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.

Set yourself up for success from your first race

Training for your first running race can be a challenge—where do you begin? What program should you follow? How long should your training last? And what exactly does “training” entail? These are common questions that we, as sports physical therapists and strength and conditioning professionals, frequently encounter.

Training involves conditioning your body to handle the demands you plan to place on it. This usually means gradually increasing the volume or intensity of your physical exercise over time, so you can perform at your best, prevent injuries, and avoid needing a visit to a sports physical therapy clinic like ours!

With countless resources and advice available online, the process can feel overwhelming. Whether you’re preparing for a 5K, marathon, triathlon, or Ironman, here are a few tips to help simplify your training journey:

1. Set Your Goals: Are you simply aiming to finish the race, or do you have a specific time goal? Defining your goals will help you determine the pace and intensity of your training sessions.

2. Assess Your Starting Point: Have you already done any conditioning for this activity, such as recreational running, biking, or swimming? If you’re starting from scratch, you’ll need to begin training earlier than someone who has been consistently active.

3. Incorporate Cross-Training: Include alternative forms of cardio (like swimming, biking, or HIIT training) and strength training in your routine. Different types of exercise target different muscle groups, which is crucial for injury prevention.

4. Taper Before Race Day: Give your body time to recover 1-2 weeks before the race—this isn’t the time to push your highest volume of training.

5. Follow a Structured Program: Depending on your race date, you can find various running programs online that suit your timeframe. Nike.com offers excellent running training plans that you can download!

If you have any questions about the tips above, the sports physical therapists and performance training specialists at Cohen Health and Performance are here to help. While these points provide a solid foundation for starting your running routine, we can offer additional guidance on calculating the right mileage to reduce injury risk, strengthening your muscles to complement your training schedule, and supporting you throughout your race preparation.

Don’t Trust Your Pain

We have all experienced physical pain (in fact, my own history of low back pain is what interested me in sports physical therapy).

Maybe you injured your back lifting weights. Perhaps you hurt you shoulder playing catch with your kids. You may have irritated your knee when training for a marathon.

You decide to see your doctor, physical therapist, or medical provider of choice. They then prescribe the recommended treatment or “plan of care.”

Throughout the course of treatment, you determine if you are getting better by monitoring your pain. Is it decreasing? Is it staying the same or getting worse? If your pain is improving, the treatment is working. If not, it is failing. Pretty straight forward.

That is the way that standard physical therapy views treatment but is short sighted.

Modifying your daily activities or exercise routines will help pain quickly improve in the short term but the root causes of the pain remain. This is when many people stop going to physical therapy or performing their home exercise routine.

This pain-free period of time provides the body with an opportunity to address the root causes of pain. This is essential if you wish to prevent it from returning in the future while returning to full activity.

Pain is a prediction made by the brain. When pain continuously occurs during a movement or activity, the body learns to expect it. This expectation must lessen for pain to ultimately disappear during aggravating activities. If you really want to nerd out on pain science, check out this article by my friend and fellow physical therapist, Zac Cupples.

Imagine that you have lower back pain every time that you attempt to lift something off the floor such as deadlifting a barbell in the gym or emptying dishes out of the dishwasher.

The brain has an expectation that this bent over position will hurt. Therefore, similar positions must be experienced without pain. Does this mean that you should start deadlifting on day 1 of treatment. Absolutely not. The best solution is to start with something less threatening and build from there. Below is an example of a great activity that physical therapy patients with low back pain start with.

The brain will then determine that these positions are not threatening, ultimately reducing risk of pain in the future while facilitating a full return to active life.

If you are an active adult ready to solve chronic pain for good, contact us to receive a customized home exercise program today!

What a Foot and Ankle Surgeon Recommends For Youth Athletes

I recently had the pleasure of interviewing Dr. Thomas Sanders for the latest edition of the CHP Spotlight Interview Series. The mission of the CHP Spotlight Interview Series is to share information with you from the greatest experts in the fields of sports medicine, physical therapy, fitness and performance. Now, more than ever, there is a seemingly infinite amount of information available and finding the most credible information is a challenge. The good news is that we are here to help you find the best information related to physical therapy, training, and sports medicine from experts surrounding us in Bethesda, DC, McLean and Northern Virginia.

If you or your child has suffered a foot/ankle ankle, don’t miss this interview! Dr. Sanders explains what you should do if you have experienced a foot/ankle injury and what risk factors your child can address right now to lower their risk of injury. He goes on to share when surgery may be appropriate and when conservative options like physical therapy are a better choice. He even shares his experiences as an athlete, playing rugby, and how that lead him to specialize in helping injured athletes!

Dr. Thomas Sanders, MD, is an orthopedic foot and ankle specialist at the Centers for Advanced Orthopedics in Northern Virginia and Chief of Foot and Ankle surgery for the INOVA Health system. Dr. Sanders specializes in the treatment of ankle arthritis, lower extremity trauma, and fractures of the ankle and foot. He also helps patients in the Washington, DC, area with post-traumatic reconstruction, midfoot and forefoot arthritis, flatfoot reconstruction, and bunions/hammertoes.

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

2 Drills to Improve Your Running Times

If you are a dedicated runner you likely have suffered an injury and maybe even gone to physical therapy. Whether you realized it or not, this injury limited your ability to train effectively.

Here in Bethesda (and soon to be, McLean!), physical therapy involves helping runners overcome injuries that otherwise would limit their ability to train, ultimately causing disappointing results.

There is not a one size fits all solution to helping runners. However, we often discover that runners are limited by the mobility of their hamstrings.

During a run, the hamstrings need the ability to lengthen as the thigh is in front of the body. This should be achieved without drastically changing the position of the pelvis. Many runners struggle to maintain control of their pelvis as the hamstring lengthens. This increases the stress placed onto a variety of soft tissues through the lower body and alters foot strike position.

Hamstrings, like many other muscles, must be strong when in lengthened positions. Otherwise the body will not allow you to keep any of the short-term flexibility improvements that you have made with stretching.

Below are 2 drills that you can incorporate into your strength training routine to improve hamstring strength and flexibility that the body will hold on to!

Kickstand RDL
Single Leg Eccentric Glute Bridge

A thoughtful and more scientific approach to training that is specifically designed for runners is likely all you need to drastically improve your running performance. It may not even require you to train any harder, just smarter!

Runners: don’t miss this part of your training!

Looking to Boost Your Running Performance Without Increasing Volume?

If you’re searching for ways to enhance your running performance without endlessly increasing your mileage, you’re not alone—many of our physical therapy clients in Bethesda have the same goal!

It’s a common misconception that the only path to becoming a better runner is by running farther and faster. While this might ultimately be the aim, strength training is a crucial element in improving overall fitness and race performance.

Incorporating strength training into your regular exercise routine has been proven to enhance running economy (efficiency!) and prevent injuries. These two factors are vital for long-term running success and are consistently emphasized in physical therapy.

More specifically, strength training reduces the risk of injury and boosts muscular endurance. Research shows that regular strength training improves a runner’s speed and VO2 max—the maximum amount of oxygen your body can utilize during exercise.

However, to reap these benefits, it’s important that a runner’s strength training program is properly designed and tailored to their individual goals and characteristics.

Fortunately, most runners share similar objectives: to run faster, run farther, and avoid injury. Strength training programs for runners should therefore focus on exercises that enhance running-specific qualities.

But with so many exercise options available, where do you begin? Starting on your own can be overwhelming.

That’s why we’re offering a FREE workshop designed to teach you the strength training program that will elevate your performance to the next level.

All ages and skill levels are welcome!

What Sprinters Teach Distance Runners

Our physical therapists in Bethesda commonly teach sprinting drills to both distance runners and field sport athletes.

Although distance running and field sports are very different activities, sprinting drills help to correct running form within both groups of people and make a positive impact throughout the physical therapy process.

For runners, sprint training teaches the body to move fast. The greater the speed is that a runner is capable of running, the easier it is to run fast for extended periods of time.

For example, if someone wishes to run a marathon in 4 hours or less, this person needs to average 9:09 minutes per mile. Prior to incorporating sprint training into their routine, this person may have been capable of running 14 mph at maximum speed. After sprint training, this person is now capable of running 15 mph at maximum speed. Due to having a faster maximum speed, running a 9:09 minute mile is now less taxing on the body, therefore requiring less energy to sustain this pace.

For distance runners and field sport athletes, sprinting improves running technique by forcing an individual to pick their hips and knees up in front of their body to larger degree. This helps to change the common habit of kicking legs far behind the body, resulting in further compensations that increase the risk for hamstring injuries among many others.

Check out the video below to learn more about how we coach running technique here at Cohen Health in Performance Bethesda!