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.

Meet our newest Performance Physical Therapist, Dr. Renee Beck!

I am thrilled to introduce you to the newest member of the Cohen Health and Performance team, Dr. Renee Beck. Dr. Beck is a native of the DMV area and is not someone to mess with! With over ten years of martial arts experience, she has achieved the rank of second-degree black belt in Tae Kwon Do. This discipline and dedication translate seamlessly into her approach to physical therapy.

Dr. Beck’s mantra, “Movement is medicine,” drives her passion for helping others stay active and pursue their passions. This philosophy underpins her dedication to guiding patients through every step of their rehabilitation journey. Whether recovering from an injury or seeking to optimize performance in sports, Dr. Beck is committed to seeing you thrive. Her extensive experience in martial arts not only demonstrates her physical prowess but also her understanding of the importance of movement and agility, both of which are crucial elements in physical therapy.

Physical therapy plays a critical role in maintaining and restoring movement and function when someone is affected by injury, illness, or disability. Dr. Beck’s unique background equips her with the skills and knowledge to provide exceptional care. Martial arts training involves a high level of physical conditioning, discipline, and an understanding of body mechanics—all of which are essential components of effective physical therapy. Dr. Beck leverages her martial arts experience to offer a holistic approach to physical therapy, ensuring that her patients receive comprehensive care tailored to their individual needs.

At Cohen Health and Performance, we understand that every patient is unique, and their physical therapy needs vary. Dr. Beck’s approach to physical therapy is not just about addressing the symptoms but also about identifying and treating the underlying causes of pain and discomfort. Her goal is to help patients regain their strength, improve their mobility, and enhance their overall quality of life. By focusing on movement as a form of medicine, Dr. Beck empowers her patients to take an active role in their recovery process.

Physical therapy is not only about rehabilitation but also about prevention. Dr. Beck is dedicated to educating her patients on how to prevent future injuries and maintain optimal physical health. She works closely with her patients to develop personalized exercise programs that promote strength, flexibility, and endurance. These programs are designed to help patients achieve their health and fitness goals while minimizing the risk of injury.

We are excited for you to meet Dr. Beck and experience her exceptional physical therapy skills firsthand. If you have been dealing with an injury that you have been ignoring, now is the perfect time to address it. Take advantage of this limited-time opportunity for a FREE 30-minute consultation with Dr. Renee Beck at our McLean location. During this consultation, Dr. Beck will assess your condition, discuss your goals, and develop a personalized treatment plan to help you achieve optimal health and performance.

Physical therapy is an invaluable resource for anyone looking to improve their physical well-being. Whether you are an athlete looking to enhance your performance, someone recovering from surgery, or an individual dealing with chronic pain, physical therapy can help you achieve your goals. Dr. Beck’s expertise and dedication make her an invaluable addition to the Cohen Health and Performance team.

CHP Spotlight Interview with Dr. Michael Antonis

Dr. Michael Antonis, a sports medicine specialist at OrthoVirginia, currently serves as the team physician for the Washington Commanders. With a previous tenure as the team physician for D.C. United and Loudoun United spanning five years, his expertise has significantly benefited our physical therapy team.

Recently, I had the pleasure of sitting down with Dr. Antonis for an engaging discussion. He shared a wealth of incredible information that I’m excited to pass on to you. Be sure to watch the full interview below and find a summary of key points right after the video!

Physical therapy plays a crucial role in addressing and preventing injuries among athletes. The injuries of professional athletes differ significantly from those of youth athletes and weekend warriors due to varying levels of physical demands, conditioning, and experience.

Differences in Injuries: Professional Athletes vs. Youth Athletes and Weekend Warriors

Professional athletes often experience injuries due to the intense physical demands of their sports. These injuries can include torn ligaments, muscle strains, and stress fractures, often resulting from overuse or high-impact activities. Due to their rigorous training schedules, professional athletes also face chronic injuries that require ongoing physical therapy for effective management and recovery.

In contrast, youth athletes are more prone to growth plate injuries, sprains, and strains as their bodies are still developing. The lack of proper conditioning and technique can contribute to these injuries. Weekend warriors, who engage in sports activities sporadically, often suffer from acute injuries like ankle sprains, knee injuries, and lower back pain. These injuries are typically a result of sudden, intense physical exertion without adequate warm-up or conditioning.

Reducing Injury Risks for Young Athletes

Parents play a vital role in minimizing injury risks for their young athletes. Ensuring that children participate in a variety of sports can help develop overall athleticism and prevent overuse injuries. Emphasizing proper technique and form through coaching and training is essential. Encouraging adequate rest and recovery time is equally important to avoid burnout and overuse injuries.

Advancements in Sports Technology

Recent advancements in sports technology have significantly contributed to reducing injury risks and facilitating a more effective return to sport. Wearable technology, such as smartwatches and fitness trackers, monitors an athlete’s physical activity, providing valuable data on performance and fatigue levels. This information can help tailor training programs to individual needs, reducing the risk of overtraining and subsequent injuries.

Innovations in sports equipment, such as improved footwear and protective gear, offer enhanced support and safety, reducing the likelihood of injuries. Additionally, advancements in diagnostic tools, like MRI and ultrasound, enable early detection and precise diagnosis of injuries, allowing for targeted and effective physical therapy interventions.

Regenerative medicine, including platelet-rich plasma (PRP) therapy and stem cell treatments, has shown promise in accelerating the healing process and reducing recovery time. These therapies, combined with personalized physical therapy programs, can significantly enhance an athlete’s return to sport.

The mental side of physical therapy

As physical therapists, we recognize the emotional and psychological impact that comes with being sidelined due to injury. An injury can feel like a part of an athlete’s identity has been taken away, and it’s crucial for us to address this throughout their rehabilitation. Physical therapy is not just about healing the body; it’s about nurturing the mind as well.

The Importance of Staying Connected During Rehabilitation

During rehab, we encourage athletes to stay connected with their team in some capacity, whether it’s attending practices or participating in team activities. This helps maintain their sense of belonging and identity. As they progress through physical therapy, it’s easy to focus solely on physical exercises and overlook how they might be feeling mentally. Staying engaged with their team can significantly boost their morale and provide a much-needed sense of normalcy.

The Psychological Challenges of Returning to Sport

As your child approaches their return to sport, they will face multiple challenges, including the pressure to perform at their peak, stress about their performance, and the fear of re-injury. These mental barriers can be as debilitating as the physical injury itself. If these mental barriers aren’t addressed, they can increase the risk of re-injury. Therefore, it’s vital to incorporate psychological support into physical therapy programs.

Bridging the Gap Between Physical and Mental Readiness

Return-to-sport testing provides valuable information about an athlete’s physical readiness but often lacks insight into their mental preparedness. To bridge this gap, we incorporate mind-body techniques early in the rehabilitation process. Visualization and mental rehearsal of successful performance, followed by controlled physical drills, are key components. Gradual exposure to movement patterns, speed, and endurance levels within a controlled environment helps build confidence and reduce fear of re-injury. This holistic approach to physical therapy fosters a sense of independence and confidence in the athlete, making their return to sport more seamless and subconscious.

The Role of Coaches and Parents in Supporting Athletes

As coaches and parents, we can support our athletes by maintaining open communication about their mental health, setting realistic timelines and expectations, and building a strong support system around them. A fearful athlete will second-guess their every move, while a confident one will perform at their best. Your support and understanding during this time are invaluable to your child’s recovery and overall well-being.

Practical Steps for Incorporating Mental Health in Physical Therapy

1. Open Communication: Encourage athletes to express their fears and anxieties. Acknowledging these feelings is the first step toward overcoming them.

2. Setting Realistic Goals: Work with the athlete to set achievable goals. This not only helps in tracking progress but also boosts their confidence as they hit each milestone.

3. Mind-Body Techniques: Incorporate techniques such as mindfulness, meditation, and visualization. These can help athletes mentally prepare for their return to sport and reduce the fear of re-injury.

4. Gradual Exposure: Slowly reintroduce athletes to the sport. This could start with light exercises and progress to more intense drills as their confidence grows.

5. Support System: Create a network of support that includes coaches, family, friends, and mental health professionals. This ensures that the athlete has a robust support system to rely on throughout their recovery.

The Long-Term Benefits of Addressing Mental Health in Physical Therapy

Incorporating mental health into physical therapy not only aids in the immediate recovery process but also has long-term benefits. Athletes who receive comprehensive care that addresses both their physical and mental health are more likely to return to their sport stronger and more resilient. They are better equipped to handle the pressures of competition and less likely to experience re-injury.

Physical therapy is a multifaceted process that goes beyond physical rehabilitation. By addressing the mental and emotional aspects of recovery, we can help athletes return to their sport with greater confidence and reduced fear of re-injury. As physical therapists, coaches, and parents, it is our collective responsibility to support our athletes holistically.

Your support and understanding during this time are invaluable to your child’s recovery and overall well-being. Please feel free to reach out if you have any questions or need further assistance. Together, we can ensure a successful and well-rounded recovery for your athlete.

Runners, don’t make this mistake

It is no secret that runners must complete a strength training program as part of their physical therapy and cross training routine, in addition to their running. Whether through social media, talking with your running friends or coach, or simply your own intuition, every runner has heard that they should be strength training. But is it as simple as picking up a 10-pound dumbbell and knocking out a few squats and deadlifts? Of course not.

There are so many benefits that strength training can offer a runner. Here’s just a few:

Decreased risk of injury
Improved running efficiency
Stronger tendons

Most runners we work with are endurance junkies, they love the feeling of pushing their bodies hard for long periods of time and the feeling of their heart pumping. A big mistake runners often make with their strength training is trying to make it feel like an endurance event, either by doing sets of 20-30 reps or doing circuit-style training with minimal rest.

One key variable is needed to effectively achieve the previously mentioned benefits of strength training: load. Strength training needs to be heavy, challenging the targeted muscles and tendons far beyond what they encounter regularly; otherwise, those tissues have no reason to adapt and get stronger.

Strength training for runners should focus on moderate to heavy weights that allow 6-10 repetitions per set. This range optimizes muscular strength by optimizing the intensity required for muscle adaptation. Additionally, adequate rest between sets (typically 1-2 minutes) allows muscles to recover and perform optimally during subsequent sets.

Remember, the goal of strength training for runners is not to mimic the cardiovascular demands of running but rather to complement it by building foundational strength and resilience in key muscle groups. By prioritizing proper form, progressively increasing the intensity, and allowing for adequate recovery, runners can maximize the benefits of their strength training regimen and enjoy improved performance and longevity in their running careers. Below is an example of a quick lower-body strength training session I recently created for a runner.

A) Heels elevated kettlebell cleans: 2×5

B) Safety Bar Squats (heavy): 3 sets of 6

C1) Kickstand RDL with a dumbbell: 3×8/side

C2) Weighted lateral step downs: 3×8/side

**C1 and C2 are a superset (perform 1 set of the first exercise, then the first exercise of the next exercise before resting and performing round 2)

D1) Prone Hamstring Curls: 3×12

D2) Double leg resisted calf raises (3 seconds on the way down): 3×12

So, next time you hit the gym or dedicate time to strength training at home, focus on lifting heavier weights with proper form and ample rest. Your body will thank you with increased durability and efficiency on the road or trail.

Speaking of durability, we are excited to announce our Running Technique and Performance Lab this Saturday at 10am at our McLean location. We’ve made some thrilling updates! This workshop is a must-attend for any runner aiming to prevent injuries and achieve new personal records this running season. Don’t miss out!

Learn more and sign up by clicking here!

I had to be the bad guy

“My Doctor Said I’m Cleared to Play!”

My patient was thrilled. After months of recovering from knee surgery, she finally received the green light to return to playing soccer. This moment was the culmination of many weeks of hard work, dedication, and patience. The journey to recovery had been long, and now, she was eager to step back onto the field.

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. This is where physical therapy plays a crucial role in the rehabilitation process. Despite making significant progress in rehab, 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 is a common misconception; many think that being “cleared” by the doctor means they are ready to return to their pre-injury activities without further physical therapy. However, this is far from the truth.

This scenario is common and understandable. It’s easy to think that rehab is over when the doctor says, “you’re cleared.” But in reality, it’s just the beginning. Physical therapy is an essential step that ensures the body is fully prepared to handle the demands of sports or physical activities.

“Cleared” means the doctor’s role is complete, and now it’s up to us, the physical therapists, to ensure that you return to play, training, or your active lifestyle as safely as possible. Physical therapy bridges the gap between surgery and full recovery, focusing on strength, flexibility, and functional movement.

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

Range of motion is a critical aspect of recovery. After surgery, it’s common for the injured area to lose some of its normal movement capabilities. Physical therapy aims to restore this range of motion to be equal to the other side of the body. This balance is essential for preventing compensatory movements that could lead to further injury.

Strength Testing

Strength testing is another fundamental component of physical therapy. The previously injured side should be within 10% of the uninjured side, but ideally, it should be equal. This ensures that the repaired area can handle the same amount of stress and load as the uninjured side, reducing the risk of re-injury.

Functional Testing

Functional testing is specific to your sport or activity and is a cornerstone of physical therapy. It includes various tests designed to evaluate how well the injured area performs in real-world scenarios. Here are a few examples:

Hop or Jump Testing: Measures your ability to absorb impact on one side compared to the other. This 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: Running analysis is a crucial part of physical therapy for athletes. It involves assessing your running form, stride, and overall biomechanics to ensure that you can run efficiently and without pain. Learn more about that here!
Throwing Assessment: For baseball players and other throwing athletes, a throwing assessment is essential. This evaluation helps ensure that your shoulder and arm can handle the repetitive stress of throwing without causing further injury.

Physical therapy doesn’t just focus on the injured area; it considers the whole body. This holistic approach helps identify any weaknesses or imbalances that could lead to future injuries. By addressing these issues, physical therapists can create a comprehensive rehab plan tailored to your specific needs and goals.

Importance of a Thorough Return-to-Play Assessment

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. Physical therapy is integral to this process, providing the necessary guidance and support to help you achieve your goals.

Physical therapy involves various techniques and exercises designed to restore function, improve mobility, and prevent further injury. But it is not a one-size-fits-all approach. Each rehab program is customized to the individual’s specific needs, goals, and progress. This personalized care ensures that you are fully prepared to return to your desired activities with confidence.

Physical therapy is a vital component of the recovery process, ensuring that you return to your sport or active lifestyle safely and effectively. The journey from surgery to full recovery involves more than just being “cleared” by the doctor; it requires the expertise and support of physical therapists to guide you through the final stages of rehab. By focusing on strength, flexibility, and functional movement, physical therapy helps you achieve your goals and reduces the risk of re-injury. So, when your doctor says you’re cleared to play, remember that physical therapy is your partner in achieving a complete and lasting recovery.

Secrets to avoiding athlete burnout

I recently had a conversation with the parent of a young athlete I was treating for an injury through physical therapy. This athlete’s schedule was as demanding as a college athlete’s, despite not even being able to drive yet.

He was dedicated to one sport but was playing on multiple teams and training with a personal coach. Eventually, his body couldn’t keep up, and he had to take a break due to an injury.

As I spoke with his parent, the young athlete was eager to jump back into his sport and make up for lost time. Unfortunately, this is a common scenario. Once an athlete feels better, they often return to the same routines that led to their injury in the first place.

The Role of Physical Therapy in Preventing Overuse Injuries

Focusing on a single sport can cause the body to move in repetitive ways, increasing the risk of overuse injuries. While specialization can make athletes more efficient in their chosen sport, it can also limit their mobility and overall athletic development. Physical therapy can play a crucial role in mitigating these risks by addressing imbalances and promoting overall wellness.

However, this doesn’t mean that specializing in a sport is inherently bad. Every athlete eventually reaches a point where they need to focus on “their sport.” Whether they’re on a recreational team or competing at a state level, life gets busy juggling multiple sports and activities.

When to Specialize and How Physical Therapy Can Help

The critical question is: when is the right time to specialize, and what are the dangers of doing so too early or too late? Is it possible to excel in a sport while preventing injuries and avoiding burnout?

Guidelines for Healthy Athletic Development and Physical Therapy

Here are some essential guidelines to help maintain a healthy balance:

1. Avoid Over-Specialization: Encourage participation in multiple sports throughout the year. Repetitive stress from a single activity can increase injury risk. Staying active across various sports can help maintain overall fitness and prevent burnout. Physical therapy can help address and correct any emerging issues.

2. The “Hours per Age” Rule: Ensure your child does not train more hours per week in one sport than their age in years. For instance, a 14-year-old swimmer should swim less than 14 hours per week.

3. Practice and Competition Limits: Limit practice sessions to 1.5 hours per day and competitions to 3 hours per week.

4. Rest Days: Ensure 1-2 rest days per week from sport practice or competition.

5. Seasonal Breaks: Young athletes should have up to 3 months off from organized sports per year, ideally in 1-month increments.

6. Focus on Form: Emphasize proper form and technique over intensity to reduce injury risk. Physical therapists can provide valuable guidance on form and technique.

Communication and Fun: Essential Elements

Managing activity levels and recognizing when an injury needs attention is challenging. Regular communication with a physical therapist when something feels off can help ensure a successful season and address potential issues early.

Above all, remember that sports should be fun! Keeping enjoyment at the forefront will help maintain a healthy, balanced approach to athletics.

By integrating physical therapy into their routine, young athletes can not only enhance their performance but also prevent injuries and ensure long-term success.