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.

Supinated Feet: When a High Arch Can Be a Problem

If you’re an active adult who deals with a high arch, also known as a supinated foot, you may be unknowingly putting extra stress on your body—especially during running, jumping, and other high-impact activities. As a physical therapist (and someone with this exact foot type), I’ve seen firsthand how a rigid, high-arched foot can lead to aches, pains, and limitations from the ground up.

Let’s break down what’s really going on—and more importantly, what you can do about it.

Supination: What It Is and Why It Matters

Supination is a normal part of how we walk and run. As we push off from one foot to the other, our foot naturally shifts into a supinated position to create rigidity and drive forward momentum. But when that position becomes our default—not just a brief phase of gait—it can become a problem.

A supinated foot has an elevated arch that shifts most of your weight to the outside edge of the foot and the heel. This reduces your ability to absorb shock efficiently and limits how well you distribute force across your foot and up the chain to the knees, hips, and spine.

Over time, this pattern can lead to:

Foot and ankle pain
Knee irritation
Hip tightness or instability
Low back discomfort
Increased injury risk during sports or exercise

Why Physical Therapy Looks at the Whole Chain

At our physical therapy clinic, we don’t just look at the foot—we look at how your body moves as a whole. A rigid, supinated foot places the lower body in a position of external rotation, making it harder for your joints to absorb impact. This sets the stage for chronic stress and eventually injury.

Our goal is to help restore balance—both literally and figuratively—by teaching your body how to load more evenly and absorb force more effectively.

Choose the Right Shoes

One of the easiest places to start is your footwear. If you have a naturally high arch, it may be structural and unlikely to change. But the right shoes can help you feel more evenly grounded, which is essential for stability and performance.

Look for shoes that:

Provide cushioning
Let you feel your entire foot—not just the outside edge
Help you connect with the ground without feeling unstable

Think of it like lying on a bed of nails: when the pressure is evenly distributed, it’s safe. But if you take away some of that support? Ouch. The same applies to your foot—spread the load, reduce the risk.

Train Your Body to Shock Absorb

Beyond shoes, it’s critical to train your body to handle impact. Supinated feet often go hand-in-hand with limited internal rotation in the lower body—a movement pattern that’s essential for shock absorption.

One of our favorite starting exercises in physical therapy for this is a flexion-based squat with a ball or yoga block between the knees.

This helps:

Encourage proper knee alignment
Drive internal rotation through the hips
Teach your body how to enter a loaded, shock-absorbing position

From there, we’ll progress into dynamic drills like jumps, hops, and landing mechanics, all with a focus on controlled loading and healthy joint positioning.

Don’t Ignore the Signals

If you’ve had a history of ankle sprains, foot pain, or feel like your body just “can’t land well,” you may be compensating for a foot type that needs attention. The good news? There’s a lot we can do to help.

At Cohen Health and Performance, we specialize in physical therapy that addresses the root cause—not just the symptoms. If you’re tired of rigid feet, stiff joints, or recurring injuries, let’s talk. I’ve been able to treat this in myself, and we’ve helped countless athletes and active adults find relief and move better.

Need help with your foot mechanics or injury prevention?

Contact us today to schedule a consultation and learn how physical therapy can help you move, feel, and perform better—starting from the ground up.

Why Objective Strength Testing Is Essential in Physical Therapy

In the world of physical therapy, precision is everything—especially when it comes to helping athletes and active adults recover from injury and return to peak performance. Yet, many rehabilitation programs still rely heavily on outdated tools like manual muscle testing (MMT) to assess strength.

While MMT can offer a general idea of a patient’s capabilities, it lacks the objectivity, consistency, and sensitivity required for high-level performance and injury prevention. At Cohen Health and Performance, we believe it’s time to stop guessing and start measuring.

The Limitations of Manual Muscle Testing

Manual muscle testing is a common practice in many physical therapy clinics. A therapist applies pressure to a limb and grades the patient’s strength based on resistance. While this method may help screen for gross weakness, it’s highly subjective.

Key limitations include:

Lack of precision
Inability to detect small, yet important, strength deficits
Inconsistent results between therapists
No ability to track subtle changes over time

When returning an athlete to sport, especially after a major injury such as an ACL tear, rotator cuff strain, or ankle sprain, relying on manual testing alone can lead to premature clearance—and an increased risk of reinjury.

Objective Strength Testing in Modern Physical Therapy

Today’s leading physical therapy practices (like Cohen Health and Performance if I don’t say so myself) use objective strength testing tools to deliver data-driven care. Whether through isometric testing devices, force plates, or handheld dynamometers, the goal is the same: measure what matters and act on real data.

Benefits of objective testing include:

🔹 Identify muscular imbalances
Catch asymmetries or deficits in strength between limbs, which are often invisible with manual testing.

🔹 Set clear, measurable goals
Define baseline numbers and establish precise strength benchmarks for return-to-sport decisions.

🔹 Reduce risk of reinjury
Research shows that inadequate strength—especially side-to-side deficits—increases reinjury risk. Objective testing ensures no major gaps are left unaddressed.

🔹 Optimize recovery timelines
Tracking strength improvements over time allows therapists to adjust training loads and progressions with confidence, ensuring that recovery is both safe and efficient.

Why It Matters for You

Whether you’re an elite athlete or an active adult who wants to stay in the game, data matters. When your recovery is based on objective strength testing, you’re no longer relying on a therapist’s best guess—you’re following a personalized plan grounded in science.

At Cohen Health and Performance, our team uses cutting-edge tools and technology to assess your progress and guide your recovery every step of the way. We don’t just help you feel better—we ensure you’re performing better.

Ready to Get Measured?

If you’re serious about your recovery, performance, and long-term health, physical therapy with objective strength testing isn’t a luxury—it’s a necessity.

Reach out to us at our Bethesda or McLean clinic to schedule your evaluation and experience the difference that data-driven physical therapy can make.

Arm Care Day: The Physical Therapy Routine Every Baseball Player Needs

When you’re deep into a baseball season—logging innings, throwing bullpens, or playing back-to-back games—the demand on your arm is relentless. If you’re not prioritizing recovery and strength maintenance, performance drops… and injuries creep in.

At Cohen Health and Performance, we emphasize one key principle to our baseball athletes: Arm Care Days aren’t optional—they’re essential.

We specialize in physical therapy for baseball players, and one of the most valuable strategies we implement for shoulder and elbow health is a consistent arm care routine. Here’s what a proper Arm Care Day should include—and why it’s a game-changer for performance, injury prevention, and career longevity.

Soft Tissue Work: Restore Mobility and Promote Recovery

Baseball places repetitive stress on the shoulder, elbow, and surrounding tissues. That’s why the first step of any Arm Care Day at Cohen Health and Performance includes soft tissue work to:

Break up adhesions and reduce tissue restrictions
Improve shoulder and thoracic spine mobility
Stimulate blood flow to accelerate recovery between games

This is a foundational aspect of the physical therapy approach we use with our pitchers and field players alike.

Isolated Muscle Activation: Build Stability and Control

Throwing isn’t just about power—it’s about control. And that control starts with the small stabilizing muscles around the shoulder blade and rotator cuff.

Our physical therapy sessions on Arm Care Days focus on:

Rotator cuff activation
Strengthening the scapular stabilizers
Reinforcing neuromuscular coordination

This helps athletes maintain healthy mechanics, reduce stress on the shoulder joint, and build a resilient throwing arm.

Overload Eccentrics: Strengthen the Deceleration Phase

The highest forces in throwing happen after ball release—when your arm has to slow itself down. This is the phase that often leads to overuse injuries if not properly trained.

At Cohen Health and Performance, we use eccentric strengthening drills to:

Improve the capacity of the posterior shoulder and forearm
Build resilience in the tissues responsible for deceleration
Maintain strength under in-season fatigue

This strategy is a staple in our sports physical therapy programs for baseball athletes who want to keep their arms strong all season long.

Why Arm Care Days Matter

At Cohen Health and Performance, we often say:
“Arm care is injury prevention, performance enhancement, and career insurance—all rolled into one.”

Whether you’re a high school pitcher chasing a scholarship or a weekend warrior who still throws heat, prioritizing your arm health will:

Keep you on the field, not in the training room
Help you throw harder, longer, and with better control
Extend your playing career by minimizing injury risk

The Cohen Health and Performance Difference

We specialize in physical therapy for athletes—and that includes creating customized Arm Care routines that are tailored to your position, workload, and goals.

If you’re a baseball player who’s serious about staying healthy and performing at your best, it’s time to make Arm Care Days a consistent part of your training.

📍 Serving athletes across Bethesda and McLean, Cohen Health and Performance is your partner in long-term arm health.

Schedule an evaluation here and take the first step toward a stronger, healthier season.

Why Foam Rolling Isn’t Fixing Your IT Band Pain (And What Actually Will)

If you’re an athletes or runner who’s been dealing with persistent pain on the outside of your thigh or knee, there’s a good chance someone has told you to grab a foam roller and go to town on your IT band.

And if you’ve tried it, you probably noticed that it didn’t do much.

At Cohen Health and Performance, where we specialize in physical therapy for runners, we see this all the time—runners struggling with IT band syndrome who are stretching and rolling with little to no relief. The truth is, there’s a much more effective approach to solving this common issue.

Understanding the IT Band: It’s Not a Muscle

The iliotibial (IT) band is a thick, fibrous piece of connective tissue—known as fascia—that runs from your hip down to the outside of your knee. Unlike muscle tissue, fascia doesn’t stretch or adapt the way muscles do. In fact, in cadaver dissections during our physical therapy training, we saw just how tough and dense this tissue is.

That means your foam roller isn’t “loosening” the IT band. You’re not breaking up tissue adhesions. And you’re definitely not lengthening it. So what can you do?

Focus on the Muscles That Influence the IT Band

The key to managing and eliminating IT band pain lies in addressing the muscles that attach to it:

Tensor Fasciae Latae (TFL)
Gluteus Maximus
Gluteus Medius

These muscles influence the tension and position of the IT band. If they’re tight, weak, or imbalanced, they can pull on the IT band in ways that cause irritation—especially during repetitive activities like running.

Why Hip Mobility Matters

One of the first things we assess in our physical therapy for runners sessions is hip mobility. If your hip joints don’t move well, the muscles surrounding them can’t work through their full range of motion. This can lead to stiffness, compensation, and excessive tension placed on the IT band.

Improving hip mobility creates a healthier foundation for movement and reduces the mechanical stress on the IT band during running.

Strength Balance Is Critical

Another common issue? Muscle imbalances.

For example, if the TFL (front/side of the hip) is more active than the glutes (back of the hip), it can pull the IT band forward and create friction or irritation. A strong, well-functioning gluteal complex helps counterbalance this tension and stabilize the pelvis—especially important with each stride during running.

At Cohen Health and Performance, our team of physical therapists uses targeted strength work to restore that balance and reduce IT band stress.

Pelvis Positioning

How your pelvis and rib cage stack during movement matters more than most runners realize. Many runners adopt an anterior pelvic tilt (hips tipped forward), which changes how muscles like the glutes and TFL function. This posture can amplify IT band tension and make even “normal” movement patterns painful.

Addressing postural habits is an important part of our assessment and treatment process.

Movement Patterns and Running Technique

Finally, we always look at how our patients move—whether it’s squatting, lunging, or running. Movement strategies that rely too heavily on compensation patterns (e.g., overusing the quads or collapsing through the hips) can place unnecessary strain on the IT band.

If you’ve never had your movement or running gait analyzed by a physical therapist, this is a great first step.

Physical Therapy for Runners: Get to the Root of IT Band Pain

The bottom line: foam rolling your IT band might provide short-term relief, but it doesn’t fix the root cause. If you’re dealing with ongoing lateral thigh or knee pain, the answer lies in a comprehensive assessment of your mobility, strength, posture, and movement patterns.

At Cohen Health and Performance, we specialize in physical therapy for runners. We’ll help you:

Identify the true source of your IT band pain
Build a personalized program to restore function and eliminate discomfort
Keep you running stronger, longer, and pain-free

Ready to Get Rid of IT Band Pain for Good?

Visit us at our Bethesda or McLean locations
Click here to schedule a 1-on-1 evaluation with one of our Doctors of Physical Therapy

Don’t let IT band pain sideline your training. Let’s get you back to what you love—stronger and smarter than ever.

Why Are Young NBA Stars Getting Injured?

It’s a tough time for Boston Celtics fans. Star forward Jayson Tatum ruptured his Achilles during the playoffs—effectively ending this season and possibly the next. But what’s even more concerning is that Tatum’s injury is not an isolated case—it’s part of a much larger and troubling trend in professional sports.

As a physical therapy practice focused on performance and injury prevention, we’re seeing patterns that mirror what’s happening in the NBA: young athletes are breaking down earlier than ever before.

Achilles Injuries Are Happening Earlier—and More Often

Tatum is only 27 years old, yet he suffered an injury typically reserved for players in their mid-to-late 30s. He’s now one of six NBA players to tear their Achilles this season—and five of them are still in their 20s:

James Wiseman (24)
Dejounte Murray (28)
Dru Smith (27)
Isaiah Jackson (23)
Jayson Tatum (27)
(Damian Lillard was the only exception, at a more expected age for this type of injury)

These numbers are highly unusual. Achilles tears and other serious injuries used to be far less common among young, elite athletes.

All-Star Absences Are Surging

In addition to the Achilles tears, six NBA All-Stars missed games due to injury in just the first two rounds of this year’s playoffs. For comparison, from 1995 to 1999, only four All-Stars missed time during the entire playoffs over that five-year span.

Even more alarming: since 2008, the rate of injury among NBA stars has increased fivefold.

What’s Causing This Spike?

The issue goes beyond just bad luck or harder training. According to NBA insiders and medical professionals, the answer often starts much earlier—in youth sports.

1. Year-Round Competition with No Off-Season

Many young athletes, especially in sports like basketball, participate in year-round leagues such as AAU. They may play 3–5 games in a single weekend, and their bodies never get a true off-season to recover.

2. Early Sports Specialization

Specializing in one sport too early limits the body’s movement diversity. This repetitive stress on the same joints, muscles, and tendons builds up over time, making injuries more likely. When athletes don’t cross-train or play other sports, they don’t develop the balanced resilience that helps protect them from breakdown.

3. Wear and Tear by Age 18

As a result of #’s 1 and 2 above, medical teams at the NBA combine have noted that 18-year-old prospects often show the wear and tear of much older veterans. This is not normal—and it highlights just how early these issues start.

What Can Be Done?

As physical therapists, we believe injury prevention starts long before an athlete turns pro. Here are a few key recommendations for youth athletes and their parents:

Incorporate an off-season: The body needs time to recover, rebuild, and adapt.
Delay sports specialization: Stick with multiple sports through at least middle school.
Monitor playing volume: Be mindful of back-to-back tournaments and long weekends.
Prioritize movement quality: Incorporate strength, mobility, and recovery work into training.

How Physical Therapy Can Help

At Cohen Health and Performance, our goal is to keep athletes healthy—both in the short and long term. We work with youth athletes, collegiate hopefuls, and even professionals to:

Develop individualized injury-prevention programs
Monitor physical load and movement patterns
Guide athletes through proper recovery protocols
Provide strength and conditioning support tailored to each athlete’s body

If you’re a youth athlete (or the parent of one) with dreams of playing in college or beyond, the time to act is now. Reducing the risk of injuries today can mean avoiding setbacks that derail your career tomorrow.

Want to learn more or schedule an evaluation? Contact us here. We’d love to help you stay healthy and strong for the long haul.

Why Are ACL Injuries So Common in Female Athletes—and What Can Be Done?

This weekend, I came across an article that caught my eye: “A WNBA Veteran Becomes the Latest Player to Suffer an ACL Tear.” The athlete mentioned was Katie Lou Samuelson of the Seattle Storm—shockingly, the third player on her team to suffer an ACL tear before the WNBA season even begins.

As a physical therapist who works with athletes of all levels, this hit home. ACL injuries are far too common, especially among female athletes. According to the American Journal of Sports Medicine, females are 4 to 8 times more likely to suffer an ACL tear compared to their male counterparts playing the same sport. Even more alarming—over 70% of these injuries are non-contact. That means they’re not the result of a collision, tackle, or fall. They just happen—or so it seems.

But these injuries are not freak accidents. There are clear biomechanical and muscular risk factors that we, as physical therapy professionals, can help address.

Understanding the Risk Factors

One of the most commonly discussed reasons for higher ACL injury rates in females is anatomical structure, particularly the Q-angle—the angle formed by the hip and knee. Due to a generally wider pelvis, many female athletes have a more pronounced Q-angle, which can result in the thighs angling inward (valgus alignment). This creates a greater tendency for the femur to internally rotate and adduct, particularly during high-speed or high-impact movements like jumping, cutting, or landing.

When combined with muscle imbalances, such as strong quadriceps and weak hamstrings or glutes, the risk increases. A poor quadriceps-to-hamstring strength ratio can reduce the knee’s ability to stabilize itself, leaving the ACL vulnerable to tearing under stress.

How Physical Therapy Can Reduce the Risk of ACL Injuries

Preventing ACL injuries is not just about stretching or doing a few leg exercises. A comprehensive physical therapy approach includes:

1. Strengthening the Right Muscles

To protect the knee, we must target the muscles that slow down internal rotation and adduction of the femur—primarily the glutes and deep hip rotators. Strengthening the hamstrings, calves, and core also plays a vital role in protecting the knee joint.

2. Improving Muscle Coordination and Timing

Being strong isn’t enough. Athletes must be able to generate force quickly, particularly during sport-specific movements. That means physical therapy needs to go beyond the weight room.

We bring our athletes to our turf space to practice jumping, landing, cutting, and acceleration drills that simulate real-game scenarios. We analyze landing mechanics and correct faulty movement patterns before they show up on the court or field.

3. Using Data to Guide Programming

Every athlete we work with is evaluated using force plates and other sports technology to understand how their body handles force and movement. This data helps us create a personalized plan to address the specific deficits or imbalances that could lead to an ACL injury.

The Bottom Line: ACL Injury Prevention Starts with Smart Physical Therapy

ACL injuries are devastating. They can take an athlete out of the game for a year or longer. But the good news is—there are things you can do to reduce the risk.

If you are the parent of a female athlete or an athlete yourself and you’re serious about protecting your knees, now is the time to take action. Our ACL prevention programs at Cohen Health and Performance are tailored to each athlete and built on the principles of scientific assessment, personalized physical therapy, and performance training.

📞 Contact us today to schedule an assessment and give yourself the best shot at staying healthy, strong, and on the field.