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.

This increases your groin injury risk by 17 times!

This week, we’re excited to feature another guest post by Dr. Samuel Kinney. Dr. Kinney is a performance physical therapist at our McLean location. You can learn more about Dr. Sam here.

As a sports physical therapist and someone who is passionate about maximizing human performance, I’m constantly intrigued by the unique challenges athletes face in different sports. Field sport athletes and hockey players, in particular, encounter distinct movement demands due to the dynamic, multi-directional nature of their sports.

Unlike athletes who primarily run in straight lines, such as sprinters, field sport athletes and hockey players rely heavily on their hip muscles. This continuous, varied use of the hips puts them at a higher risk of injury, especially in the hip and surrounding muscles. Gaining a deep understanding of the anatomy and demands of these sports is essential for both injury prevention and achieving peak performance.

The hips are driven by four primary muscle groups. The glutes and hip flexors manage forward and backward movement, while the abductors (located on the outside of the hip) and adductors (found in the groin or inner thigh) control lateral or side-to-side movements. Sports involving a lot of lateral movement, like skating, place extra stress on the abductors and adductors, making them more prone to overuse or strain injuries.

Maintaining a balance in muscle strength is crucial. Ideally, we aim for a 1:1 strength ratio between these muscle groups. If an athlete’s adductor-to-abductor strength ratio drops below 0.8, their risk of suffering a groin strain skyrockets by 17 times.

To reduce the risk of hip injuries, it’s essential for athletes to focus on strengthening both the adductors and abductors equally. Keep in mind that hip strength can fluctuate throughout the season, so it’s vital to work on these muscles beyond regular practice sessions.

Wondering about the strength ratio of your hips? I suggest scheduling an appointment with one of our sports physical therapy specialists to assess your hip strength. This proactive step could significantly reduce your risk of groin injuries during the season.

For those eager to start strengthening their adductors and abductors, here are two exercises to include in your routine:

1. Copenhagen Plank for Adductor Strength: Aim for 3 sets of 30-45 second holds. This exercise is excellent for building up your inner thigh muscles.

2. DNS Side Plank for Hip Abductor Strength: Try 3 sets of 12 reps. This exercise helps strengthen the outer hip muscles, which are essential for lateral movements.

Remember, whether in sports, physical therapy, performance training, or life, balance is key. By maintaining a balanced strength ratio in your hips, you’re not only preventing injuries but also optimizing your performance on the field or rink.

What breaking my nose taught me about physical therapy and performance training

My nose healed up, so I assumed I was fine (this was clearly before I became a sports physical therapist)…

It was the late 90s, and I had broken my nose a few weeks prior. My doctor cleared me to return to wrestling practice as long as I could avoid contact to the face.

Surprisingly, my middle school teammates respected that, and I was able to fully return to the mat. What was also a surprise was that I struggled to rebuild my conditioning as I continued to struggle to breathe through my nose. Turns out I had a deviated septum because of the fracture and ultimately had to get surgery to fix it.

I quickly realized that feeling better and hitting peak performance is about more than heavy training and conventional approaches to sports physical therapy.

Survival is your body’s number 1 priority, and it will pull out all the stops to maintain that sweet ability to breathe– even if it means putting more stress on other areas.

Nasal breathing is the VIP pass to effective respiration. It’s the body’s go-to strategy when you’re relaxing and even during those moderate sweat sessions. Breathing through your nose isn’t just about getting air in and out – it’s a full-service operation. It filters, humidifies, and regulates the temperature of the air you’re breathing. And here’s the kicker – it lets you extract more oxygen because it takes longer than mouth breathing.

But wait, there’s more. Breathing through the nose isn’t just a respiratory hack; it’s a triple threat. It’s like the Swiss Army knife of wellness, regulating stress, blood pressure, and even boosting the immune system.

Now, how do you get in on this nasal breathing action? Easy. Start with a 5-minute daily ritual of relaxed breathing. Inhale and exhale through the nose, throw in 5-second pauses after each exhale, and ensure that the exhale is twice as long as the inhale. It’s like a mini-vacation for your respiratory system.

Quick side note: if you’ve got anything messing with your ability to breathe – asthma, allergies, or a deviated septum – don’t be a hero. Talk to your doctor or physical therapist about it. These issues can throw a wrench in your nasal breathing game and mess with all your best efforts.

CHP Spotlight Interview with Dr. Steven Bernstein

How long will my athlete be in sports physical therapy after their ACL repair?

What’s going on with Aaron Rodgers? Can he really rehab his achilles repair in 14 weeks?

What is the one thing that you can do to play your sport for as long as possible?

I recently interviewed Dr. Steven Bernstein to tackle these questions and more in the latest edition of the CHP Spotlight Interview series. Dr. Bernstein practices orthopedic surgery with Summit Orthopedics, focusing on sports medicine. He specializes in arthroscopic surgery of the knee, shoulder and ankle.

The mission of the CHP Spotlight Interview Series is to share information with you from local experts in the fields of sports medicine, physical therapy, personal training, and sports performance. Now, more than ever, a seemingly infinite amount of information is available, and finding credible information is challenging. But we have good news. We are here to help you find the best information about physical therapy, personal training, and sports medicine from experts in Bethesda, Chevy Chase, DC, McLean, and Northern Virginia.

If you or someone you love has had a shoulder, hip, or knee injury, don’t miss this interview!

To learn more about Dr. Bernstein, click here and check out our interview below!

3 physical therapy exercises to keep your back healthy from home

I hope that you took full advantage of last week’s long holiday weekend.

My weekend was full of food, family, football, and plenty of time to relax.

In today’s constant, go-go-go society, we all can benefit from a little more time to relax and may help improve your outcomes in physical therapy. But for those of us who are used to moving constantly, this can result in back discomfort.

Research shows that decreased daily movement increases the risk of lower back pain.

Our spines are designed to move, and the structures in our lower backs (most notably, our discs) do not receive optimal nutrition and blood flow when we are sedentary.

The risk for lower back pain further increases if you have a history of lower back pain.

If the holidays are causing you to be less physically active than normal or you have a history of lower back pain, the activities below can make a huge difference!

The goals of these activities are to get the back moving and get the stabilizing mechanisms of the spine going!

Start by performing these activities a couple of times per day as a “movement break”.

Spinal Segmentation: 3 spinal waves in each direction
90/90 Hip Lift: 3 sets of 5 breathing cycles (each breathing cycle is in through the nose, followed by a full exhale, followed by a 5-second pause)
Physioball rollouts: 2-3 sets of 5 (try performing this with a breath at the top of each rep!)

P.S. If you are looking to solve your chronic back pain once and for all, contact us to set up an evaluation for back pain physical therapy in our McLean or new Bethesda location!

Traveling hurts!

Recently, I was working with a physical therapy client who was sharing her Thanksgiving travel plans with me—multiple rest stops and long hours in the car.

If you enjoy crowded airports and endless traffic, then this is almost your favorite time of year!

But, if you’re like most people, holiday travel isn’t exactly your idea of fun.

It seems like delays are inevitable. Remember the Southwest fiasco last year?

All that extra time sitting in the car or waiting at the airport can be uncomfortable. Your back stiffens up, your hips ache, and you start to feel tight all over. We hear about this a lot at our physical therapy clinics in McLean and Bethesda.

Holiday travel is already stressful, and discomfort is the last thing you need.

So, what can you do?

Move around! There’s no such thing as a perfect sitting posture—what’s important is to keep changing positions.

In our daily lives, we naturally shift from side to side as we stand and move. But this decreases when we’re sitting in a car, at the airport, or on a plane, causing discomfort in more sensitive areas of the body.

When sitting, try to locate your “sit bones”—the bones at the bottom of your pelvis that you sit on. Every 10-15 minutes, shift your weight from one “sit bone” to the other, and occasionally distribute your weight evenly for 5-10 minutes.

As a physical therapist, I often recommend alternating between having your legs straight and bent, and whenever possible, get up and take a walk. If you’re on a flight with me, you’ll see me stand up as soon as the seatbelt sign goes off!

If your neck, chest, or upper back starts to feel tight, remember the 20/20/20 rule!

Staring at your phone for too long can cause upper body discomfort.

The 20/20/20 rule, which comes from optometry, suggests that for every 20 minutes of focused activity, you should take a 20-second break and look at something 20 feet away.

This reduces strain on a single point and helps alleviate upper body tension.

These strategies should help reduce the tension that comes with holiday travel. However, they might not be enough if you have areas of your body that are recovering from an injury or are particularly sensitive.

Reach out to us to find the ultimate solution to your discomfort and start feeling your best this holiday season!

Physical therapy and performance training now open on River Road in Bethesda!

Our new Bethesda facility, located at 5272 River Road, Suite 350 is open! It’s been an exciting journey, and I’m excited to share this incredible 3100-square-foot space with you. But don’t forget about our amazing 2500-square-foot physical therapy and performance training place in McLean, Virginia!

Our new Bethesda facility boasts a range of features, including the CHP Performance Center and Physical Therapy clinic, designed to cater to your health and performance needs.

In case you missed it, in addition to our exceptional physical therapy services, CHP Performance will be introducing an array of exciting programs to enhance your athletic and physical performance:

Performance U: This small-group program is designed for high school athletes who dream of playing in college. It is uniquely tailored and designed using recent advances in sports technology. This personalized approach ensures that athletes receive the training they need to excel in their sport while minimizing the risk of injury. To learn more, click here!

Peak Performance Blueprint: This state-of-the-art assessment provides athletes a customized blueprint for optimizing their athletic potential. Incorporating our years of experience working with elite athletes and force-plate technology (more info about that here), the PPB will show, using clear metrics, how an athlete compares to collegiate athletes in their sport. They will also receive customized recommendations on improving their score to be better prepared for collegiate athletics. To learn more, click here!

Adult Strength and Conditioning: This program is designed for adults worried about re-injury when exercising or seeking a more scientifically designed training program. Our one-on-one sessions are under the direction of a Doctor of Physical Therapy and Certified Strength and Conditioning Specialist. To learn more click here!

If you are interested in any of these programs or have an injury that is bothering you, contact us now!

P.S. We will host our grand opening after the holidays, so stay tuned for future announcements!