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.

What All Rotational Athletes Must Be Capable Of (Part 2)

The best ability is availability.

Rotational athletes come to physical therapy for help for with a variety of different overuse injuries (for more information, check out part 1 here). These injuries are the result of an excessive amount of stress placed onto one area which exceeds the body’s ability to tolerate.

Excessive stress accumulates in a particular area (often the lower back) as it is forced to pick up the slack from another area of the body that is not doing its part. Injury rehabilitation often involves discovering what these areas are.

Many times, it is the hips.

The hips are large joints with powerful muscles (ex. The glutes) surrounding them. This area should be generating the power to make things easier elsewhere.

The med ball hip toss teaches the body to generate rotational power at the hips and ultimately propel the ball through the arms. Once you have mastered this drill, step things up and give the perpendicular med ball throw a shot!

Do you feel your body is getting beat up during golf, tennis, or baseball? Come discover the root cause of your discomfort and specific strategies to address it. Visit our website to schedule a FREE phone consultation with a member of our team! Link in bio.

What All Rotational Athletes Must Be Capable Of

Low back pain with golf or arm pain with throwing. At our performance physical therapy practice, we see this constantly.

Swinging a golf club, throwing a baseball and hitting a tennis ball involve a great deal of rotation. Many areas of the body should be involved in these movements, however that is not always the case.

It is common to see baseball pitchers that are experiencing arm issues demonstrate the habit of trying to “arm” the ball as they throw it. There is not much contribution from the legs which places a great deal of stress on the arm and over time results in overuse injuries.

Many golfers and tennis players experience lower back pain because they do not effectively link the power that they generate in the lower body through the trunk, into the upper body and ultimately to the head of the club. As a result they compensate elsewhere, placing increased stress onto the lower back.

The rotational row is a great drill to train the body to generate rotational power through the legs and connect it through the trunk. View this exercise here.

Once you have mastered the rotational row and learned how to link the power generated in the lower body to the trunk, we can now add in the upper body! The rotational lift trains the body to generate rotational power through the legs and connect it through the trunk and arms. Check this exercise out here.

Interested in learning more ways you can address lower back pain while enjoying your active lifestyle? Sign up for a FREE phone consultation today!

A different form of shoulder strength

Building Shoulder Strength in End Ranges: How Physical Therapy Can Prevent Injury

Many shoulder injuries that bring athletes to physical therapy are the result of overuse or instability when the shoulder reaches its end range of motion. Whether you’re lifting weights, throwing a ball, or performing overhead movements, your shoulder is vulnerable when pushed to its limits.

It’s common to assume that the solution to these issues lies in increasing flexibility through stretching and mobility drills. While flexibility is important, it’s only part of the equation. The real issue often lies in a lack of strength and stability when the shoulder is in these extreme positions.

Why Strength at End Range Matters

When the shoulder reaches its end range of motion—whether during an overhead press, a throw, or any extreme movement—your muscles can’t generate the same amount of force as they can when the shoulder is in a more neutral position. This weakness leaves the shoulder joint less stable and more prone to injury.

Without the ability to control the joint at these extreme ranges, you’re at an increased risk of instability-related injuries such as shoulder dislocations or subluxations. Over time, these challenges can lead to wear and tear on the shoulder joint, causing issues like rotator cuff tears, labral injuries, or impingement syndromes.

However, there’s good news! By incorporating targeted physical therapy exercises, you can train your shoulder to be strong even in these vulnerable positions. Strengthening the muscles that support the shoulder at end range can significantly reduce your risk of injury and improve your overall performance in sports and daily activities.

Strengthening the Shoulder in End Ranges with Physical Therapy

At its core, physical therapy is about improving movement quality and building strength where it’s needed most. For athletes and active individuals, this often means focusing on increasing shoulder stability in the ranges of motion where injuries are most likely to occur.

Here’s where physical therapy really shines—helping you develop strength at the edges of your mobility. Instead of simply increasing flexibility, we work to build strength and control in these end ranges. This approach not only enhances performance but also prevents injuries by ensuring that your muscles can stabilize the shoulder joint in even the most extreme positions.

PAILs and RAILs in Shoulder Rehab

One of the best ways to strengthen the shoulder at end range is through Progressive Angular Isometric Loading (PAILs) and Regressive Angular Isometric Loading (RAILs) exercises. These exercises involve applying tension to the muscles in both their stretched and shortened positions, helping to increase both flexibility and strength in end ranges.

For example, Shoulder Flexion PAILs with a Lift Off Challenge and Shoulder External Rotation PAILs with a Lift Off Challenge are highly effective exercises for targeting the muscles that stabilize the shoulder when it’s in its most extended and rotated positions. These exercises focus on developing strength while the joint is near its limit of movement, allowing for greater control and reducing the likelihood of injury.

I recently demonstrated these drills to a group of CrossFit athletes, who need exceptional shoulder strength and stability to lift heavy weights overhead and perform complex movements. However, you don’t need to be a CrossFit athlete to benefit from these exercises. Whether you’re involved in overhead sports like swimming, tennis, or volleyball, or simply want to improve your shoulder health, these exercises are fantastic for anyone looking to build strength and prevent injuries.

Exercises to Try:

1. Shoulder Flexion PAILs with a Lift Off Challenge

2. Shoulder External Rotation PAILs with a Lift Off Challenge

Why Physical Therapy is Key for Shoulder Health

Incorporating these types of exercises into your routine can dramatically improve your shoulder strength and stability, particularly in those vulnerable end ranges of motion. Working with a physical therapist ensures that you’re doing the exercises correctly and progressively, so you can safely build strength without putting your joint at risk.

A physical therapist will assess your specific needs, tailoring exercises to your unique shoulder mechanics and helping you regain control over your movements. With proper guidance, you can significantly reduce your risk of injury and improve your overall performance in your sport or daily life.

Ready to Strengthen Your Shoulders and Prevent Injury?

If you’re experiencing shoulder pain or instability, or if you want to improve your strength in end ranges of motion, physical therapy can help. Contact us today to learn how a tailored treatment plan can get your shoulders strong, stable, and ready for anything life or sport throws your way!

How Focusing on Mental Health Improves Physical Therapy Outcomes

Can focusing on mental health improve outcomes in physical therapy?

Yup!!

This concept is challenging to grasp because the medical system often tries to attribute physical pain to a direct cause. However, it isn’t that simple and this is important for every physical therapist to understand.

Humans are complex and physical pain is influenced by several different factors. One of which is the brain.

An individual’s mental state has a large impact on their physical state and the effectiveness of physical therapy interventions.

Do not miss the latest episode of the CHP Spotlight Interview series with Dr. Kelly Forys Donahue and Dr. Danielle Miro from DC Health Psychology (www.dchealthpsychology.com).

Check out the full interview here.

Photo Credit

“World Mental Health Day Observance” by United Nations Photo is marked with CC BY-NC-ND 2.0.

1 Trick to Perfect Running Foot Strike Position

If you ever experience back pain when running, are a runner that has been to physical therapy, or are curious about foot strike position, this article is for you!

One of my favorite workshops to conduct is the CHP Running Technique and Performance lab. I have a blast throughout the workshop, but the Q&A portion is my favorite. I have gotten the opportunity to answer many different questions which have forced me to expand my knowledge and has helped me to create a better workshop over time.

While the questions that I receive consistently differ, one topic remains consistent. Someone inevitably asks about foot strike position and my answer often surprises them.

There is no correct foot strike position.

Among other things, foot strike position is dependent on an individual’s body dimensions (limb length as an example) and the position of the body above.

While we cannot change your anatomy, we can change the position, aka the posture, of our bodies.

A “stacked” posture will facilitate a foot strike that occurs directly underneath the body. This foot strike position results in a more efficient stride and minimal stress to the body. To learn about the stack, check out a previous article that I wrote on Learn to Stack Like a Snowman.

Attempt the drill below to feel what it is like to have a stacked posture while running.

Grab a partner and ask him/her/they to stand behind you (you are also standing)
Have your partner press down on your shoulders with a moderate amount of force and do not let them squish you
As you resist them you should feel your abs engage and feel as if you are standing tall
Next, attempt to shift your weight onto 1 leg and pick up your opposite foot while resisting the force of your partner
Try the other leg

For a video on this drill, click here.

After performing this drill, you should have a better sense of your optimal running posture. Try to replicate this feeling the next time you go on a run!