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.

2023: A Year of Growth and Reflection

This past year has been nothing short of transformative—both personally and for our physical therapy and sports performance practice.

In December 2022 (close enough to count!), we opened a new physical therapy clinic in McLean, led by our Clinic Director, Dr. Kelly Henry. As we continued to expand our presence in Northern Virginia, Dr. Samuel Kinney joined our team later in the year, further strengthening our ability to make an impact in the community.

November marked another milestone with the relocation of CHP Bethesda to a larger, more advanced facility, under the leadership of Clinic Director, Dr. Sebastian Bellitto. This cutting-edge space not only allowed us to grow our physical therapy offerings but also launched CHP Performance U, directed by Dr. Ethan Lennox. Performance U is our latest initiative, providing small-group sports performance training designed specifically for elite high school athletes aspiring to compete at the collegiate level. You can check out their festive, holiday-themed training session in the video below.

While 2023 was a year of expansion and progress for CHP, it was also a year of personal growth for me. I embraced discomfort and learned the importance of trusting our exceptional team to guide the ship forward.

However, my most valuable lesson from this year wasn’t about growth—it was about reflection.

I’ve often struggled with reflection, constantly focused on what comes next. While forward-thinking is essential, this single-minded focus has sometimes taken a toll on my mental well-being. This year, I made a conscious effort to slow down and reflect.

Looking ahead is crucial, but what’s the point if we don’t pause to appreciate the positive things we’ve accomplished along the way? As I reflect on this past year, I’m filled with gratitude for everything we’ve achieved at CHP and in my personal life. This includes our beloved pup, Reina, who has bravely battled cancer all year and continues to show incredible resilience.

As we step into 2024, I encourage you to take a moment to reflect on the wonderful experiences and accomplishments of 2023.

Here’s to a bright and fulfilling New Year!

Cheers!

Conquer the slopes: physical therapy for skiers

The air is crisp, morning frost is on the car windshield and the skin on my hands are cracking.

Winter is officially here and instead of just “surviving” winter, why not embrace and enjoy it?

It’s a fantastic time to embrace the great outdoors and stay active, especially when chilly weather tends to encourage a more sedentary lifestyle.

In McLean and Bethesda, several of our physical therapy clients have been preparing for the ski season. Their goals vary, from recovering from past injuries to simply wanting to be in top physical shape to handle the rigors of skiing.

It’s important to recognize that skiing is a demanding sport due to the unique constraints it places on the body.

Ski boots, while providing necessary support, significantly limit the movement of the ankle and calf muscles, unlike activities that involve running or jumping. These limitations shift more demand onto the knees and hips to control movement. This is reflected in the common ski-related injuries, with ACL and MCL injuries in the knee being particularly prevalent.

Beyond improving your skiing skills and avoiding falls, preparing your lower body for skiing is an effective strategy for injury prevention. As part of your physical therapy and exercise regime, consider incorporating the following exercises into a warm up before hitting the slopes:

Wall Squat Hold: Find a challenging position and perform 2-3 sets of 30-second holds. This exercise strengthens your thighs and glutes, crucial for maintaining stability while skiing.

Single Leg Drop: Execute 2-3 sets of 6 reps on each side. This exercise not only improves balance but also targets the muscles around the knees and hips, areas that bear the brunt of the workload while skiing.

Whether you’re an avid skier coming back from an injury or someone looking to enhance your physical fitness for skiing, incorporating these physical therapy exercises into your routine can make a significant difference.

Stay safe, enjoy the slopes, and make the most of this winter season!

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!