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.

Can Hiking Make You A Better Runner?

If you’re running is starting to feel stale or boring, it might be time to switch things up. Officially known as “cross-training” in sports physical therapy, hiking can be an effective training strategy to help prepare for running. From both a physical and mental standpoint, there are several benefits that hiking will have on your running performance.

Aerobic gains with less chance of injury

Hiking is the perfect low-impact cardio alternative to running that vastly decreases the impact on the joints and muscles. Doing this low-intensity activity over long periods can help improve your aerobic engine, which helps new runners.

Engage different muscle groups

In our experience with performance physical therapy in Bethesda and Chevy Chase, we’ve noticed that runners can sometimes rely heavily on certain muscle groups while ignoring other important ones. The uneven terrain of hiking requires lunging and squatting movements, which help activate different muscle groups. Adding hiking to your training can help to utilize less-utilized muscles.

Improves balance and leg strength

Hiking, specifically on uphill climbs, requires you to use your glutes and quads to get over hills. This motion is similar to the act of running and gives the body a chance to exert itself without the added stress of actually running. Maintaining a steady pace while hiking also engages the core and stabilization muscles, improving balance and running form.

Stress relief

Let’s be honest — most runners choose time-saving routes in the neighborhood or treadmill rather than getting out on a trail. Though this is great in a pinch, being in nature can help alleviate stress and anxiety, improve productivity, and increase creativity. By cross-training with a hike, you’ll not only improve your performance but your mental health as well.

CHP Spotlight Interview Series: Dr. Anjali Dsouza

Check out this edition of the CHP Spotlight Interview Series with Dr. Anjali Dsouza. Dr. Dsouza is a physician at the District Center for Integrative Medicine. She specializes in integrative medicine, functional medicine, and is an expert in palliative care, as well as psychiatry! She shared so much incredible information that I know will help us during the injury rehabilitation process!

Single-Leg Strength Training Exercises That Reduce Your Risk of Injury

Years of performance physical therapy have revealed that running injuries are often caused by repetitive stress injuries when running. The better you can control the adverse effects of repetitive stress, the fewer injuries you’ll get as a result.

One simple way to control repetitive stress is by implementing single-leg strength training exercises into your training. The benefits of these exercises are numerous. Not only will single-leg exercises increase a runner’s ability to shock absorb in a single leg position, but they’ll also decrease ground contact times, resulting in faster pacing. Lastly, because of your improved capacity to handle stress, your risk of injury is diminished.

Here are some great single-leg exercises to start incorporating into your strength training routine:

Single-Leg Snapback

Single-leg snapbacks help runners improve footstrike mechanics and better understand the impact of different body positions.

Single Leg Snapback

Single-Leg RDL’s

The single-leg RDL is a perfect exercise to train the glutes and hamstrings effectively. This exercise also helps eliminate strength imbalances between the left and right sides of the body, increasing lower-body stability and protecting the knee from injury.

Single Leg RDLs

Single-Leg Bounding Drills

Bounding drills are great for improving force absorption qualities when running or jogging. These drills will help enforce proper trunk, hip, leg positioning, and control needed to land stably on every stride. There are a couple of great bounding drills, but our favorites are Single Leg Forward Bound + Stick⁠, Single-Leg Forward Triple Bound + Stick, and the SL Lateral Bound + Stick⁠.

Single Leg Bounding

Are You Ready to Start Running Again? This Self Assessment will Help!

Are You Ready to Start Running Again? This Self Assessment Will Help

If ankle injuries occur, it’s important to give your body time to recover. That said, how do you know when you’re ready to run again? This short self-assessment is used in sports physical therapy in Bethesda and Chevy Chase to gauge when patients are ready to return to running after an injury.

Do you have enough dorsiflexion?

Dorsiflexion is the action of moving the foot upwards towards the shin. The degree of dorsiflexion in the foot/ankle plays a major role in avoiding injury, increasing speed, and improving efficiency.

We recommend dorsiflexion of 15 degrees or more before a return to running.

The single-leg hop test

Can you perform a single-leg hop (at least a couple feet) with a soft, steady landing that’s similar between both feet? Athletic physical therapists frequently use the single-leg hop test to determine the patient’s ability to return to high-level athletics after an injury.

https://www.youtube.com/watch?v=ZxvJ7iRawh0

In addition to comparing your results to the accept recovery rates, it’s important to measure how your ankle feels when performing a single-leg hop test. Ideally, the pain level during the test should be 0/10.

Is cardiovascular health good enough?

After several weeks or months of inactivity, there’s a good chance the patient’s cardiovascular health has declined. To return to running safely, it’s important to increase running time and distance gradually. This ensures the body has enough time to adapt to the added stress of running again.

Injuries are bound to happen at some point. The key is to give your body enough time to recover by making sure you don’t return too soon. By following this simple self-assessment, you’ll help ensure you don’t re-injure yourself by returning before your body is ready.

A Physical Therapist’s View: How Does LeBron’s Ankle Injury Impact His Season?

Los Angeles Lakers star LeBron James is out “indefinitely” after suffering a high ankle sprain in a recent game against the Atlanta Hawks. “Indefinitely” paired with “high ankle sprain” is usually a bad sign in the sports world. However, from a performance physical therapy and performance training perspective, LeBron’s injury would likely have been much worse had it not been for his rigorous off-season training program.

A high ankle sprain occurs when there’s tearing or damage to the ligaments (known as the syndesmosis) located above the ankle. Less common than low ankle sprains, high ankle sprains caused by a sudden turning, cutting, or twisting motion. Athletes playing high-impact sports that require frequent running and jumping, such as basketball, soccer, football, and lacrosse, are at higher risk for these more severe sprains.

The average recovery for high ankle sprains can take significantly longer than typical sprains. In general, it takes roughly 6–8 weeks to fully, though it can take up to 3 months in severe cases. LeBron is expected to be out “indefinitely” as he recovers from his recent injury. However, given his intense training and recovery regime, it’s likely that he’ll be back on the court sooner than expected.

After watching the gruesome video of Solomon Hill tripping into LeBron’s ankle, it would have been easy to assume a severe injury. However, LeBron’s off-season training program may have kept his ankle sprain from becoming something more serious. Still dominant in his 18th year in the NBA, LeBron’s continued focus on training and recovery is very apparent. For the past 16 years, LeBron has worked with trainer Mike Mancias, who helped LeBron continue to dominate by focusing on nutrition, mobility, and strength training.

Most people think that strength training can prevent injuries. However, strength training often just prevents injuries from becoming more serious. It’s hard to avoid certain things from happening in a game. That said, off-season training can help prevent injuries from becoming severe.

Two Common Reasons You Have Neck Pain (And How to Fix It)

Neck pain is a common complaint of people seeing a physical therapist in Chevy Chase or Bethesda. Although a variety of different factors can cause it, two of the most common explanations of neck pain and discomfort are rib cage stiffness or overtraining.

One effective treatment of neck pain can be to reduce any rib cage stiffness that may be causing a lack of mobility below the neck. The muscles of the upper back and shoulders attach directly to the neck and can cause tension when unable to expand freely. To have pain-free neck mobility, the rib cage must be able to expand 360 degrees.

One simple method to improve rib cage stiffness is with a breathing exercise such as Rockback Breathing off an elevated surface (see below).

Rockback Breathing on a Bench

Another common cause of neck pain in our patients is overtraining. When patients disregard the warning signs and continue to push themselves, there is an increased stress response throughout the body. This causes the accessory respiratory muscles to work harder, thus developing neck stiffness and discomfort.

If overtraining is the issue, it can help take a couple of days to give your body time to rest and recharge. Similarly, it can be invaluable to work directly with a professional to ensure overtraining doesn’t become a long-term issue. Although it’s enticing to continue to train harder, you can usually achieve better results by giving your body more opportunity to recover.

When your neck pain has persisted for longer than a few weeks, it’s time to meet with a professional who can help identify more subtle reasons for the discomfort. If you’re in the Bethesda or Chevy Chase area, our physical therapists can help you get back to living your life pain-free!