Shoulder Pain? Here’s Why the Right Diagnosis Matters More Than the Right Exercise

Shoulder pain is frustrating.

It can make lifting uncomfortable, limit your workouts, and even affect simple daily activities.

Recently, I found myself dealing with a shoulder issue of my own.

It wasn’t severe enough to stop me from training, but it was nagging enough that I knew I needed to figure out what was going on before it became a bigger problem.

So I did what we encourage our patients to do every day.

I had another physical therapist evaluate it.

As physical therapists, we’re trained to assess movement and diagnose injuries. But it’s surprisingly difficult to evaluate yourself objectively. Having someone else take a step back, perform the right tests, and look at the full picture makes a huge difference.

In my case, we identified that one of my rotator cuff muscles, the supraspinatus, was irritated.

That diagnosis changed everything.

The Best Exercise Depends on What’s Actually Causing Your Pain

If you’ve ever searched for shoulder pain exercises online, you’ve probably found hundreds of videos and programs promising quick relief.

Some are well intentioned.

Some are based on good research.

The problem is that none of them know why your shoulder hurts.

Two people can both have shoulder pain but need completely different treatment plans.

One person may have irritation in a rotator cuff tendon.

Another may have limited shoulder mobility.

Someone else may have weakness that’s affecting how their shoulder moves.

The symptoms can feel similar, but the underlying problem is very different.

That’s why trying random exercises often leads to frustration.

Before choosing the right treatment, you need the right diagnosis.

Your History Matters

The shoulder doesn’t exist in isolation.

When we evaluate someone, we don’t just look at the painful area.

We want to understand how the symptoms developed.

Previous injuries.

Training volume.

Exercise selection.

Work demands.

Movement habits.

All of those factors help explain why pain developed in the first place.

For me, years of football, my current training routine, and the specific demands I place on my shoulder all influenced the plan we created.

That’s why rehabilitation should never be copied from someone else.

It should be built around you.

Teaching the Shoulder to Work Together Again

Pain doesn’t just affect one muscle.

It can change how the entire shoulder functions.

One of the first goals in my rehabilitation was improving how my rotator cuff muscles worked together to stabilize the shoulder.

We started with simple weight-bearing exercises that encouraged the shoulder muscles to coordinate and create a stable base before progressing to more demanding movements.

As the shoulder became more tolerant of load, we gradually introduced exercises that specifically challenged the irritated tissue.

The progression mattered just as much as the exercise itself.

Loading an irritated muscle too early can increase symptoms.

Waiting too long can delay recovery.

Finding the right balance is one of the most important parts of rehabilitation.

There Isn’t One Perfect Shoulder Exercise

People often ask what the best exercise is for shoulder pain.

The answer depends on the person.

The same exercise that helps one individual could make someone else’s symptoms worse.

That’s why rehabilitation isn’t about collecting exercises.

It’s about understanding when to use them, how much load to apply, and how to progress them over time.

Those decisions should always be based on a thorough evaluation.

Sports Physical Therapy in Bethesda and McLean

Whether you’re dealing with shoulder pain from lifting, throwing, tennis, pickleball, CrossFit, or another activity, getting the right diagnosis is the first step toward recovery.

At Cohen Health & Performance, we take the time to understand not just where your shoulder hurts, but why it’s hurting. Our one-on-one approach combines movement analysis, strength testing, and individualized rehabilitation to create a plan that’s built around your goals.

If you’re looking for sports physical therapy in Bethesda or sports physical therapy in McLean, our team is here to help. We work with active adults and athletes to identify the root cause of pain, improve movement, and get you back to training and competing with confidence.

The sooner you understand what’s driving your symptoms, the sooner you can stop guessing and start making meaningful progress.

Is Your Training Preparing You for Your Sport? Why Sport-Specific Training Matters Before the Season Starts

Why sport-specific training matters before your fall season

As summer comes to an end, athletes everywhere are getting ready for the fall sports season.

Whether it’s football, soccer, basketball, field hockey, or another fall sport, practices are about to become more intense and competition is right around the corner.

The question is, has your training prepared you for what you’re actually about to do?

This is one of the biggest mistakes we see every year. Athletes spend the offseason improving their fitness, but as the season approaches, they don’t make the transition to sport-specific training. As a result, we often see a spike in hamstring strains, hip flexor injuries, calf strains, and other soft tissue injuries during the first few weeks of the season.

The good news is that many of these injuries are preventable.

General fitness is only the first step

Building an aerobic base is important.

Long runs, steady bike rides, and other endurance workouts improve your cardiovascular fitness and help create a solid foundation for training.

The problem comes when that’s the only type of training you’re doing right before your season begins.

Most sports don’t require continuous, steady movement.

Football players sprint for just a few seconds before the next play.

Basketball players accelerate, stop, cut, jump, and change direction throughout the game.

Soccer players alternate between jogging, sprinting, recovering, and repeating that cycle for an entire match.

If your training doesn’t resemble those demands, your body may not be ready when practices become more intense.

Your body adapts to the stress you give it

One of the amazing things about the human body is its ability to adapt.

If you consistently expose your body to a certain type of stress, it becomes better at handling that stress over time.

That’s why preparing for your sport means training the movements, speeds, and intensity you’ll actually experience during competition.

Athletes searching for Chevy Chase physical therapy often ask how they can reduce their injury risk before the season begins. One of the biggest factors is making sure training reflects the actual demands of their sport instead of relying solely on general conditioning. Whether you’re recovering from a previous injury or simply trying to stay healthy throughout the season, preparing your body for the stresses you’ll actually experience is one of the most effective ways to improve both performance and durability.

For an athlete who’s been running several miles each day, the next step may be adding sprint intervals.

Instead of one continuous run, perform repeated short sprints followed by recovery periods. Over the following weeks, gradually increase the effort while maintaining good movement quality.

This allows your muscles, tendons, and nervous system to adapt before the season begins instead of being surprised by the sudden increase in workload.

Every sport has different demands

Sport-specific training isn’t one size fits all.

Football players benefit from explosive, short-duration sprints because most plays last only a few seconds.

Soccer players often need longer sprint intervals because the game requires repeated high-intensity efforts over a much longer period.

Basketball players should also spend time working on jumping, landing, acceleration, deceleration, and change of direction.

The goal isn’t simply to get tired during a workout.

The goal is to prepare your body for the exact stresses you’ll encounter once competition begins.

Why we see so many injuries early in the season

Every fall, we treat athletes who develop muscle strains shortly after practices begin.

In many cases, the injury isn’t caused by one specific event.

Instead, it’s the result of a sudden increase in workload.

Practices become longer.

The intensity increases.

Athletes sprint more often.

They cut harder.

They jump more frequently.

If the body hasn’t gradually adapted to those demands beforehand, the risk of injury increases.

That’s why preseason preparation matters so much.

Train for the sport you play

As your season approaches, ask yourself one simple question:

Does my training look like my sport?

If the answer is no, it may be time to adjust your program.

Making that transition before preseason starts can help improve performance while reducing the risk of unnecessary injuries.

Sports physical therapy in Bethesda and McLean

If you’re dealing with a muscle strain, recovering from an injury, or simply want to make sure you’re prepared for the upcoming season, our team is here to help.

At Cohen Health & Performance, we work with athletes of all ages to develop individualized rehabilitation and performance programs based on the specific demands of their sport. Whether you’re looking for sports physical therapy in Bethesda or sports physical therapy in McLean, our one-on-one approach helps athletes recover efficiently, reduce injury risk, and return to competition with confidence.

The best time to prepare for your season is before injuries happen. If you or your athlete wants to head into the season feeling strong, healthy, and ready to perform, schedule an evaluation with our team today.

CHP Spotlight Interview: Nutrition, Performance, and Recovery with Registered Dietitian Emily Arkin

At Cohen Health & Performance, we often talk about the importance of looking at the whole athlete. Great training and great physical therapy matter, but they are only part of the equation.

In our latest CHP Spotlight Interview, we sat down with registered dietitian Emily Arkin, founder of RD Emily & Team, to discuss one of the most overlooked aspects of performance, recovery, and long-term health: nutrition. Emily and her team work with athletes, active adults, and individuals navigating a wide variety of nutrition concerns, helping people cut through the noise and create sustainable strategies that fit their lives.

Meet Emily Arkin, RD

Emily Arkin is a registered dietitian and owner of RD Emily & Team, a group nutrition practice serving the DC, Maryland, and Virginia area. Her team specializes in sports nutrition, eating disorder recovery, gastrointestinal health, cardiometabolic health, and more. Their approach focuses on helping people make informed decisions about nutrition without relying on restrictive diets or one-size-fits-all recommendations.

One of the Biggest Problems Facing Young Athletes

One of the most valuable parts of our conversation centered around a challenge we frequently see in high school athletes: under-fueling.

According to Emily, many young athletes simply are not eating enough to support the demands of training, competition, recovery, growth, and everyday life. This is often unintentional. Busy schedules, school, practices, games, social activities, and a lack of planning can make it difficult for athletes to consistently consume enough calories throughout the day.

The consequences can be significant:

  • Slower recovery between practices and games
  • Increased fatigue
  • Reduced performance
  • Difficulty building strength and muscle
  • Higher risk of recurrent injuries
  • Poor sleep and recovery

As Emily explains, nutrition is not separate from athletic performance. It directly impacts how athletes train, recover, adapt, and stay healthy throughout a season.

Why Nutrition Advice for Athletes Is Different

One topic that generated a great discussion was the difference between nutrition advice for the general public and nutrition advice for athletes.

Many nutrition messages online focus on avoiding sugar, cutting calories, or restricting certain foods. While those recommendations may make sense in some contexts, athletes have very different demands.

Emily explained that carbohydrates, including simple sugars in the right situations, can be valuable fuel sources for training and competition. Athletes often need strategies that support performance and recovery rather than simply following generalized nutrition trends.

The takeaway?

Athletes are not the general population. Their nutritional needs should reflect the demands they place on their bodies.

Nutrition and Injury Recovery

As physical therapists, one area we are particularly passionate about is helping injured athletes return to the activities they love.

During our conversation, Emily discussed a common mistake athletes make after getting injured: dramatically reducing their food intake because they are no longer training at full capacity.

While it may seem logical to eat less when activity levels decrease, recovery itself requires energy. Healing tissues, maintaining muscle mass, and supporting rehabilitation all require adequate nutrition. Athletes who aggressively cut calories during recovery may unintentionally make the rehab process more difficult.

This is something we see regularly at CHP. The best rehabilitation program in the world can only take someone so far if recovery, sleep, stress management, and nutrition are not supporting the process.

Performance Is Bigger Than Any One Provider

One of the themes that emerged throughout the interview was the idea that optimal performance requires a team approach.

Physical therapists, strength coaches, physicians, nutrition professionals, parents, and athletes all play important roles. When these pieces work together, athletes are positioned to recover more effectively, perform at a higher level, and stay healthy longer.

If you are an athlete, parent, coach, or active adult looking to better understand how nutrition impacts performance and recovery, we encourage you to watch the full CHP Spotlight Interview with Emily Arkin.

At Cohen Health & Performance, we believe the best outcomes happen when every aspect of health and performance works together. Nutrition is one of the most powerful tools available, and this conversation is packed with practical insights to help you get more out of your training, recovery, and overall health.

To learn more about Emily, click on the link! https://www.rdemily.com

Are Your Corrective Exercises Actually Working?

If you’re an athlete, runner, lifter, or active adult, there’s a good chance you have some form of maintenance routine. Maybe it’s a mobility program, a handful of stretches, or a few corrective exercises that you perform before or after workouts to stay healthy.

At our physical therapy clinics in Bethesda and McLean, we love seeing people take a proactive approach to their health and performance. However, we often see two common mistakes that prevent these programs from delivering the results people expect.

The Biggest Mistake We See in Physical Therapy Bethesda and McLean

Many people treat corrective exercises differently than they treat strength training.

When it’s time to squat, deadlift, run, or play a sport, effort is usually not a problem. But when it comes to mobility drills, stability exercises, or rehab work, people often go through the motions without challenging themselves enough.

The reality is that tissues need an appropriate amount of stress to adapt.

If your knee, shoulder, hip, or back has been giving you trouble, simply performing an exercise is not always enough. The muscles, tendons, and joints involved need sufficient loading to improve their capacity and tolerate the demands of your sport or activity.

This is one reason why many people feel like they’ve been doing the “right” exercises for months without seeing significant improvement.

Why Effort Matters During Corrective Exercise

One of the goals of physical therapy in Bethesda and McLean is helping patients build resilience, not just improve mobility.

For example, if you have a history of knee pain, stretching and mobility work may be helpful. But if the tissues surrounding the knee cannot handle the forces required during running, lifting, or sports, the problem often returns.

Corrective exercises should challenge the body enough to create adaptation. If they are too easy, they may not produce the changes you’re looking for.

The Second Mistake: Rushing Through Your Program

Another common issue we see is impatience.

Many athletes have a list of exercises they want to complete before moving on to the “real workout.” As a result, they rush through their corrective exercises with minimal rest and limited attention to detail.

Unfortunately, this often reduces the effectiveness of the program.

When you rush:

  • Exercise technique often suffers
  • Muscles fatigue too quickly
  • You cannot generate as much effort on subsequent sets
  • The targeted tissues may not receive the stimulus they need

Sometimes doing fewer exercises with better execution produces far better results than trying to complete a long list as quickly as possible.

Quality Over Quantity

Whether you’re managing shoulder pain, knee pain, back pain, or simply trying to stay healthy, the quality of your corrective exercises matters.

A shorter program performed with focus, proper technique, and appropriate intensity will often outperform a longer program that is rushed and completed with minimal effort.

This is something we emphasize frequently in physical therapy because consistency and execution often determine whether a maintenance program succeeds or fails.

How Physical Therapy Bethesda and McLean Can Help

If you’ve been performing mobility drills, corrective exercises, or a home program without seeing the results you expected, it may be time to take a closer look at how the program is being performed.

At Cohen Health & Performance, our team helps athletes and active adults identify the exercises that will have the biggest impact, determine the appropriate level of intensity, and ensure every exercise serves a specific purpose.

Whether you’re looking to stay healthy, recover from an injury, or improve your performance, the right plan can make all the difference.

If you’re looking for physical therapy in Bethesda or physical therapy in McLean, our team would love to help you build a program that actually works.

What Norway’s Olympic Dominance Can Teach Us About Long Term Athletic Development

I recently returned from Milan after spending a week at the Winter Olympics. Watching the best athletes in the world compete is always inspiring, but one thing stood out in a major way.

Norway, a country with a population of just five million people, is dominating the medal count. They are significantly outperforming much larger countries, including the United States.

Naturally, the question becomes: how?

One of the biggest differences may lie in how Norway approaches youth sports and long term athletic development. And for families here in Bethesda and McLean who care about performance, health, and injury prevention, there are some important lessons worth considering.

A Different Approach to Youth Sports

In Norway, the structure of youth athletics looks very different from what many of us are used to in the United States.

They do not officially keep score until around age thirteen. All children are encouraged to participate, and recognition is universal at younger ages. Athletes are not sorted into elite or travel pathways until their teenage years. Children also have input into how much they train and whether they want to compete.

As a result, approximately ninety three percent of Norwegian children participate in organized sports. That is an extraordinarily high number.

The early focus is not rankings, scholarships, or national exposure. It is enjoyment, skill development, and confidence.

Why This Matters for Sports Physical Therapy

From a sports physical therapy perspective, this approach aligns closely with what research and clinical experience show about long term athlete development.

When young athletes are not pushed into high intensity competition too early, several positive outcomes tend to occur.

They develop broader athletic foundations by playing multiple sports.

They reduce the risk of overuse injuries that are common with early specialization.

They experience less burnout and are more likely to stay active through high school and beyond.

At our sports physical therapy clinics in Bethesda and McLean, we frequently see young athletes dealing with stress fractures, tendon issues, and chronic joint pain that stem from year round specialization in a single sport. Many of these injuries are preventable with a more balanced developmental approach.

Long term performance depends on movement variability, progressive loading, and internal motivation. When athletes enjoy the process, they are more consistent. When they are consistent, they improve.

Early Specialization and Injury Risk

In the United States, it is common to see travel teams at very young ages, national rankings in middle school, and pressure to gain exposure early. While ambition is not inherently problematic, the timeline often becomes compressed.

Early specialization can increase cumulative tissue stress before the athlete has developed adequate strength, coordination, and movement control. From a sports physical therapy standpoint, this increases injury risk.

We often remind families that the body adapts to progressive stress. It does not adapt well to repetitive overload without variation. Multi sport participation during childhood builds a more resilient athlete.

Internal Motivation Drives Longevity

Another important factor is motivation. When participation is driven primarily by external pressure, burnout rates increase. When athletes are internally motivated, they are more likely to remain engaged long term.

Norway’s emphasis on fun and autonomy appears to support that internal drive. The Olympic results may be a byproduct of sustained participation rather than early intensity.

For adult athletes reading this, the lesson is similar. Sustainable training and intelligent load management matter more than short bursts of overreaching. Longevity in sport is a performance advantage.

What This Means for Parents and Athletes

If you are the parent of a youth athlete, especially before high school, consider the following principles.

Encourage multi sport participation to build broad movement skills.

Allow your child input into training volume and competition level when appropriate.

Prioritize skill development and confidence over rankings and short term wins.

Support transitions if they want to explore different sports or adjust their level of participation.

For adult athletes, the takeaway is to build intelligently. Progress gradually. Address movement limitations early. Treat minor issues before they become chronic injuries.

How Sports Physical Therapy Supports Long Term Development

High quality sports physical therapy is not just about treating injuries. It is about optimizing movement, managing load, and creating resilient athletes.

At Cohen Health and Performance in Bethesda and McLean, we focus on one on one care that integrates rehabilitation with strength and performance training. Our goal is not simply to get athletes out of pain. It is to help them move better, perform better, and stay in the game longer.

Whether you are a youth athlete navigating growth and competition or an adult athlete pursuing performance goals, the principles remain the same. Sustainable development outperforms rushed progression.

Norway’s Olympic success may offer a simple reminder.

Long term health and enjoyment of sport are not obstacles to performance. They are often the foundation of it.

If you or your athlete are dealing with pain, recurrent injuries, or questions about safe progression in training, schedule an evaluation with our sports physical therapy team in Bethesda or McLean.

Investing in longevity is one of the smartest performance decisions you can make.

10-Minute Sports Physical Therapy Warmup To Stay In The Game

Athletes and parents of young athletes all want the same outcome: staying healthy, confident, and on the field for the entire season. At Cohen Health and Performance, our sports physical therapy team works with athletes every day who are trying to balance school, practices, games, and multiple teams, all while avoiding injury.

One of our physical therapists at our McLean location, Dr. Samuel Kinney, recently shared a simple and practical strategy based on his experience as both a former college soccer player and a sports physical therapist. While his examples come from soccer, these principles apply to all field- and court-based sports, including basketball, lacrosse, field hockey, football, and more.

Why Many Athletes Skip Strength Training

Most athletes already perform a decent warm-up. This usually includes jogging, sport-specific drills, and dynamic stretching. While this prepares the body to move, it often does not address strength deficits that contribute to common injuries.

The challenge is time. Between school, work, practices, games, and travel, many athletes do not have the capacity to strength train multiple days per week. As a result, strength training is often skipped entirely, increasing injury risk over the course of a season.

A More Effective Warm-Up Strategy

A practical solution used frequently in sports physical therapy is to build small amounts of strength training directly into the warm-up. Adding just 10 minutes before practice or games does not replace full strength training, but it significantly improves consistency and injury risk reduction.

This approach is especially effective for reducing overuse injuries and serious knee injuries that commonly bring athletes into sports physical therapy clinics.

Common Injuries We See in Sports Physical Therapy

Across soccer and other field- and court-based sports, three injuries consistently appear:

  • Groin strains
  • Hamstring strains
  • ACL tears

Below are three simple exercises commonly used in sports physical therapy and ACL physical therapy programs that can be added directly into a team warm-up.

Groin Injury Risk Reduction

Groin muscles play a major role in lateral movement, cutting, and stabilizing the plant leg during kicking and change of direction. Groin strains are common when strength and control are lacking.

Exercise: Copenhagen Plank
This exercise strengthens the groin muscles and their attachment points.

It can be performed using a bench or bleacher with padding under the knee, or with a teammate supporting the top leg.

Recommended dosage is 2 sets of 15 to 30 seconds. Athletes should start with the short-lever version. Once they can confidently complete 2 sets of 30 seconds, they can progress to the long-lever version and reduce time back to 15 seconds.

ACL Injury Risk Reduction and ACL Physical Therapy Principles

The ACL plays a critical role in knee stability during cutting, pivoting, and landing. ACL tears are among the most serious injuries we treat in sports physical therapy, often requiring surgery and 9 to 12 months of rehabilitation.

One of the primary goals of ACL physical therapy is improving strength and control around the knee, particularly through the quadriceps and hip musculature.

 

Exercise: Split Squat Isometric Hold
Athletes hold the bottom position of a split squat, focusing on knee alignment and control.

Perform 2 sets of 20 to 30 seconds per side.

This type of isometric exercise is commonly used in both ACL injury prevention programs and post-operative ACL physical therapy to improve knee stability.

Hamstring Injury Risk Reduction

Hamstring strains frequently occur during sprinting and rapid acceleration. Strong hamstrings also contribute to knee stability and play a role in reducing ACL injury risk.


Exercise: Elevated Hamstring Bridge
Athletes begin with both feet on a bench or bleacher.

Perform 2 sets of 20 to 30 seconds, then progress to a single-leg variation when ready.

This exercise is commonly prescribed in sports physical therapy to improve posterior chain strength and protect both the hamstrings and knees.

Why This Matters for Athletes and Parents

A consistent warm-up that includes even a small amount of strength work can meaningfully reduce injury risk. These exercises do not require additional training days, specialized equipment, or long workouts. They help athletes stay healthier, miss fewer games, and build a stronger long-term relationship with their sport.

How Sports Physical Therapy Can Help

If you or your athlete is dealing with a sports-related injury, recovering from an ACL injury, or wants to be proactive about injury prevention, our sports physical therapy team is here to help.

At Cohen Health and Performance, we specialize in sports physical therapy and ACL physical therapy for athletes of all levels. We create individualized, sport-specific plans to help athletes return to play safely and perform at their best.

Schedule an evaluation with a member of our team to receive a clear, personalized plan built around your athlete’s goals.

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