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.

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.

Winter Running Tips from a Performance Physical Therapist

Running through the winter months can be a challenge, especially when cold temperatures, ice, and wind threaten to derail your training. But with the right strategy, runners can stay consistent, healthy, and injury-free all season long.

Today, we’re excited to share insights from Dr. Elizabeth Farmer, a Performance Physical Therapist at our Bethesda location and an avid runner herself. After logging miles in recent frigid DC conditions, Dr. Farmer combined her personal experience with her clinical expertise in physical therapy for runners to share practical tips that help runners safely train outdoors during the winter.

If you hate the treadmill but feel stuck indoors every time the temperature drops, these tips are for you.

1. Dress Smart with Thin, Layered Clothing

When it comes to winter running, layering is key. Instead of bulky clothing that restricts movement, opt for multiple thin layers that trap warmth while allowing sweat to escape.

Dr. Farmer recommends:

Tucking shirts into leggings or tights
Wearing wool socks tucked into leggings
Using merino wool base layers for temperature regulation and moisture control

On a recent easy run in 7°F temperatures (with a 2°F windchill), Dr. Farmer wore two pairs of leggings (one fleece-lined), a merino wool long-sleeve shirt, a lightweight sweatshirt, a windbreaker, gloves, a beanie, and tall wool socks and was warm enough to break a sweat within the first mile.

Proper layering helps runners maintain performance while reducing the risk of muscle tightness and cold-related injury.

2. Keep Your Pace Easy on Icy Surfaces

Winter running requires flexibility. If you’re unsure whether your route is icy or clear, prioritize safety over speed.

Running at an easy pace allows you to:

Adjust to unpredictable footing
Reduce fall risk
Avoid compensations that lead to overuse injuries

For runners in Bethesda, the Maryland portion of the Capital Crescent Trail has been plowed and is often more ice-free than neighborhood roads. Regardless of location, always assess conditions before attempting speed work.

From a physical therapy for runners perspective, slips and sudden muscle guarding are common causes of winter injuries, especially to the calves, hamstrings, and low back.

3. Warm Up Indoors Before Heading Out

Cold weather works against your body’s natural ability to warm up. That’s why an indoor warm-up is even more important in winter.

Dr. Farmer recommends completing your entire warm-up inside so you’re already warm before stepping outdoors. This helps:

Improve mobility
Reduce stiffness
Lower injury risk during the first mile

A proper warm-up is one of the simplest ways runners can protect themselves during winter training and a key component of injury prevention we emphasize in performance physical therapy for runners at our Bethesda and McLean clinics.

4. Use Warm Pre- and Post-Run Nutrition

Fueling properly in winter isn’t just about performance, it’s also about staying warm.

Try these simple swaps:

Replace cold juice with warm apple cider before your run
Swap chocolate milk for hot chocolate post-run to get carbs and protein while warming up

Adequate pre- and post-run nutrition supports recovery, energy levels, and muscle health, especially during high-volume winter training blocks.

5. Consider Winter-Specific Running Shoes

Many running shoe brands offer winter models that include:

Waterproof materials
Increased warmth
Improved traction for icy conditions

Cold temperatures can also affect how shoe foam responds. If your regular running shoes feel stiffer in winter, it doesn’t necessarily mean they’re worn out, they may simply be reacting to the cold.

For runners experiencing foot, ankle, or knee discomfort, footwear choice is a frequent topic we address during physical therapy for runners sessions at our McLean and Bethesda locations.

Physical Therapy for Runners in Bethesda & McLean

Winter is one of the most common times we see runners develop nagging aches, stiffness, or overuse injuries. The combination of cold weather, altered mechanics, and reduced recovery can add up quickly.

If you have questions about winter running, are dealing with pain, or want help optimizing your training, our team specializes in physical therapy for runners. We work with runners of all levels—from recreational runners to competitive athletes, helping them stay healthy, strong, and consistent year-round.

📍 Locations: Bethesda, MD & McLean, VA
📞 Reach out to schedule an evaluation or ask a question. We’re happy to help support your running goals.

Snow Shoveling and Back Pain: What You Need to Know to Stay Safe This Winter

The recent snowstorm in the DC area was different than what we usually see. Not only did we get a much larger volume of snow, but the sleet that followed packed everything down, making the snow significantly heavier than expected. For many people, that meant long hours of shoveling driveways and sidewalks under cold, challenging conditions.

Unfortunately, events like this often lead to a spike in injuries and back pain is one of the most common reasons people seek physical therapy after heavy snowfall.

Why Snow Shoveling Is a Common Cause of Back Pain

Snow shoveling places a unique and often underestimated load on the body. Snow can weigh two to three times more than most people expect, especially when it’s wet or compacted by sleet. Combine that with cold temperatures and repetitive movements, and the risk of injury rises quickly.

Cold weather causes muscles, tendons, and joints to feel stiffer and less responsive. Unlike a typical workout, most people don’t warm up before shoveling. That means the body is suddenly asked to lift, bend, and twist repeatedly while tissues are at their least prepared state.

From a biomechanics standpoint, shoveling is especially demanding on the spine. The weight of the snow is held far out in front of the body, increasing stress on the lower back. Unlike lifting a weight close to your body, something we coach regularly in back pain physical therapy. Shoveling often involves reaching forward, rounding, and then twisting to throw the snow. Repeating this pattern over and over can overload the spine and surrounding muscles.

Cardiac Risks During Heavy Snowfall

While back pain is the most common complaint we see after snowstorms, it’s also important to acknowledge the cardiovascular risks. Many cardiac events occur during snow shoveling due to the combination of cold temperatures and sudden, intense physical exertion.

If you are over the age of 45 or have risk factors such as high blood pressure, high cholesterol, or diabetes, it’s especially important to pace yourself, take breaks, and avoid overexertion during heavy snowfall.

How to Reduce Back Pain Risk When Shoveling Snow

The best way to approach snow shoveling is to think of it like a workout rather than a household chore.

Before heading outside, take a few minutes to warm up with light, dynamic movements. The goal is to get your body warm enough that you’re almost sweating before you start lifting heavy snow. This can significantly reduce strain on the lower back and shoulders.

Staying hydrated is also important. Cold, dry air increases fluid loss, even if you don’t feel thirsty. Proper hydration supports muscle function and recovery and can help reduce stiffness.

During shoveling, try to minimize excessive twisting and avoid lifting more snow than necessary at once. Smaller loads and frequent breaks go a long way in protecting your back.

What to Do If You’re Feeling Back Pain After Shoveling

It’s very common to feel sore or stiff after shoveling, especially in the lower back, shoulders, and neck. Gentle movement, relaxed breathing, and light mobility exercises can help calm irritated tissues and reduce next-day soreness.

However, if your back pain lingers, worsens, or limits your ability to move normally, it may be time to seek back pain physical therapy. Many snow-shoveling injuries are very treatable with the right approach, and addressing them early can prevent the issue from becoming chronic.

How Back Pain Physical Therapy Can Help

Back pain physical therapy focuses on more than just pain relief. The goal is to identify why your back was overloaded in the first place, whether that’s poor movement mechanics, limited mobility, or insufficient strength and address those factors directly.

Through targeted mobility work, strength training, and education, physical therapy can help you recover faster, move more confidently, and reduce your risk of future injuries, whether from snow shoveling or everyday activities.