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.

Why Distance Runners Sprint in Physical Therapy

If you’re a distance runner training for a 5K, 10K, half marathon, or even a full marathon, the idea of sprinting might seem a bit strange. After all, why would you focus on short bursts of speed when your goal is to cover long distances? Surprisingly, incorporating sprints into your training can significantly boost both performance and injury prevention. As physical therapists often emphasize, sprinting can make a big difference in improving biomechanics and reducing injury risk. Let’s dive into why distance runners should sprint and how it can benefit your training.

Raise Your Speed Ceiling

Think of sprinting as raising the ceiling of what your body is capable of. Imagine you’re driving a car. If the car has a top speed of 100 mph, cruising at 60 mph feels easy. But if your car’s top speed is only 70 mph—like the 1991 Mercury Topaz I drove in high school—going 60 mph might feel like it’s about to fall apart.

The same principle applies to running. If you increase your top-end speed through sprinting, running at slower paces for longer distances will feel much easier and more efficient. In other words, sprinting improves your speed reserve, enabling you to sustain faster paces during races without exhausting yourself. In physical therapy we often recommend sprinting as a way to condition the muscles and nervous system to handle faster speeds efficiently.

Injury Prevention Benefits

Sprinting isn’t just about getting faster—it also plays a critical role in injury prevention. When you sprint, you naturally strike the ground underneath your body rather than reaching out in front of you. This reduces the braking forces that occur when your foot lands too far forward.

Remember Newton’s Third Law from high school science? Every action has an equal and opposite reaction. When your foot lands ahead of your body, the ground pushes back against you, creating extra stress on your feet, ankles, knees, hips, and lower back. Over time, this repetitive impact can lead to discomfort, inefficiency, and even injuries. Many physical therapy programs focus on drills and techniques similar to sprinting mechanics to retrain the body and reduce injury risk.

Sprinting teaches you to land underneath your center of mass, reducing impact forces and improving running mechanics. It also builds elasticity in your joints, making you more springy and bouncy. This elasticity helps you spend less time on the ground with each foot strike, which adds up to faster, more efficient running over long distances. Physical therapy principles emphasize the importance of joint elasticity to enhance performance and lower injury risk.

Simple Ways to Incorporate Sprinting

The good news is that you don’t need to overhaul your training plan to start reaping the benefits of sprinting. You can incorporate a few sprint drills into your warmups or cross-training sessions without adding excessive stress to your body. These drills are also often included in physical therapy sessions focused on improving running mechanics.

Some great drills to get started include:

A-March – Focus on proper posture and knee drive.

A-Skip – Adds rhythm and coordination to the marching movement.

Step-Over Drill – Enhances knee lift and foot placement.

Performing a couple of sets of these drills as part of your routine can make a big difference. These exercises help reinforce proper running mechanics and prepare your body for both speed and endurance. If you’ve ever attended a physical therapy session, you may recognize some of these movements as foundational drills to improve mobility and stability.

Take the First Step

Not sure where to start? Check out our YouTube page for detailed demonstrations of these drills. For those of you who have been training with us for a while, you might even recognize a familiar face in the videos!

Sprinting might not seem like the obvious choice for a distance runner, but it’s one of the most effective ways to elevate your performance and protect yourself from injury. Start small, stay consistent, and watch how your running transforms. If you’re struggling with any specific discomfort or mobility issues, consider reaching out to our physical therapy team to guide you through personalized strategies.

Break Free from Desk Stiffness: Physical Therapy Tips for Active People

Do You Feel Stiff After Sitting All Day?
If you’re like many of our physical therapy patients, you spend hours sitting at a desk for work or school. Whether you’re locked into meetings, answering emails, or studying for exams, long periods of sitting can leave your body stiff, sore, and uncomfortable. Sound familiar? You’re not alone!

Hopefully, you had a chance to break the cycle over the holidays, but now that you’re back in your routine, you might be feeling that tightness again. Don’t worry—there’s good news. Today, we’re going to share strategies we use with our physical therapy clients to help reset the body and get you moving comfortably again.

Why Sitting Can Make You Stiff
Think about what happens when you sit for hours on end. Your posture often slumps forward, and the muscles in the front of your chest stay in a shortened position. Over time, this can make them feel stiff and restrict their movement. And when those muscles don’t move as they should, they’re not prepared for activity later—like hitting the gym after work.

Picture it like taking a car that’s been idling all day and suddenly flooring the gas pedal. That’s a recipe for poor performance—or even injury. But don’t worry—there are simple ways to reset your body before you train, and we’re here to help!

The Role of Breathing in Mobility
Breathing may seem simple, but it plays a huge role in how your body feels and moves. Your rib cage is designed to expand and compress like an accordion with every breath. When you sit slouched for hours, your rib cage can’t expand fully. That leaves the muscles around it—especially in your chest, back, and neck—stiff and unable to move properly.

Good breathing mechanics not only improve mobility but also help your muscles reset, making you better prepared for activity. Let’s go over two quick breathing drills we often use with our clients to unlock stiffness and get their bodies ready for action.

Drill 1: Hook-Lying Overhead Reach

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Lie on your back with your knees bent and feet flat on the floor.
Roll your pelvis slightly underneath you so your lower back gently flattens against the ground.
Reach your arms overhead without letting your ribs flare up.
Focus on deep inhales that expand your chest and exhales that compress it back down.

This drill teaches your rib cage to expand and compress properly, reducing tightness in your chest and shoulders. Do 2-3 sets of 5 deep breaths before upper-body workouts.

Drill 2: Crab on Elbows

Sit on the floor with your knees bent and your hands behind you, resting on your elbows.
Press your chest up slightly, creating a gentle stretch in your pecs.
Inhale deeply, directing the breath into the front of your chest, and then exhale fully.
Focus on slow, controlled breathing, feeling your chest expand and compress with each breath.

This position exaggerates the stretch in your chest muscles, helping to reset them for movement. Aim for 2 sets of 5 breaths before workouts or whenever you feel stiff during the day.

Ready to Feel Better? We Can Help.
These drills are great for giving your body a quick reset, but if you’re dealing with ongoing aches, pains, or stiffness, a more customized approach might be what you need. At our clinic, we specialize in helping active people get back to doing what they love—pain-free.

Visit our website to learn more about how we can help you tackle your specific challenges. Whether you’re recovering from an injury or just want to move and feel better, we’re here to help you reach your goals.

Don’t let stiffness hold you back—take the first step toward feeling your best today and contact us!

Our most popular physical therapy article of 2024

Here’s a little gift—our most popular article of 2024, just for you!

“My Doctor Said I’m Cleared to Play!”

My patient was thrilled. After months of physical therapy, recovering from knee surgery, she finally received the green light to return to playing soccer.

Unfortunately, I had to bring her back to reality.

The surgeon had done an excellent job—the surgery went smoothly, the knee healed perfectly, and there was no swelling or pain. But while his job was complete, mine was far from over.

Despite making significant progress in physical therapy, the muscles around her repaired knee were still about 30% weaker than those on the other side. Our force plate technology (learn more about that here) revealed that her ability to absorb shock on the repaired side was compromised, and her reaction time was slower.

As much as I wanted to give her the news she was hoping for, allowing her to return to play immediately would have put her at high risk of re-injury.

This scenario is common and understandable. It’s easy to think that physical therapy is over when the doctor says, “you’re cleared.” But in reality, it’s just the beginning.

“Cleared” means the doctor’s role is complete, and now it’s up to us to ensure that you return to play, training, or your active lifestyle as safely as possible.

So, how do we determine when you’re ready to get back in the game? Here are a few key factors we continuously assess throughout the rehab process:

Range of Motion: Should be equal to the other side.
Strength Testing: The previously injured side should be within 10% of the uninjured side, but ideally, it should be equal. We utilize our technology to make it objective and take away any guesswork.
Functional Testing: Specific to your sport or activity.
- Hop or Jump Testing: Measures your ability to absorb impact and produce force on one side compared to the other. Should be within 10% of the uninjured side, but ideally equivalent. This also gauges how reactive or “bouncy” one side is compared to the other—the closer to equal, the better!
- Running Analysis: Learn more about that here!
- Throwing Assessment: For baseball players and other throwing athletes

The last thing anyone wants is a re-injury or a new injury because the body wasn’t 100% ready to return. A thorough return-to-play assessment is essential for anyone looking to resume their sport, activity, or active lifestyle as safely, quickly, and effectively as possible.

Contact us with any questions that you have about how you can ensure that you or your athlete is ready to get back in the game!

Why “corrective exercises” in physical therapy fall short

Back when I was in physical therapy school, I also worked as a strength and conditioning coach with athletes at Northeastern University. Part of our job was to include “corrective” exercises in every training session to address mobility limitations or movement issues. These were low-intensity stretches commonly seen in physical therapy, mobility drills, and other movements that athletes did as part of their warmup.

The idea was solid: reduce the risk of injury by fixing underlying issues. But with 15 years of experience now, I’ve realized that this approach wasn’t as effective as we thought.

The issue with these types of exercises is that they are often performed at an intensity that is too low to produce significant results. Whether you’re a competitive athlete or a recreational gym-goer, your body is used to exerting significant effort when you play, train, or compete. To be effective, corrective exercises need to match that intensity. Your body adapts to effort, not passive movements.

At Cohen Health and Performance, we approach corrective exercises differently. We design customized corrective exercises tailored to each individual. For our physical therapy patients, these are incorporated into their daily routines as “daily essentials” or performed independently before exercise. For our training clients, these correctives are strategically woven into warmups or the training session itself.

But here’s the thing: the best corrective exercise is simply exercise done correctly.

When you perform any exercise with proper technique and enough intensity to challenge your body, it becomes “corrective.” Progress happens when the body is forced to adapt, whether that’s by increasing resistance, moving faster, working through a broader range of motion, or training in a fatigued state.

A strong body is a resilient body—especially when it’s strong through a wide range of motion and capable of handling stress in various conditions. That’s why mastering foundational lifts and progressing them step by step is far more effective than running through a long list of low-effort exercises.

Take the barbell deadlift, for example. It’s a fantastic exercise that can double as a “corrective” for athletes with hip mobility issues or back pain. It challenges core, glute, and hamstring strength while teaching the body how to create intra-abdominal pressure to protect the lower back. It might take time to safely progress to heavier weights, but the payoff is immense: a back that’s strong, resilient, and ready to handle stress.

Watch our Deadlift Tutorial below for tips on how to perform this powerful lift safely and effectively.

We also emphasize high-level movement quality in the end stages of rehab. For athletes, this means testing their ability to maintain excellent form and strength, even under fatigue. This is a critical step to ensure they’re fully prepared to return to their sport or activity.

Check out the video below to see how we approach end-stage rehab for athletes.

If you’re ready to move better, feel stronger, and get back to doing what you love, let’s make it happen. Schedule an evaluation with one of our expert Doctors of Physical Therapy today. Click here to get started.

Surgery or physical therapy?

“Do I Need Surgery? “

If you’ve faced a significant injury and are anything like our sports physical therapy patients, this question probably crossed your mind.

It’s natural to think of ourselves like machines: when something breaks, we believe it needs fixing. But here’s the reality—you’re not a machine, and surgeons aren’t mechanics simply “repairing” broken parts.

In fact, surgeons are more like cleanup crews addressing the aftermath of accumulated wear and tear. And the truth is, many injuries don’t require surgical intervention to heal effectively.

A comprehensive review published in the prestigious Journal of Orthopaedic & Sports Physical Therapy (JOSPT) found no consistent evidence that surgery outperforms non-surgical care in nine different areas of the body. That’s huge!

Now, let’s be clear: surgery has its place. If you’ve suffered a major trauma—like a displaced fracture or a complete rupture of the ACL or Achilles tendon—surgery might be the only path to regaining functional mobility. In these cases, surgical intervention is necessary to restore structural integrity for sports or daily life.

But what about injuries that don’t fit this profile? Chronic pain, nagging injuries, or wear-and-tear issues often drive people toward surgery, believing it will “fix” the problem. Here’s where things get tricky: research consistently shows that surgery doesn’t always deliver long-term benefits, especially when it’s used to address conditions better managed with active, non-invasive approaches like physical therapy.

Surgery doesn’t address the root cause of injuries. If strength deficits, or movement limitations/compensations led to the damage in the first place, those same issues will persist post-surgery unless properly addressed. It’s like mopping up a spill without fixing the leak—temporary relief, but the problem will return.

Active interventions, such as physical therapy, strength training, and movement re-education, can often help you avoid surgery altogether. These approaches focus on restoring balance, improving function, and addressing the underlying factors contributing to pain or injury.

Here’s what you can do to take charge of your health and minimize the need for surgery:

Get Moving: Movement is medicine! A good physical therapist can create a scientifically designed plan tailored to your needs, helping you regain capabilities necessary for the activities that you love.
Address Lifestyle Factors: Stress, poor sleep, and inactivity can all affect your body’s ability to heal. Prioritizing holistic wellness is key.
Be Patient: Healing without surgery takes time, but the results are often more sustainable and come with fewer risks.

Even when surgery is the best option, it’s crucial to address the underlying issues during recovery. Comprehensive rehabilitation ensures you won’t be revisiting the operating room down the road. Think of it as “fixing the leak” while cleaning up the spill.

So, before you consider going under the knife, ask yourself: Have I explored every active option to restore my health?

If you’re dealing with an injury and unsure whether surgery or physical therapy is the right path for your recovery, we’re here to help you figure that out. Schedule an evaluation with one of our expert Doctors of Physical Therapy today and take the first step toward getting back to what you love. Click here to get started.

Traditional physical therapy advice resulting in a fragile spine

Have you been told to always keep your back straight and stiff when lifting? When it comes to preventing back pain, the truth is, it’s not as simple as that.

For years, the advice to lift with a “perfectly straight back” has been the go-to solution, but there’s no solid evidence that it reduces back pain or injury. Surprised? Let’s explore why this outdated advice might be holding you back and how back pain physical therapy can help you build a stronger, more resilient back.

Debunking the “Straight Spine” Rule

The idea of lifting with a straight, neutral spine has been considered the gold standard for decades. It seems logical: keep your back rigid to keep it safe. But studies reveal that this advice hasn’t reduced back injuries in the workplace. Why? Because back pain isn’t caused by a single factor like lifting posture.

Back Pain: A Multifactorial Issue

Back pain is influenced by many factors—age, fitness level, recovery habits, stress, and even sleep quality. If you’ve experienced back pain after lifting, chances are the issue wasn’t simply bending your spine. The root cause is often a combination of problems, like poor endurance, lack of strength, or inadequate recovery.

Physical therapy for back pain can help you address these factors by improving your overall strength and movement capacity, rather than just focusing on how you lift.

Why Avoiding Spinal Flexion Can Be Harmful

The advice to “never bend your back” can actually weaken your spine over time. Avoiding natural movements like bending or twisting may leave your back less prepared for real-world demands.

Think about it: everyday life involves movements like lifting a laundry basket, picking up a child, or twisting to grab something off a shelf. Avoiding these actions doesn’t protect you—it makes your back less adaptable and more vulnerable to injury.

Through physical therapy, you can safely reintroduce these movements and build the confidence and strength needed to handle life’s physical demands.

How to Build a Strong, Pain-Free Back

Preventing back pain isn’t about avoiding movement—it’s about building strength and resilience. Here’s how physical therapy can help:

Train for Everyday Life: Your physical therapist will guide you through exercises that mirror real-world movements, like squats, deadlifts, and rotational lifts.
Gradual Progression: With a personalized plan, you’ll start with lighter loads and progress over time, preparing your spine for various challenges.
Movement Variety: Learn how to lift using different techniques—straight back for heavier loads, rounded back for lighter ones—to build adaptability and confidence.
Listen to Your Body: If a movement feels painful, your therapist will help you modify it and reintroduce it as you get stronger.

The Role of Physical Therapy in Back Pain Recovery

If you’re recovering from a back injury, physical therapy for back pain can help you uncover the root cause of your discomfort and create a tailored plan to address it. This approach not only relieves pain but also prevents future issues by improving strength, mobility, and movement patterns.

Take Control of Your Back Pain Today

Rigid rules like “always lift with a straight back” oversimplify a complex issue. Instead of avoiding movement, embrace it. With the right guidance from physical therapy, you can prepare your back for life’s twists and turns while building strength and resilience.

If you’re ready to overcome back pain and get back to the activities you love—whether it’s the gym or everyday tasks—schedule an evaluation with one of our expert Doctors of Physical Therapy. Click here to get started!

Let’s build a stronger, pain-free back together. Because when it comes to your spine, you’re stronger than you think.