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.

From the Field to the Physical Therapy Clinic: Common Fall Sports Injuries We’re Seeing

The fall sports season is officially here in the DC area!

Athletes are returning from their summer break, easing back into practices, and—unfortunately—we’re already starting to see a familiar trend in our clinics: a rise in sports-related injuries.

At Cohen Health and Performance, with locations in McLean and Bethesda, we work with athletes every fall who develop issues as they ramp up their training and competition schedules. Whether it’s a cranky knee, a sore ankle, hip discomfort, or a soft tissue strain, these injuries can derail a season before it really gets going.

Why Are Athletes Getting Injured at the Start of the Season?

The start-of-season injury spike often happens for two main reasons:

Sudden Increase in Training Volume
Some athletes simply aren’t fully prepared for the jump in intensity that comes with daily practices, scrimmages, and games. Even if they’ve stayed active over the summer, their bodies may not be ready for the sport-specific demands of their season.
Mismatch Between Off-Season Training and In-Season Demands
Many athletes train hard in the summer—lifting weights, running, and following conditioning plans from coaches—but those workouts don’t always replicate the unpredictable, reactive movements of live gameplay. Without that sport-specific preparation, even well-trained athletes can still get hurt.

The Importance of Sport-Specific Preparation

The best off-season training programs start general and gradually become more specific to the sport as the season approaches. This ensures the athlete’s muscles, tendons, and ligaments are ready for the exact movements they’ll face on the field or court.

For example, football is highly reactive—players must change direction quickly in response to opponents. Our video above shows one hurdle based drill that we use in our McLean and Bethesda physical therapy clinics. The athlete reacts to an unpredictable cue, changing direction while clearing hurdles—just like they might have to do in a game. This type of training prepares the body for rapid deceleration, re-acceleration, and sudden direction changes.

Why Deceleration Training Matters

Many injuries, especially hamstring strains, happen during deceleration—when the body must slow down rapidly. The hamstring works hardest when it’s putting on the brakes during sprinting, and if it’s not prepared for that high force, injury risk skyrockets.

That’s why we integrate drills designed to strengthen the hamstring’s ability to decelerate quickly, reduce injury risk, and keep athletes competing at their best.

Free Injury Consultations for High School Athletes

Right now, our McLean physical therapy location is offering free injury consultations for high school athletes returning to play.

If your son or daughter is:

Complaining about pain in a joint or muscle
Recovering from a recent sports injury
Feeling “off” since the season began

…our team can help identify the problem, address it quickly, and get them back to playing without missing significant time.

These consultations are performed by our expert sports physical therapy team in McLean, including myself, Dr. Matt, and Dr. Sam. We’ll assess the injury, pinpoint the cause, and provide sport-specific drills to get the athlete back to full strength as quickly as possible.

Don’t Wait—Act Early

The earlier we address sports injuries, the faster athletes can return to pain-free performance. If you’re in the McLean or Bethesda area and want to make sure an injury doesn’t sideline your athlete this season, contact us today to schedule an appointment.

Are You Really Out of Alignment? What You Need to Know Before Your Next Adjustment

“I think my hips are out of alignment.”
“My pelvis feels shifted.”
“My sacrum must be twisted.”

These are phrases we hear all the time at Cohen Health and Performance. If you’ve ever said something similar—or been told this by a friend or provider—you’re not alone. The idea of being “out of alignment” is a commonly held belief and often used to explain nagging pain or movement issues. But here’s the truth:

Your body is built to move—and that includes your pelvis.

Understanding “Misalignment”

Let’s clear something up: your pelvis, hips, and sacrum are supposed to move. With every step you take, your pelvis naturally rotates, shifts, and adapts. This isn’t dysfunction—it’s a sign of a healthy, dynamic system.

The sensation of being twisted or “off” often comes from the body favoring one side over the other. It’s not that you’re structurally broken. It’s that your movement patterns are biased—and over time, those biases can create imbalances that feel like misalignment.

Why Do We Get Stuck in These Patterns?

Most people have a natural tendency to favor one side, especially the right. Why?

We’re mostly right-handed
We carry kids, bags, or groceries on the right
Even society is designed for right-handers (think door handles, tools, etc.)

This daily repetition subtly trains our bodies to prefer the right side. Over time, this can show up in the gym—like when one leg feels stronger during a leg press—or in daily life, where you feel “off” or stuck on one side.

But here’s the important part: you don’t need to be cracked, popped, or adjusted repeatedly to fix it.
You need a plan to address the underlying cause.

A Smarter Approach to Feeling “Realigned”

One of our go-to exercises at Cohen Health and Performance (see the video at the beginning for a demonstration) is a drill that retrains how the body pushes off the right side to shift weight to the left. Here’s what it looks like:

Lying on your back with your right foot on a wall
Left leg lifted with the hip in flexion
Pushing through the arch of the right foot to activate the right glute

This simple but effective movement mimics what your glute should do during walking, sprinting, or cutting—helping you get off the right side and balance your body’s movement patterns.

Done consistently, drills like this can help you:

Reduce your reliance on constant adjustments
Improve strength and control in underused muscles
Feel more balanced and symmetrical in daily life and workouts

Physical Therapy That Addresses the Root Cause

At Cohen Health and Performance, our goal isn’t just to “fix” you temporarily.
We help you understand why you feel off in the first place—and give you the tools to stay better aligned through movement, not manipulation.

Whether you’re looking for physical therapy in Bethesda or physical therapy in McLean, our team specializes in performance-based care that empowers you to move better, feel stronger, and stay pain-free.

Ready to Stop Chasing Adjustments?

If you feel like your body is out of alignment—or you’ve been told that it is—it’s time to dig deeper. Contact us today to schedule an evaluation. We’ll help you understand what’s really going on and create a plan that actually sticks.

Your Physical Therapy Guide to Knee Pain Relief

Is Your Knee Pain Trying to Tell You Something? Here’s When to Listen

Knee pain doesn’t always shout—it often whispers.

Maybe it started as a dull ache after a workout or a twinge when walking down stairs. It’s easy to brush it off, thinking some rest and ice will do the trick. And sometimes, it does. But what happens when the pain lingers longer than expected?

That’s when it’s time to listen more closely—and consider physical therapy as your next step.

Why Physical Therapy Should Be Your First Stop for Knee Pain

When knee pain doesn’t go away within a few days—or even worsens—it’s easy to assume you need to see an orthopedic specialist right away. But here’s the truth: a qualified physical therapist is often the best place to start.

Not only is knee pain physical therapy more accessible and cost-effective than many medical appointments, but sports-trained physical therapists can also help identify the root cause, guide treatment, and decide if additional medical care is needed.

If your knee discomfort lasts more than a week or starts interfering with your daily activities, it’s time to schedule an evaluation.

Common Causes of Knee Pain Physical Therapy Can Help

Every knee injury is unique, and so is its solution. Below are several conditions we treat regularly with great success at Cohen Health and Performance:

Meniscus Injuries

The meniscus cushions your knee joint and is prone to tearing—especially in sports or twisting movements. In many cases, physical therapy can match the results of surgery, improving strength, mobility, and long-term function without going under the knife.

Knee Ligament Sprains

Injuries to the ACL, MCL, or other ligaments often benefit from a structured rehab plan. A combination of support (like bracing), strengthening, and functional exercises can help you return to your normal routine safely and confidently.

Osteoarthritis (OA)

If you have stiff, achy knees in the morning or after sitting, you may be dealing with OA. Physical therapy helps strengthen the muscles around your joint, improve mobility, and reduce the stress on the knee—giving you better control over symptoms without relying solely on medications.

Patellofemoral Pain Syndrome

This condition, often felt as pain around the kneecap, can stem from many sources: muscle imbalances, poor mechanics, or even your footwear. A skilled physical therapist will assess the entire kinetic chain—from hips to feet—to develop a personalized treatment plan that addresses the root cause.

Post-Fracture Rehab

If you’ve suffered a knee fracture, physical therapy is essential for restoring normal motion, rebuilding strength, and safely transitioning back to walking, stairs, and eventually higher-level activities.

Signs Your Knee Pain Needs Immediate Medical Care

While most types of knee pain are appropriate for physical therapy, some situations call for immediate medical attention. Contact your doctor if you experience:

Inability to bear weight or straighten your knee
Noticeable deformity or severe swelling
Feeling like your knee might “give out”
Persistent redness and warmth
Intense tenderness in your calf (possible sign of a blood clot)
Fever or general malaise along with swelling (could indicate infection)

Choosing the Right Knee Pain Physical Therapy Provider

Not all physical therapists are the same. When dealing with a knee injury, make sure you work with someone who:

Specializes in sports and orthopedic rehab
Understands the demands of your lifestyle or sport
Builds custom plans based on your goals and movement patterns

At Cohen Health and Performance, we bring elite-level care to active adults and athletes across Bethesda and McLean. Whether you’re looking to avoid surgery, recover from injury, or simply move better with less pain, our team is here to help.

Let’s Get You Moving Again

Don’t let knee pain limit your life. If it’s been nagging you for more than a few days, or you’re tired of managing it on your own, we’re ready to help.

Book your physical therapy evaluation at our McLean or Bethesda location today—and take the first step toward lasting relief.

Still Struggling with Knee Pain? Why Physical Therapy May Be the Missing Link

At Cohen Health and Performance, we recently worked with an athlete who came to us months after injuring his knee during a workout at the gym. After seeing his doctor, he was told there was nothing structurally wrong—no damage on imaging, no major red flags. The advice? Take a couple of weeks off and slowly return to exercise.

Fast forward several months, and he was still modifying workouts and struggling with lingering pain and frustration.

Sound familiar?

This scenario is incredibly common—especially among active individuals dealing with chronic knee pain. Whether you’re a weekend warrior, a gym enthusiast, or a competitive athlete, you may have been told to rest, stretch, or foam roll your way out of pain. And yet, the discomfort persists.

Why Traditional Approaches Often Fall Short

Most general advice focuses on reducing symptoms—not solving the root cause. Many rehab programs stop as soon as pain decreases or when daily activities become tolerable again. But for those who want to lift heavy, sprint, or change direction on the field, this simply isn’t enough.

Effective knee pain physical therapy needs to go beyond the basics. It should train your knees to handle the specific stresses of your sport or activity.

For example, sports that involve cutting and multidirectional movement place your knees in angled, high-force positions. If your rehab never prepares you for those forces—if your shin is never loaded at those angles during training—you’re setting yourself up for continued breakdown.

The Importance of Load-Specific Training

To truly recover and thrive, the tendons and muscles around the knee—especially the patellar tendon and quad tendon—must be reconditioned to tolerate the demands of real movement. Whether you’re jumping, landing, or squatting under load, your knees must be gradually exposed to the stresses they’ll face in the real world.

That’s why our rehab process includes drills and exercises tailored to your goals. Below is an example from our specialist, Dr. Cat, demonstrating exercises that teach the knee how to absorb and produce force under real-world conditions.

By gradually increasing load and focusing on the angles and demands of your sport, we prepare the knee—and the entire lower body—to handle life beyond the treatment table.

Don’t Let Knee Pain Linger

If you’ve been dealing with chronic knee issues, tried resting, icing, stretching, or following online exercise videos with no real progress, it’s time to dig deeper. At Cohen Health and Performance, we take a comprehensive look at your movement patterns, strength, mobility, and sport-specific demands to uncover why your knee pain persists—and how to fix it for good.

We don’t just want to help you feel better.

We want to get you back to training, competing, and living life without limitations.

Ready to Get to the Root of Your Knee Pain?
Contact us today to schedule a comprehensive evaluation and find out how physical therapy for knee pain can help you move better, feel stronger, and finally leave knee pain behind.

Why Shoulder Injuries Are So Complex

At Cohen Health and Performance, we specialize in physical therapy in Bethesda and physical therapy in McLean for active adults and athletes who want to get back to the activities they love. One of the most common mistakes we see in traditional care—yes, even among other physical therapists—is a failure to appreciate how complex the shoulder really is.

The shoulder is the most mobile joint in the entire body. That’s what makes it so essential: reaching, throwing, lifting, pushing, and pulling all require freedom of motion. But that same mobility also opens the door to a ton of possible compensations and dysfunctions when something isn’t moving well.

Your Shoulder Isn’t Just a “Ball-and-Socket”

Think of your shoulder like a golf ball sitting on a tee. The ball is your humeral head (upper arm bone), and the tee is the glenoid (part of your shoulder blade or scapula). But that “tee” isn’t grounded into the earth—it’s actually floating on your rib cage. That means your shoulder’s stability is influenced by your rib cage shape, position, and even how you breathe.

Most providers stop at the shoulder joint itself. But for us at Cohen Health and Performance, whether it’s physical therapy in McLean or physical therapy in Bethesda, we know that treating shoulder pain means looking beyond the joint.

If the shoulder blade doesn’t sit securely on the rib cage, the muscles around it—like the upper traps or rhomboids—often work overtime to stabilize things, leading to tightness, knots, and nagging pain in the upper back or neck.

The Rib Cage is the Unsung Hero

One of the foundational drills we use to retrain shoulder mechanics involves placing your forearms on the wall. Here’s the key:

Straight line from wrist to elbow
Externally rotate through the shoulders
Use your rib cage—not your arms—to press back into the shoulder blades. Perform 5 breaths in this position.

A cue we love: Imagine a hot poker hovering in front of your sternum. Your job? Pull away from it without slumping forward. This activates a crucial muscle called the serratus anterior, which helps anchor your scapula and sets the stage for clean, pain-free movement.

Getting the Shoulder Blade Moving Again

Once you’ve created a supportive rib cage, the shoulder blade (scapula) can do its job again—mainly rotating upward as your arm reaches overhead.

A simple but effective exercise to improve this scapular movement is Downward Dog:

Start in a push-up (or all 4’s) position
Press away from the floor with your hands
Drive your chest toward your knees
Focus on feeling the shoulder blades rotate upward and outward

This kind of targeted movement work is exactly what we emphasize in our programs for physical therapy in Bethesda and physical therapy in McLean. Without proper scapular motion, your rotator cuff is forced to overwork—and that’s when breakdowns happen.

What About the Rotator Cuff?

Only after we’ve addressed rib cage position and scapular movement do we move to the rotator cuff. By this point, rotator cuff exercises are finally in the right environment to be effective—rather than just throwing rubber band exercises at a deeper problem that hasn’t been solved yet.

Final Thoughts: There’s Hope for Your Shoulder

If you’ve had shoulder treatment in the past and it didn’t work—or if you’ve been dealing with shoulder pain for months or even years—don’t lose hope.

The truth is, shoulder pain is multifactorial. It can stem from poor rib cage positioning, scapular movement limitations, limited mobility, or underdeveloped rotator cuff function. And many healthcare providers simply don’t take the time to look at all of these layers.

That’s where we come in.

If you’re looking for expert-level physical therapy in Bethesda or physical therapy in McLean that goes beyond surface-level care, contact us today. Our team of Doctors of Physical Therapy will work with you to get to the root of your shoulder pain and get you back to doing what you love—stronger and smarter than ever.

Having a 6-Pack Is Overrated?!

When it comes to fitness, the six-pack — those visible abs known as the rectus abdominis — gets all the glory. But from a physical therapy and spine health standpoint, it’s time we set the record straight: having a 6-pack is overrated.

At Cohen Health and Performance, we frequently work with active adults and athletes who want to prevent or recover from back pain, improve their core stability, and get more out of their workouts. A key misconception many bring in is the belief that the rectus abdominis is the holy grail of core strength.

Let’s break that myth down.

What the Rectus Abdominis Really Does

The rectus abdominis runs from your ribcage to your pelvis, right down the front of your abdomen. It’s the most superficial abdominal muscle — meaning it’s closest to the surface — which is why it’s the one you see in the mirror. But it’s not the most functional when it comes to spinal support or back pain prevention.

Its attachment points on the ribcage and pelvis are small and weak compared to deeper abdominal muscles. This means it doesn’t do a great job controlling how your ribcage and pelvis align — a key part of keeping your spine supported during movement.

The Real Core Stabilizers: What Actually Helps with Back Pain

At Cohen Health and Performance, where we provide sports physical therapy in McLean and Bethesda, we focus heavily on training the deeper core muscles that make a real difference:

-Transverse abdominis: The deepest abdominal muscle, wraps around your torso like a corset.
-Obliques: Help with rotation, side bending, and crucially, stabilizing your ribcage and pelvis.
-Diaphragm and pelvic floor: Work in sync with your core to manage internal pressure and support the spine.

These deeper muscles have stronger connections to your ribcage and pelvis and play a much greater role in controlling spinal position — making them essential for back pain relief and injury prevention.

How We Teach Patients to Engage the Right Muscles

Many people struggle to “find” or activate these deeper muscles because they’ve been trained — often unknowingly — to only rely on superficial muscles like the 6-pack.

One of the first drills we teach many of our physical therapy patients in Bethesda and McLean is something you can try at home:

1. Lie on your back with knees bent and feet flat.
2. Breathe in through your nose.
3. Exhale slowly through your mouth — as long as you possibly can.
4. As you exhale fully, you should feel your ribs draw down and in — and your deeper abs engage.
5. Hold that feeling for 5 seconds at the end of the exhale.
6. Try to quietly breathe in without losing that muscle engagement and repeat this cycle 5 times

This is often the first step toward building true core control — and a key part of our rehab process for those dealing with chronic or recurrent low back pain.

How This Applies to Movement and Exercise

Once you learn how to activate those deeper muscles, we help you bring that control into movement:

-Lifting one leg at a time while lying down
-Overhead arm motions while continuing to feel your deep abdominals
-Transitioning to standing drills like squats or deadlifts
-Returning to sport or high-level athletic performance

This progressive, intelligent approach is what sets our physical therapy practice in Bethesda and McLean apart — and what helps our patients get long-term results, not just temporary relief.

Struggling with Back Pain? Want Smarter Core Training?

If you’ve been dealing with low back pain, poor posture, or feel like your workouts just aren’t translating to improved performance or comfort, it may be time to train your core smarter, not harder.

Our Doctors of Physical Therapy in Bethesda and McLean can help you:

-Eliminate chronic or nagging back pain
-Improve core strength and stability
-Optimize your breathing and movement patterns
-Return to sport, the gym, or simply a pain-free life

Ready to Get Started?

If you are looking to move and feel better, don’t waste time chasing six-pack abs. Schedule an appointment with our team at Cohen Health and Performance in Bethesda or McLean, VA and start building a strong, functional core that actually protects your back and enhances your performance. Click here to get started!