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.

An Alternative to X-Rays and MRIs

This week’s article is written by Dr. Michael Auriemma, a member of Regenerative Orthopedics and Sports Medicine. He is a key member of our physical therapy team here in Bethesda and Chevy Chase and has helped many athletes, active adults, and runners overcome injury in conjunction with a comprehensive physical therapy plan. Dr. Auriemma specializes in sports and musculoskeletal medicine, and has received extensive training in the use of sports ultrasound for both diagnostic and interventional procedures.

He is the perfect person to tell us about an alternative solution to X-rays and MRIs that also happens to be a lot easier, quicker, and more pleasant to use!

Enjoy!

Regenerative Orthopedics and Sports Medicine (ROSM) is a growing private practice centered in the DMV. It is comprised of physicians who specialize in non-operative orthopedic and sports medicine.

ROSM physicians strive to provide a higher quality of care through extended patient visits (ie. more 1 on 1 time with patients) and the use of diagnostic musculoskeletal ultrasound, a bedside tool that allows for real-time imaging of muscle injuries, tendon and ligament injuries, fascia injuries, arthritis, and nerve entrapments.

In certain situations, ultrasound can eliminate the need for X-rays or MRIs, while other times it serves as a complimentary imaging modality.

In addition to advanced diagnostics, ultrasound can also be utilized to guide targeted treatments to enhance recovery. These include prolotherapy, platelet rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and microfragmented adipose transfers (MFAT).

ROSM physicians help patients choose appropriate treatments through a combination of evidence-based research and individual patient needs.

Visit our website to learn more!

-Dr. Michael Auriemma, MD

CHP Spotlight Interview: Dr. Scott Faucett

Do not miss this interview with internationally renowned orthopedic surgeon, Dr. Scott Faucett! Dr. Cohen and Dr. Faucett discussed a myriad of different topics that pertain to the worlds of physical therapy, athletics, performance, and surgical medicine. This interview is a MUST SEE if you are experiencing any hip or knee pain, or simply wish to learn more so that you can increase the longevity of these joints!

Reach out to Dr. Faucett via the information below

scottfaucettmd.com

(202) 912-8480

clinical@scottfaucettmd.com

Special guest post on regenerative medical treatment

The fields of athletic performance physical therapy and regenerative medicine frequently intersect. Today, we’re featuring a special guest post by Dr. Mayo Friedlis, a renowned physician at Stem Cell Arts in Chevy Chase and a certified Regenexx provider. With over 20 years of experience in regenerative therapies, Dr. Friedlis has been practicing since 1983 and brings a wealth of knowledge to the table.

At CHP, we often receive questions about regenerative medicine—a relatively new and exciting field. You might be wondering: What exactly is regenerative medicine? Does it really work? Could it benefit me?

Dr. Friedlis graciously took the time to address these questions and more. Check out the valuable insights he shared below!

What is Regenerative Medicine?

Regenerative therapies harness the body’s natural ability to heal itself by using growth factors, stem cells, or platelets from the patient’s own body. These treatments stimulate healing and tissue regeneration, offering a non-surgical solution for many injuries. But when should you consider regenerative medicine?

Many injuries naturally heal over time with proper exercise and rehabilitation. However, when pain persists despite these efforts, regenerative therapies might be the next best step.

It’s important to think of regenerative medicine differently from surgical interventions. Surgery is often considered a last resort, something we turn to only when all other options have failed and our quality of life is significantly affected.

Regenerative therapies, on the other hand, are most effective when used earlier in the recovery process. By stimulating the body’s healing mechanisms, these treatments can prevent further damage and degeneration of tissues. If first-line treatments aren’t enough and you’re still unable to return to the activities you love, it might be time to consider regenerative therapies.

The Importance of Early Intervention

The earlier you explore regenerative therapies, the better your chances of fully recovering from an injury. For athletes, managing pain alone isn’t enough; it’s critical to address the root cause of the injury. Regenerative therapies, much like sports physical therapy, focus on healing the source of the pain rather than just masking symptoms. This is where these therapies truly shine.

What Type of Regenerative Therapy is Right for You?

A common question is which type of regenerative therapy to choose. The answer depends on the specific injury and the structure involved.

– Prolotherapy and PRP (Platelet-Rich Plasma) are particularly effective for ligament and tendon injuries, such as rotator cuff tears, hip labrum issues, meniscal tears, or other ligamentous injuries.

– Stem cell treatments are more suited for conditions like joint degeneration or osteoarthritis, where more advanced tissue regeneration is needed.

The severity of the injury also plays a role. For example, smaller tears in ligaments, tendons, or the meniscus often respond well to PRP or prolotherapy. However, more significant tears may require the use of stem cells. Similarly, mild arthritis can be treated with PRP or prolotherapy, while severe arthritis typically benefits from stem cell therapy.

– Dr. Mayo Friedlis, MD

3 Indications You Should Ignore a Social Media Post

Today there is more access to information then ever. This access to information is no more prevalent than in the realms of health, medicine, fitness/performance, or any other area of athletic physical therapy. Anyone with a social media account can quickly find thousands of posts related to these topics which creates a whole new challenge.

Because everyone can promote themselves as an expert on social media, it is essential to have a discerning eye for quality information. Unfortunately, social media platforms, such as Instagram, do not promote posts based on the validity of the information presented.

Amongst such a vast array of information, how do you determine when you should ignore a social media post related to health, fitness, or performance physical therapy information?

The presenter speaks in absolutes. Commonly the best answer that a professional can give you is “it depends.” The reason for this is that a person’s experience is context dependent and is the result of several different factors that must be considered together. For example, stretching or improving mobility is often promoted as a “fix” for a given injury. However, this does not apply to those that have more important problems to solve or possess full range of motion in the area being discussed. For more information on this topic, check out our post on Is Mobility Overrated? Furthermore, it is impossible to know of every possible factor that could be contributing to pain, injury, limitations, or challenges. Therefore, even the best among us cannot claim to be 100% certain, especially on social media.
The information is unnecessarily complicated. An expert can take a complex topic and break it down so that it makes sense to you. Overly complicated terminology and unnecessary use of medical jargon are red flags that the presenter may not fully understand the material being presented.
Promoting personal success stories as evidence. Personal success stories are anecdotal. The definition of anecdotal is “not necessarily true or reliable, because based on personal accounts rather than facts or research.” Many medical and fitness professional post personal success stories as evidence for the validity of their method, approach, or something that they are attempting to market. This ignores all the other factors that may have contributed to these results (see #1 above). Even if the results being presented are valid, it only applies to the person being shown. Quality research commonly requires thousands of trials before being considered valid. A case study of 1 or 2 people only applies to the people being referenced and ignores your unique circumstances.

**Bonus: If a presenter promotes “quick fixes”, run!

Discerning quality from poor information is very challenging in the modern age. Everyone can promote themselves as an expert, however there are several ways to determine when it is best to ignore a presenter. These are just a few of several ways that you can do so.

Photo Credits

“Social Media” by MySign AG is licensed under CC BY 2.0

Why We Need to Stop Comparing Adult Movements to Children’s

It has become common in fields of physical therapy and performance training to compare adult movement to the ways that babies move. You may have spoken to a professional that uses this comparison in their approach.

The logic usually goes something like this…“Humans were born with the ability to squat fully, and our modern lifestyles robbed us of that ability, so we need to regain it.”

Sounds understandable, right?

I thought so too. I even took a couple of continuing education courses based loosely upon this concept. The class instructors showed pictures of babies at various development stages and attempted to teach movements that mimicked these phases. The idea was to help adults gain back some of the movement capabilities that they once had as children and this new freedom of movement would help to alleviate pain and resolve injury.

Adults Are Not Babies

While I think we’d all love to be able to squat to the floor, crawl around all day, and never get tired, the truth is that we are not babies anymore.

Babies have a large amount of joint laxity that allows them to get into a variety of different positions, that we don’t have as adults. Babies also have a very large head in relation to the body, which helps to provide a counterbalance for easy squatting. In fact, according to Healthline, many of a baby’s bones are composed of cartilage, a type of connective tissue that is tough but flexible. This cartilage turns to bone as we grow.

Their bodies are still growing and changing. They fall often and make mistakes (essential for learning), which flexibility and mobility help with. Because of this, the ability to squat to the floor is normal for a baby. The same cannot always be said for adults.

Adults are not babies, and we cannot use a baby’s movement as a model for how an adult should move. Not only do babies have much different bone and structural compositions, but all adults have different movement capabilities due to variations in torso lengths and body proportions (among other reasons). Using singular movement standards would overlook this critical aspect.

It is nice to think that we could be able to squat to the floor like we once did when we were a toddler. However, adults are not babies, and our bodies are not the same as they once were.

Because of this, we do not expect our physical therapy patients to squat to the floor. It is essential for all of us to set realistic movement standards that will help to live pain-free and healthy lives. For help in the arena, talk to our experienced physical therapy team in Bethesda!

Want to return to running after an ankle sprain?

Ankle sprains are often dismissed as minor injuries, yet they frequently lead runners and other athletes to seek physical therapy.

The seriousness of these injuries is frequently underestimated, with athletes returning to their activities too soon.

The most common type of ankle sprain that we see in physical therapy is an inversion sprain, where the foot typically remains planted as the ankle turns inward, causing the outer edge of the foot to roll onto the ground—hence the term “rolled ankle.” This motion damages the ligaments on the outside of the ankle, often leading to varying degrees of tears.

The severity of the injury and the number of ligaments affected determine the grade of the sprain, ranging from grade 1 to grade 3.

After an ankle sprain, it’s crucial to rule out a fracture. Athletes should seek an X-ray if they are unable to bear weight on the injured leg or experience severe pain around the malleolus (the prominent ankle bone on the outside).

If no fracture is found and the aforementioned symptoms are absent, the focus can shift to gradually returning to running.

During running, there is never a moment when both feet are on the ground simultaneously. This means the body is continuously bouncing from one leg to the other, placing repeated stress on the ankles as they absorb the full impact of the body.

Unfortunately, after an ankle injury, the capacity of the affected area to handle stress (the cumulative amount it can bear before re-injury) is significantly reduced. As a result, recovery from an ankle sprain often takes longer than expected, with many athletes attempting to run before their ankle has fully healed.

To ensure a safe recovery, injured tissues need to gradually reacclimate to the stress associated with running or other sports.

A careful and progressive return to running might start with non-weight-bearing movements, gradually advancing to low-impact, weight-bearing exercises such as squats, split squats, and lunges. From there, single-leg activities like balance drills and single-leg squats can be introduced, followed by plyometric exercises involving two-legged jumps, and eventually, hopping on one leg.

Finally, activities such as jump roping, short runs, and longer runs can be reintroduced into the routine.

In summary, every ankle sprain is unique, making it essential to have a trained medical professional assess the injury to rule out a fracture. This professional can then design a personalized return-to-sport program tailored to your needs.

For further assistance and information on how we can help, you know where to find us!