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.

Cold plunges in physical therapy; worth it?

A few months ago, while on vacation, I was surprised and excited to find that our hotel had a cold plunge. Every morning, I would brave the cold temperatures for 10 minutes, feeling refreshed and ready for the day as soon as I got out. The invigorating chill seemed to shake off any lingering drowsiness, leaving me energized and mentally clear.

The Search for a Home Cold Plunge

When I got home, I found myself researching how I could have a cold plunge at home. I was determined to recreate that sense of vitality and well-being I experienced during my vacation. My initial search led me to various options, from high-end cold plunge tubs to DIY solutions involving stock tanks and ice. However, amidst this enthusiasm, I felt it was essential to investigate whether cold plunging genuinely works or if the benefits I felt were simply a result of the placebo effect.

Cold Plunges in Physical Therapy and Performance Training

If you follow any athletes, fitness influencers, or people in the health/wellness space, you have likely heard someone touting the benefits of cold-water immersion. Ice baths are often claimed to aid recovery by reducing inflammation, relieving sore muscles, and supporting immunity and mental health. These assertions intrigued me, prompting a deeper dive into the science behind cold plunging and its role in physical therapy and performance training.

The Theories Behind Cold Plunging

There are a variety of theories to support why cold plunging might be beneficial. Here are three of the more common ones:

1. Fluid Shifts: When the body is immersed in cold water, fluid moves away from muscles and inflamed or sore tissues into the circulatory system to be pumped away. This shift can potentially reduce swelling and speed up recovery, making it a valuable tool in physical therapy.

2. Cardiac Assistance: As fluid moves from inflamed tissues into the bloodstream, more blood is pumped into the heart. This increased blood volume helps the heart pump more efficiently, moving nutrients throughout the body faster and aiding in muscle repair and recovery, which is crucial for performance training.

3. Psychological Benefits: The soothing effect of cold water immersion can reduce the perception of fatigue, helping the mind stay sharp. The shock of cold water may also trigger the release of endorphins, improving mood and overall mental health, which can enhance both physical therapy and performance training outcomes.

The Evidence: Placebo Effect or Real Benefits?

On the surface, scientific theories such as these make sense, and recent trends suggest potential benefits. However, the research surrounding ice plunges remains inconclusive and has yet to prove that it provides notable benefits beyond the placebo effect. Studies show mixed results, with some indicating minor benefits in recovery and mental clarity, while others find no significant difference compared to other recovery methods used in physical therapy and performance training.

My Decision

So, what did I end up doing? I did not get a cold plunge. As the husband of a scientist, I would have had a hard time justifying an ugly tub sitting in the backyard without any solid evidence to back it up! My wife’s scientific rigor rubbed off on me, and I decided that more evidence was needed before making such an investment.

This isn’t to say you shouldn’t do an ice plunge. If you feel better after, and don’t have cardiovascular or other risk factors, go for it! Anecdotal evidence from athletes and wellness advocates can’t be completely dismissed, especially if you experience tangible benefits in your physical therapy and performance training routines.

Final Thoughts

Reflecting on my cold plunge journey, I realize that personal experiences and scientific evidence both play crucial roles in health and wellness decisions. While science provides a foundation of understanding, individual responses can vary. If cold plunges make you feel invigorated and aid your recovery, they might be worth incorporating into your physical therapy and performance training routine. Just remember to listen to your body and consult with a healthcare professional if you have any underlying health conditions.

For now, I’ll stick to other proven recovery methods like proper hydration, nutrition, and sleep. But who knows? If future research provides more conclusive evidence, I might just reconsider and take the plunge once more.

Common Myths About Physical Therapy – Debunked

Many people have misconceptions about physical therapy and those who have never experienced treatment often misinterpret what physical therapists can offer. The expertise of the physical therapy team at Cohen Health and Performance goes far beyond simple stretching routines. Here are 4 common myths about physical therapy that we hear at our Bethesda and McLean facilities.

Myth 1: “I Need a Doctor’s Referral to Go to Physical Therapy”

At least once a week I hear this one and I am always happy to shine a light on the most common physical therapy myth that we see. Thanks to legislation known as Direct Access, you can schedule an appointment with a physical therapist without needing a referral. The benefits of Direct Access are significant: faster treatment and less hoops to jump through. Instead of taking the extra time to see a physician, you can visit a physical therapy clinic and start receiving care immediately. This streamlined approach not only saves you time but also helps you address your pain or injury more swiftly.

Myth 2: “I can see another healthcare provider for physical therapy”

This is a dangerous misconception. Only licensed physical therapists are qualified to provide the specific care required in physical therapy. According to Move Forward PT, approximately 37 percent of people believe that any healthcare professional can perform physical therapy methods on patients. It’s crucial to understand that physical therapy requires specialized training and knowledge that other healthcare professionals do not possess.

Myth 3: “Physical Therapy Is Only for Injuries”

It’s a common misconception that physical therapy is solely for treating injuries. While treating injuries is a significant part of what physical therapists do, our scope of practice is much broader. Physical therapy can benefit a wide range of conditions and goals, from enhancing athletic performance to managing bone loss associated with aging. For example, at Cohen Health and Performance, we provide customized running analysis and training recommendations for runners looking to improve their performance or reduce future injury risk. Physical therapy is about improving overall well-being, not just recovering from injuries.

Myth 4: “Surgery Is More Effective”

Many people believe that surgery is the most effective treatment for pain relief. While, surgery is necessary in many situations, that is not always the case. Depending on the injury or health condition, physical therapy can be a more effective and less invasive option. For instance, conditions like low back pain or meniscus tears may respond better to physical therapy than surgery. Before opting for surgery, consulting with a physical therapist can help you explore all available treatment options. Physical therapy might offer a less risky and more holistic approach to pain management and recovery.

Unseen Benefits of Physical Therapy

Now that we’ve debunked these common myths, let’s explore the real benefits of physical therapy that often go unnoticed.

Enhanced Quality of Life

Physical therapists aim to improve your overall quality of life. This involves not just treating pain or injury, but also enhancing your physical function, mobility, and overall health. For athletes, physical therapy can optimize performance and prevent injuries, allowing them to excel in their sports.

Preventive Care

Physical therapy isn’t just reactive; it’s also proactive. Physical therapists work with patients to prevent injuries before they occur. Preventive care at Cohen Health and Performance often includes educating patients on proper body mechanics, developing strength and conditioning programs for sport, and providing ergonomic advice for work or daily activities. By addressing potential issues early, physical therapy helps you avoid future pain and injury.

Holistic Approach

Physical therapy takes a holistic approach to health and wellness. Physical therapists consider all aspects of a patient’s life, including their physical, emotional, and social well-being. This comprehensive approach ensures that the treatment plan addresses the root cause of the problem, not just the symptoms. For example, a physical therapist might recommend stress-reduction techniques or lifestyle modifications into a treatment plan to support overall health and recovery.

Personalized Treatment Plans

Each patient is unique, and physical therapists create personalized treatment plans tailored to individual needs and goals. This personalized approach ensures that the treatment is effective and aligns with the patient’s lifestyle and goals. Whether you’re an athlete looking to return to your sport, a senior aiming to maintain independence, or someone managing a chronic condition, your physical therapist will design a program that’s right for you.

Physical therapy is a dynamic and essential field that offers much more than most people realize. Physical therapists are highly trained professionals who provide comprehensive care that can improve your quality of life, prevent future injuries, and offer effective alternatives to surgery. By debunking these myths, we hope to shed light on the true value of physical therapy and encourage more people to take advantage of its many benefits.

So, the next time you’re dealing with pain, recovering from an injury, or looking to improve your overall health, consider seeing a physical therapist. You might be surprised at how much they can help.

5 Mistakes Athletes Make Returning to Sport After a Shoulder Injury

Navigating the path through physical therapy and back to training after a shoulder injury is like threading a needle. It’s tricky and demanding, and if not done right, it can lead to setbacks. At Cohen Health and Performance, our experiences in McLean and Bethesda have given us invaluable insights into what works and what doesn’t. Here are five common errors that can derail your recovery journey in physical therapy.

Jumping the Gun: Increasing Workload Too Quickly

This is the big one. When athletes feel no pain or get the green light from their doctor, they often rush back to their previous training levels. But this excitement can quickly turn into a setback.

It’s crucial to educate early to prevent this. Feeling better doesn’t mean you are back to your pre-injury levels.

Progressive loading is critical. Develop a detailed plan that helps you slowly and progressively increase activity. This gives your shoulder a chance to acclimate to more stress and loading over time. Include physical therapy exercises to care for your rotator cuff and improve the movement capabilities of your scapula-thoracic joint and rib cage.

Start with 1 arm exercises

Everyone has a dominant arm, but rushing into bilateral exercises like bench presses and pull-ups requires addressing unilateral strength imbalances. After an injury, your body may be experiencing something called protective inhibition when the nervous system prevents you from fully activating the muscles of the injured arm. In addition, you may be experiencing weakness and atrophy from not using your injured arm for a period.

At Cohen Health and Performance, we use tools to measure force output and look for upper extremity strength to be symmetrical before moving to bilateral exercises. Ensuring that your strength is balanced can save a lot of headaches and prevent re-injury.

Treating the Symptom, Not the Cause

It’s easy to focus on the source of the pain, but it’s vital to look at the bigger picture. Ask yourself: What caused this shoulder injury?

There are numerous factors to look at here, but we’ll discuss a couple common issues.

Let’s start by looking assessing an athlete’s overall workload. Many are consumed by games, practices, and workouts without sufficient recovery built in.

In addition, their bodies may not be able to handle all the stress that they are asking of them. Many of our physical therapy patients do not have the movement capabilities and loading tolerance necessary to withstand the rigors of their sports schedules.

Lack of Individualized, Objective Return-to-Sport Programs

A one-size-fits-all approach needs to be revised. Every athlete is an individual with unique traits, strengths, and weaknesses. A personalized, detailed roadmap to recovery is needed.

Your athlete’s personalized program must start with their goals. Next, they must undergo a thorough assessment to determine their current situation.

The athlete’s goals are the destination, and the assessment is the starting point. The program is the roadmap to get them from the start to their destination.

Lack of Communication

Open communication with all parties involved (parents, coaches, physical therapists, trainers, and physicians) is essential for a triumphant return to sport. Everyone needs to be on the same page, which ultimately helps the athlete return to sport faster and safer.

At Cohen Health and Performance, we request to be in touch with an athlete’s coaches, parents, and other healthcare team members.

If you avoid these common mistakes, you’ll be back in the game stronger and more resilient than before your injury.

Are you seeking ways to overcome your shoulder injury and return to the field immediately? Contact us to get back out there ASAP!

2 Performance Training Exercises for Future College Athletes

In 2010, I was a graduate physical therapy student at Northeastern University and an assistant strength and conditioning coach with their varsity athletics program. The summer season was particularly exciting, as it marked the arrival of first-year student-athletes who were eager to begin their team’s rigorous strength and conditioning program.

As the new athletes arrived, our strength and conditioning staff advised me that many freshmen typically had limited sports performance training experience. This often left them lagging behind their more experienced teammates. They were right.

The incoming freshman athletes were noticeably unprepared in the weight room. Their initial performance assessments revealed significant weaknesses compared to their older counterparts. These deficiencies not only increased their risk of injury but also hampered their ability to perform at the high level required for collegiate athletics.

To address these challenges, we implemented a series of targeted exercises designed to build foundational strength and improve movement mechanics. Here are two key exercises we used to help prepare these athletes for the demands of collegiate sports:

Lateral Step Down: This exercise was crucial for developing lower body strength and enhancing single-leg stability. It involved stepping down laterally from a raised platform, which required the athletes to control the descent of their body. This movement is essential for efficient deceleration, a critical component during cutting maneuvers and other sport-specific movements. By mastering the lateral step down, athletes learned to manage their body’s momentum, reducing the risk of injuries such as strains and sprains during dynamic sports actions.

Split Stance Deceleration: Deceleration is a fundamental skill in many sports, and improper technique can lead to severe injuries, such as ACL tears. The split stance deceleration drill was designed to teach athletes how to decelerate effectively. We incorporated resistance bands into this exercise to increase the challenge and more accurately replicate the forces encountered during sports activities. Athletes practiced lowering their center of gravity and maintaining control, which is essential for preventing lower body injuries when stopping or changing direction quickly.

Reflecting on these experiences, I often wonder about the potential benefits if more high school athletes participated in comprehensive strength and conditioning programs before entering college. Such early preparation could significantly enhance their physical capabilities, reduce the risk of injuries, and give them a competitive edge over their peers.

High school athletes who engage in structured training programs are likely to arrive at college with a solid foundation in strength and conditioning. This preparation would not only impress their coaches but also increase their chances of securing playing time in their first year. Early exposure to proper training techniques can foster long-term athletic development, leading to improved performance and longevity in their sports careers.

At Cohen Health and Performance, we’ve recently expanded our Performance Division by launching Performance University (Performance U). In addition to complementing our sports physical therapy services, this small-group performance training program is specifically designed for elite-level high school athletes. Performance U tailors its training to meet each athlete’s unique needs, utilizing the latest advances in sports technology to optimize results.

If your child dreams of playing collegiate sports or if you are seeking the best training option available, Performance U is here to help. We are currently accepting new clients for our summer Performance U group, which begins on May 20th. To learn more about Performance U and how it can benefit your athlete, check out the video below or click here for more information.

How to know your athlete’s sports performance program is any good

Lately, I’ve noticed a nice change.

High school athletes better understand the importance of sports training during their off-season(s), most notably during the summer.

What a relief! In the past, I spent countless hours teaching my physical therapy clients about the importance of participating in a well-designed sports training program after they’ve hit puberty.

But now there is a new challenge.

Choosing the right performance program!

Young athletes have many different options, including different programs, coaches, companies, etc. So, how do you know which option is best?

Start by understanding the design of the sports performance program and who is directing it.

The Coach

When selecting a coach for your athlete, it’s crucial to prioritize experience, qualifications, and expertise. A coach should possess a deep understanding of athletes across various skill levels and abilities. This breadth of experience ensures that they can tailor their approach to meet the unique needs of each individual under their guidance. Moreover, qualifications play a pivotal role in ensuring the efficacy of the training program. Look for coaches who have obtained a college degree in a relevant field such as Kinesiology or exercise science. These degrees provide a solid foundation of knowledge in human movement, physiology, and sports performance.

Furthermore, certifications like the CSCS (Certified Strength and Conditioning Specialist) indicate that the coach has undergone rigorous training and testing in the principles of strength and conditioning. This certification ensures that they are well-equipped to design and implement effective training programs that prioritize safety and performance optimization. Additionally, access to a quality sports physical therapist can be invaluable in preventing injuries and addressing any underlying issues that may impact athletic performance. By prioritizing these qualifications and resources, you can ensure that your athlete receives the highest standard of coaching and support to achieve their goals.

The Program

When considering a training program for your athlete, it’s essential to evaluate its components to ensure comprehensive development and optimal results. Here are key elements that every program should encompass:

Goal Setting: Effective coaching begins with a clear understanding of the athlete’s objectives. Coaches must align training strategies with the athlete’s goals to measure success accurately. Without defined goals, progress evaluation becomes challenging.

Testing: A thorough assessment of the athlete’s current abilities is fundamental. Identifying strengths and weaknesses through objective metrics lays the groundwork for tailored training plans. Quantifiable data provides insights into progress and informs adjustments to optimize performance.

Research-Backed Programming: Cookie-cutter approaches won’t suffice. Each program should be meticulously crafted based on scientific principles and individual assessments. By integrating research-backed methodologies, coaches can design training regimens that address specific needs and sport-related demands effectively.

Facilities and Environment: The training environment significantly impacts motivation and performance. A well-equipped facility with adequate space fosters optimal training conditions. It should promote positivity and motivation, enhancing the athlete’s focus and commitment to improvement.

Re-testing: Continuous evaluation is essential for tracking progress and refining training strategies. Regular re-testing, ideally every 4-6 weeks, allows coaches to gauge advancements and identify areas for adjustment promptly. This iterative approach ensures that athletes stay on the right track towards their goals, with any necessary modifications implemented promptly to maximize results.

By ensuring that these components are integral to the training program, athletes can experience holistic development and tangible progress towards their athletic aspirations.

What options are available in the DMV?

You’re looking at it!

We’ve recently grown the Performance Division of Cohen Health and Performance, starting with Performance University.

Performance U is a small-group performance training program designed for elite-level high school athletes. It is tailored to your athlete’s needs and designed using recent advances in sports technology.

If your child dreams of playing collegiate sports or you’ve been searching for the best training option, we’ve got you!

We are accepting new clients for our summer Performance U group, beginning on May 20th! Learn more about Performance U by checking out the video below or clicking here!

Contact us if you are interested in hopping on a phone call with CHP’s Director of Sports Performance, Dr. Ethan Lennox, to learn more or partake in a free trial session!

How a physical therapist will help you conquer knee pain

Decoding the Subtle Signs of Knee Pain: When to Seek Help

Knee pain often begins as a subtle, almost mysterious discomfort that doesn’t always require immediate attention from a professional. Many instances of knee pain develop gradually, remain mild, or appear after exercise, only to fade away with some at-home care. Simple remedies like rest, ice, compression, elevation, and careful use of anti-inflammatory medications are often the first line of defense against these occasional knee aches.

But how do you know when knee pain has escalated from a minor issue to something that requires professional intervention? The answer lies with skilled sports physical therapists. Their expertise, developed through rigorous training, allows them to determine whether knee pain can be managed with physical therapy or if it requires a physician’s care. Since physical therapy is usually more accessible and cost-effective than a doctor’s visit, it’s wise to consider a physical therapist as your first option for knee pain that persists beyond a week. If your symptoms last longer than this, it’s time to schedule an evaluation.

Understanding Knee Conditions That Physical Therapy Can Treat

Knee pain isn’t a one-size-fits-all problem; it encompasses a variety of conditions that physical therapy can effectively address. These range from sudden injuries to chronic issues, each requiring a specific treatment approach.

Meniscus Tear

The meniscus, which serves as the knee’s natural shock absorber, can suffer tears, but physical therapy is often a strong alternative to arthroscopic surgery. Recent studies show that physical therapy can provide results similar to surgery in improving knee function, even two years after the injury. The physical therapy approach combines muscle strengthening with stretching, focusing on enhancing the muscles around the knee to better absorb shocks and fine-tuning daily movements to reduce pain during activities like walking and squatting. This progression eventually leads to more advanced, sport-specific movements.

Knee Ligament Sprain

Similar to the treatment for a meniscus tear, a knee ligament sprain may initially require bracing or taping to support the knee, reduce swelling, and alleviate pain. The physical therapy plan for this condition includes strengthening exercises, improving range of motion, balance training, and gradually returning to pre-injury activities.

Osteoarthritis (OA)

For chronic conditions like knee osteoarthritis (OA), physical therapy focuses on strengthening the muscles around the knee, much like the supports of a building, to help them absorb daily impacts with ease. Stretching is essential to maintain the knee’s range of motion and protect it from further injury. Physical therapy may also involve modifying daily activities or refining movement patterns to reduce pain during routine tasks, such as standing up from a chair. A home exercise program, designed by a physical therapist, can serve as a long-term strategy for managing knee OA.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a complex condition that requires a thorough physical therapy evaluation. The cause could be anything from your footwear to the strength of your hips. Whether the solution involves foot orthotics to realign the patella or hip-strengthening exercises to correct knee alignment, physical therapy is tailored to address the specific factors contributing to this type of knee pain.

Physical therapists also play a crucial role in the rehabilitation of knee fractures, helping patients regain strength, flexibility, and the ability to perform everyday activities like walking and climbing stairs.

When to Seek Immediate Medical Attention

While many forms of knee pain can be managed with physical therapy, certain symptoms signal the need for immediate medical care:

– Inability to bear weight on your knee or bend it past a right angle
– Visible deformities in your leg or knee
– A feeling of instability, as if your knee might give way
– Persistent pain that doesn’t improve with home care
– Swelling and redness that don’t respond to elevation
– Severe tenderness in the calf, which could indicate deep vein thrombosis
– Swelling, redness, general malaise, and/or fever, which may suggest an infection

Choosing the Right Physical Therapist for Knee Pain

When seeking a physical therapist for knee pain, look for someone who specializes in sports and orthopedic injuries and has extensive experience with these conditions.

Physical therapy for knee pain is a blend of science and art, requiring a keen eye and a skilled practitioner. It combines expert knowledge, personalized care, and evidence-based practices—all aimed at restoring harmony to your knees and getting you back to your normal activities.

If you’ve read this far, you know there’s no better team than ours at CHP. Contact us today to schedule your physical therapy evaluation at our McLean or Bethesda facility!