risk of pain or injury rises.

For snowboarders, rotational forces through the hips and knees are constant. Controlling the board requires the knees to tolerate twisting forces while staying stable. Skiers face repeated knee flexion and extension under load, especially when carving or navigating uneven terrain.

If you have ever noticed your knees becoming sore late in the day, struggling to carve clean turns, or feeling stiff after a trip, those are signs your body may not be fully prepared for the demands of the sport.

Our team sees this every winter, which is why knee pain physical therapy is one of the most common reasons skiers and snowboarders come into our clinics.

You can learn more about common causes of knee pain we treat here:
Knee Pain Physical Therapy in Bethesda and McLean

The Role of Strength, Endurance, and Control

One of the biggest misconceptions is that knee pain is only about weakness. In reality, skiing and snowboarding demand a combination of strength, muscular endurance, and control.

Most gym exercises are performed in mid-range positions for short sets. On the mountain, however, your knees live in deeper positions for long periods of time. This means your muscles must sustain force, not just produce it briefly.

In knee pain physical therapy, we often shift training to better match sport demands. This may include:

Longer sets with moderate loads to build endurance
Hinge-based exercises such as RDL and deadlift variations
Controlled rotational drills to improve knee and hip stability
Landing and deceleration training to prepare for jumps and terrain changes

Small programming changes like increasing reps from 5 to 10 or 12 can significantly improve how your knees tolerate a full day on the slopes.

Why Falls Matter for Knee and Joint Health

Falls are part of skiing and snowboarding. When they happen, the body often ends up in vulnerable positions. Knees, shoulders, wrists, and elbows are commonly exposed to sudden forces.

Most people train strength with their arms and legs close to their body. Injuries, however, tend to occur when limbs are farther away. Part of effective knee pain physical therapy includes preparing the body to tolerate force in these vulnerable positions.

This means incorporating drills that teach the body how to absorb force quickly and safely, helping protect the knees and surrounding joints when things do not go as planned.

If you have had a previous knee injury, this type of preparation becomes even more important. You can read more about how we approach post-injury knee rehab here:
Sports Physical Therapy for Knee Injuries

Do Not Forget About Ankles and Feet

Knee pain is often influenced by what is happening above and below the joint. Boots and bindings limit ankle mobility, which changes how force is transferred through the legs.

Snowboarders, in particular, know the burning sensation in the shins that can build up when riding the toe edge or getting stuck on flats. If the ankles and shins fatigue, the knees often compensate.

A comprehensive knee pain physical therapy program will address ankle strength, endurance, and control to reduce unnecessary stress on the knees.

Skill Level Matters

The demands on your knees vary depending on how you ski or ride. Higher-level skiers and snowboarders who ride steeper terrain or hit jumps experience much higher forces through the knees.

In these cases, plyometric training and controlled jumping drills are often incorporated to prepare the knees for rapid deceleration and landing forces. These drills are progressive and tailored to the individual, not random high-impact exercises.

This is a core principle of how we approach knee pain physical therapy for active adults and athletes.

Keep It Simple and Consistent

Preparing for ski and snowboard season does not require an overhaul of your workouts. In fact, simpler is usually better.

Choose two or three drills that closely match the demands of your sport. Spend five to ten minutes incorporating them into your warm up two to three times per week. This approach is often more effective than long, exhausting workouts that are difficult to sustain.

Consistency matters more than complexity.

When Knee Pain Physical Therapy Can Help

If you already have knee pain, a history of injury, or want a personalized plan to prepare for ski or snowboard season, knee pain physical therapy can help you address the root cause rather than just managing symptoms.

This is something we see consistently every winter at our Bethesda and McLean clinics. Our goal is to help you enjoy longer days on the mountain with fewer setbacks.

If you would like to learn more or schedule an evaluation, visit:
Schedule a Physical Therapy Evaluation

Skiing and Snowboarding Physical Therapy FAQs

Q: Why do skiers and snowboarders commonly experience knee pain?
A: Skiing and snowboarding place repeated rotational and impact forces on the knees. Fatigue, poor muscular endurance, limited mobility, or prior injuries can increase stress on the knee joint, leading to pain during or after time on the slopes.

Q: How can knee pain physical therapy help before ski season?
A: Knee pain physical therapy helps identify strength, mobility, and control deficits that increase injury risk. A targeted program improves knee stability, muscular endurance, and force absorption to better prepare the body for skiing and snowboarding demands.

Q: Should I do physical therapy even if I don’t currently have knee pain?
A: Yes. Preventive knee pain physical therapy can reduce injury risk, improve performance, and help you tolerate longer days on the mountain by preparing your joints and muscles for winter sport demands.

Q: What exercises help prevent knee pain for skiing and snowboarding?
A: Common exercises include hinge-based strength work, controlled rotational drills, landing mechanics training, and muscular endurance exercises. These movements better match the real demands placed on the knees during skiing and snowboarding.

Q: How often should I train to prepare my knees for ski season?
A: Incorporating 5 to 10 minutes of targeted knee-focused drills into your warm-up two to three times per week is often sufficient to build resilience and reduce knee pain risk.

Sports Physical Therapy Lessons From The Daniels Jones Injury

If you watched NFL football 9 days ago, you probably saw the heartbreaking moment when Colts quarterback Daniel Jones ruptured his Achilles in what had been shaping up to be a breakout season. The kind of year that shapes a career in an instant.

What made it even more concerning is that he had been playing for weeks with a fractured fibula in the opposite leg. And while we’ll never know for certain if one injury caused the other, the situation highlights an important truth:

Your body reacts to injury as a system, not as a single joint or muscle.

This same pattern is something we see every day at our sports physical therapy clinics in McLean and Bethesda.

Pain Is Often Not the Real Problem

One of the biggest misconceptions in injury recovery is assuming pain always means something is wrong exactly where it hurts.

Your body is a chain. When one link is weak or restricted, the rest of the chain absorbs stress.

At our
Sports Physical Therapy McLean and
Sports Physical Therapy Bethesda clinics, we commonly see:

• An ankle injury showing up later as knee pain
• Hip stiffness leading to low back issues
• A stiff upper back contributing to shoulder pain

A stressed area may feel like the problem, but it often is just compensating for another weakness elsewhere.

Young Athletes Should Not Copy Pro Athletes

Professional athletes live in a different world.

Playing is their job. The reward may be millions of dollars, championships, and career-defining moments.

For high school athletes, the goal should not be to sacrifice long-term health to win the next game. The goal is development, confidence, and staying healthy for years to come.

At our McLean and Bethesda sports physical therapy locations, we help families and athletes make smart decisions every day about when it is okay to push through discomfort and when the risk is simply not worth it.

The Most Common Risk We See: Incomplete Rehab

Most re-injuries don’t happen from a freak accident.

They happen when athletes return before their bodies are truly ready.

We regularly see athletes who can:

Run straight
Jog pain-free
Walk normally

But cannot yet:

Cut safely
Decelerate under control
Jump and land with good mechanics
Handle full game-speed movements

Pain may be gone, but the body may still be under-prepared for the stresses of sport.

If you’re interested in our approach, check out our program for
High School Athlete Injury Rehabilitation — where rehab is not just about healing, but restoring movement, strength, and readiness.

The Right Question to Ask

Instead of asking:
“Can I play?”

A better question is:
“Can I move the way my sport demands without compensating?”

At our sports physical therapy clinics in Bethesda and McLean, return-to-play decisions are based on far more than pain relief.

We evaluate strength, symmetry, movement quality, coordination, and readiness for sport-specific stresses.

How Technology Helps Us Make That Decision — Not Guesswork

One of the biggest advantages we offer is our use of advanced technology for return-to-play testing and performance evaluation. No more guessing if someone “feels fine.” We get objective data.

We’ve written more about this on our dedicated page for How Technology Is Changing Sports Physical Therapy in Bethesda and McLean.

Here’s how that technology helps:

Precise movement analysis to catch compensations
Strength and power testing to verify balanced return
Data on jump mechanics, landing, and force absorption
Objective criteria for return-to-play. Not opinions

That means when we clear an athlete for sport again, we can be confident they’re ready for the demands ahead. Not just based on feeling or judgment but on real, measurable performance.

How Sports Physical Therapy in McLean and Bethesda Can Help

If your athlete is coming back from an injury and something still doesn’t feel right, but you’re not sure why, they deserve answers.

At Cohen Health and Performance, we provide:

One-on-one sports physical therapy
Strength, mobility, and performance testing using advanced technology
Sport-specific rehab progressions
Return-to-play guidance based on data and movement quality

Whether you are searching for sports physical therapy McLean or sports physical therapy Bethesda, our mission is simple:

Keep athletes healthy now and strong for the future.

Toughness is admired in sports. Preparation and smart decisions are what prevent injuries.

The best athletes aren’t the ones who ignore pain.
They are the ones who listen to their body early and fix the problem before it becomes a season-ending setback.

Looking for sports physical therapy in McLean or Bethesda?

If you are unsure whether your athlete is truly ready to return from injury or want a professional evaluation before letting them get back into full sport, we’d love to help.

Visit:
• https://cohenhp.com/mclean-va/
• https://cohenhp.com/bethesda-md/

Because staying on the field isn’t just about grit.
It’s about preparation, smart rehab, and long-term health.

How Technology Is Changing Sports Physical Therapy in Bethesda and McLean

If you’ve been inside our clinic recently, you’ve probably noticed that sports physical therapy today looks very different than it did just a few years ago. At Cohen Health & Performance, we combine expert clinical care with advanced performance technology to help athletes, runners, and active adults recover faster and return stronger.

With locations in Bethesda, Maryland and McLean, Virginia, our sports physical therapy clinics focus on delivering results through data driven decisions, individualized care, and objective testing that takes the guesswork out of rehabilitation.

Why Technology Matters in Sports Physical Therapy

Traditional sports physical therapy relied mostly on observation, experience, and how an injury “felt.” While those things absolutely matter, modern technology now allows us to combine clinical expertise with objective data.

That means fewer setbacks, faster decisions, and safer progressions.

Instead of relying on timelines, we measure readiness.

Instead of guessing, we test.

This approach leads to smarter rehab and better outcomes for both high school athletes and athletic adults across Bethesda, McLean, and surrounding communities.

The NordBord: Protecting Hamstrings and Preventing Reinjury

Hamstring injuries are common among runners, soccer players, football players, and any athlete who sprints or cuts. The NordBord allows our sports physical therapy specialists in Bethesda and McLean to measure hamstring strength and side to side balance with precision.

During a Nordic hamstring exercise, we capture how much force each leg produces. That data helps determine whether an athlete is truly ready to progress or return to sport without elevating reinjury risk.

Hamstrings work as braking muscles when the leg swings forward during sprinting. If one side cannot tolerate that demand, strains usually follow.

Using the NordBord ensures that return to play decisions are based on real performance data rather than time since injury.

The ForceFrame: Strength Testing That Improves Sports Physical Therapy Outcomes

The ForceFrame is a high level strength testing system that measures isometric force through the shoulders, hips, knees, and ankles.

In our Bethesda and McLean sports physical therapy locations, we use this system to assess limb differences, detect weaknesses that increase injury risk, and monitor progress across visits.

It provides clear answers to important questions like:
Are you truly stronger?
Is one side compensating for the other?
Are you ready for higher load training?

That information allows us to tailor rehab for each person rather than applying generic protocols.

The ForceDecks: Understanding Movement and Impact

ForceDecks are dual force plates that allow us to analyze how athletes interact with the ground when they jump, land, and accelerate.

This technology gives our sports physical therapy teams in Bethesda and McLean insight into:
Force production
Landing mechanics
Imbalances
Stress patterns across joints

For runners, team sport athletes, and parents of youth athletes, this is incredibly valuable. It allows us to identify risky movement patterns before pain even starts.

If something feels off when you jump, sprint, or cut, we can convert that feeling into data and use it to guide treatment.

Dynamos: Tracking Strength and Mobility

Dynamos allow us to measure strength and range of motion across joints with precision.

In our sports physical therapy clinics in Bethesda and McLean, these tools help us verify that treatment is working rather than simply hoping it is.

We use dynamos to track:
Joint motion improvements
Muscle strength gains
Rehab progress accuracy

It gives patients proof of progress and clinicians better direction on how to load and advance exercise safely.

Why Our Approach to Sports Physical Therapy Works

We use technology to enhance our clinical decision making, not replace it.

By combining hands on treatment with objective testing, we create treatment plans that adapt in real time rather than following rigid timelines.

This allows us to:
Progress athletes sooner when appropriate
Slow down when necessary
Reduce repeat injuries
Improve confidence in return to play decisions

For active individuals in Bethesda and McLean looking for sports physical therapy that focuses on results, this approach delivers a higher level of care.

See the Technology in Action

We created a video walkthrough showing how each of these tools works inside our Bethesda and McLean clinics.

You’ll see how testing is performed, how we analyze results, and how it translates into better rehab outcomes and safer return to sport.

If you’re dealing with pain, stiffness, or a lingering injury, this behind the scenes look will help you understand how modern sports physical therapy is different from traditional rehab.

And if you’re ready to experience it firsthand, our team at Cohen Health & Performance would love to help.

Should You Train Through Pain? A Guide for Athletes and Parents

If you are an athlete or the parent of a high school athlete, you already know that pain shows up sooner or later. Soreness, stiffness, and the occasional ache are all part of training hard. But knowing when to push through pain and when to stop is where many athletes get stuck.

As a sports physical therapy team working with athletes in Bethesda and McLean, we see this problem every single day. Athletes often choose one of two extremes. They either ignore the pain completely and keep pushing or they shut everything down at the first sign of discomfort. Neither approach helps you perform your best or stay healthy.

There is a much better way to understand pain during training. We teach our athletes a simple and effective system that helps them stay safe, stay active, and stay on the field. It is the traffic light system for pain.

Understanding Pain Like a Traffic Light

Green Light Pain

Green light pain is mild, dull, and harmless. Sometimes your knee feels a little stiff when you start warming up or you notice a small ache when you first walk into the gym. Once you start moving, the discomfort fades. It does not change how you move and your body feels the same or even better the next day.
If this sounds familiar, you are good to keep training. This type of pain is extremely common in active athletes and often improves with movement.

Yellow Light Pain

Yellow light pain is more noticeable. It may slightly alter your movement or force you to compensate. It might get worse as you load the area or repeat certain exercises.
This is the time to modify your training rather than stopping completely. For example, if squats bother your knee at a certain depth, you might switch to split squats or use a machine based variation. You might also decrease the weight, reduce the number of reps, or shorten the range of motion.
The key is that whatever modification you choose should not make things worse during the workout or afterward.

Red Light Pain

Red light pain is a clear warning sign. This pain is sharp, intense, or unstable. It might come with tingling, catching, popping, or sudden weakness. It clearly worsens during exercise and forces you to move differently.
When you experience red light pain, you need to stop immediately and have it evaluated. Continuing to train through these symptoms can turn a small issue into a much bigger one.

The 24 Hour Rule Every Athlete Should Use

No matter what type of pain you feel, the next day is the real test. Symptoms should return to baseline or feel better within 24 hours of your workout.
If your pain is worse the next day, especially with yellow light pain, you need to modify further or choose a different exercise the next time. If symptoms continue to worsen, it is time to get assessed by a sports physical therapy specialist.

When to Seek Professional Help

If you are not sure whether your pain is green, yellow, or red light pain, or if you already know your symptoms are limiting your performance, you should have it evaluated.

Our physical therapy clinics in Bethesda and McLean work with athletes every day to help them understand their pain, train safely, and get back to the activities they love. Sports physical therapy is not just about treating injuries. It is about helping athletes stay in motion, stay strong, and stay confident.

If you or your athlete is unsure what the next step should be, we would love to help you figure it out. The right guidance can keep you out of harm’s way and help you continue progressing toward your goals.

What Do ACL Rehab and Vince Lombardi Have in Common?

Guest post by Dr. Samuel Kinney, Performance Physical Therapist at Cohen Health & Performance – McLean

If you’re an athlete in the McLean area recovering from an ACL injury, you already know how demanding the process can be. At our sports physical therapy clinic in McLean, Dr. Samuel Kinney takes a page from one of football’s greats, Vince Lombardi, to help athletes master the fundamentals that make the difference between average recovery and peak performance.

Back to Basics: The Lombardi Lesson

Back in 1959, Vince Lombardi was hired to turn around the struggling Green Bay Packers. Reporters wanted to know his plan. Would he redesign the offense, invent new formations, or bring in something flashy and new?

His answer was simple: master the basics.

Lombardi believed football games were won not through trick plays but through relentless execution of fundamentals. Things like blocking and tackling done to perfection. His five championships speak for themselves.

Much like Lombardi’s approach, early-phase ACL rehab centers on the same idea: mastering the fundamentals. At Cohen Health & Performance in McLean, one of those core fundamentals is activation of the quadriceps muscle, a skill that’s often tougher than it sounds.

What’s Going On: The Quad Isn’t Just Weak. It’s Disconnected

After a knee injury such as an ACL tear or surgery, the muscle may look fine, but the nervous system that activates it can become inhibited.

This phenomenon is known as arthrogenic muscle inhibition (AMI) and it’s one of the biggest early obstacles we see in sports physical therapy McLean patients recovering from ACL injuries.

Here’s how it happens:

Nerves within the injured ACL and joint become disrupted.
Swelling, pain, and trauma trigger a protective response.
That protection reduces the signal from the brain and spinal cord to the quadriceps.

The result: athletes think they’re activating the quad, but the signal isn’t strong enough to produce full contraction. Even during “quad sets” or knee extensions, the activation may fall short and recovery can stall.

Why It Matters

You might wonder, “If my athlete is lifting and making progress, what’s the problem?”

Here’s why early quad activation is critical:

Stability: When the quad isn’t firing properly, the knee loses stability, raising the risk of reinjury or compensations at the hip or ankle.
Performance: Even if strength returns, delayed activation impacts cutting, pivoting, and jumping mechanics, a split-second difference that affects performance.
Longevity: Research shows quad activation issues can persist for months post-surgery if not addressed early.

For parents supporting their young athletes, this early stage sets the tone for safe, confident return-to-sport progressions.

How We Address It at Cohen Health & Performance in McLean and Bethesda

Our sports physical therapy team in McLean and Bethesda focuses on reconnecting athletes with their quads and rebuilding a strong, stable foundation:

Early Stage — Control Swelling & Restore Motion
Swelling and pain inhibit the quad. We prioritize compression, elevation, and restoring full knee extension as quickly as possible to improve activation.
Early Activation — Get the Quad Turning On
Once cleared post-surgery, we begin re-educating the nervous system. Using neuromuscular electrical stimulation (NMES), we help re-establish the brain-to-muscle connection — a proven strategy to accelerate recovery.
Progressive Strengthening
When activation becomes consistent, we progress into strength training and functional movement patterns. The fundamentals never get skipped; reliable quad activation remains the base for every phase of rehab and performance.

How Parents Can Help at Home

Supporting your athlete’s recovery outside the clinic makes a huge difference:

Ask about NMES: Ensure your child’s therapist includes NMES and teaches home use.
Encourage consistency: Simple activation drills repeated daily rebuild the mind-muscle link.
Watch their movement: Hesitation or favoring one leg can signal incomplete activation.
Reinforce their home program: Progress continues between sessions — not just in the clinic.

At Cohen Health & Performance, we believe lasting results come from doing the basics exceptionally well — just like Lombardi preached.

If your athlete is recovering from an ACL injury, our sports physical therapy team in McLean and Bethesda are ready to help them move, feel, and perform at their best.

Cohen Health & Performance – McLean
Tailored ACL rehabilitation and performance physical therapy for athletes who want to come back stronger.

Contact us today to learn more about our individualized sports physical therapy McLean programs.

What Pro Athletes Teach Us About Sports Physical Therapy

Before moving to the DMV, I spent several years in Dallas, Texas working for a company called EXOS, a world-renowned leader in sports performance and sports physical therapy. If you haven’t heard of them, EXOS works with some of the best athletes in the world. NFL players, Major League Baseball athletes, professional basketball players, and Olympians across multiple sports.

When I first started there, I assumed these elite athletes recovered faster from injuries simply because they were the best of the best. They’re in the top 1% of their sport, with incredible genetics and access to every resource imaginable. Daily rehab sessions, personalized nutrition, and world-class sports medicine teams.

And yes, all of those factors help.
But over time, I realized something bigger: what really sets these athletes apart isn’t just their access to care. It’s their approach to sports physical therapy.

1. They Start Rehab Immediately After Injury

When most people get injured, they wait.
Work, family, and other commitments get in the way, and rehab gets pushed to “next week.” But delaying treatment allows stiffness, swelling, and compensations to set in, making recovery longer and more frustrating.

Professional athletes don’t wait. They start sports physical therapy almost immediately after injury. Their therapists get the injured area moving safely and within pain-free limits right away. Early motion helps maintain mobility, reduces swelling, and speeds up recovery.

The lesson for the rest of us?
The sooner you start rehab, the sooner you’ll get back to the activities that matter most.

2. They Treat Rehab Like Training

Elite athletes view every rehab session like a workout. They track everything. Strength, volume, reps, and intensity, just like they would in the weight room. Every session has purpose and measurable progress.

At Cohen Health and Performance, that’s exactly how we approach sports physical therapy. We track objective progress through force-plate testing, strength metrics, and movement quality. Every session builds on the last, helping athletes and active adults see small, consistent gains that add up to big results over time.

The takeaway:
Your rehab shouldn’t be random. Treat it with the same focus and structure you’d give your training program.

3. They Trust the Process and Don’t Rush the Return

By the middle of every football season, nearly every player is dealing with something. Many could technically “play,” but smart teams and medical staffs know that coming back too soon increases the risk of re-injury and more time lost in the long run.

The same principle applies to anyone going through sports physical therapy. You might feel better after a few sessions, but that doesn’t mean your body is fully ready for the demands of your sport or activity. Strength, power, and control need to be rebuilt gradually so you can perform confidently without setbacks.

That’s why we test and track readiness. So you don’t just get cleared; you get truly ready.

4. They Build a Team Around Their Recovery

No professional athlete recovers alone. They have a team. Physical therapists, athletic trainers, physicians, strength coaches, and family, all communicating and working toward the same goal.

Your team might look a little different, but the principle is the same. Recovery works best when everyone is aligned: you, your physical therapist, your doctor, and even your support system at home. When everyone’s working together, you stay accountable and make steady, confident progress.

Bringing a Pro Athlete Mindset to Your Recovery

You don’t have to be a professional athlete to benefit from sports physical therapy. The same mindset that helps the pros get back on the field can help you get back to the gym, the court, or the activities you love most.

Start early.
Stay consistent.
Track your progress.
Trust the process.
And surround yourself with the right team.

If you’re looking for expert-level sports physical therapy in Bethesda or McLean, our team at Cohen Health and Performance is here to help. We work with athletes and active adults every day to recover faster, move better, and perform at their best, on and off the field.