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.

Maybe You Don’t Need Rotator Cuff Surgery After All…

When someone hears the words “rotator cuff tear,” the first thought is often surgery. But many people with rotator cuff tears (even full-thickness ones) get better without ever going under the knife. At Cohen Health & Performance, we see this every day, and the latest research continues to back it up.

What the Research Says About Rotator Cuff Tears

At the Mid-Atlantic Shoulder and Elbow Symposium, Dr. John Kuhn of Vanderbilt University presented a study following nearly 500 patients with rotator cuff tears. His team found that 75% of patients improved with physical therapy alone—even when the tears were large or full-thickness, as long as they were atraumatic (developed over time, not from a sudden injury).

Even more impressive? These results held up over 10 years. Many patients regained shoulder function, reduced their pain, and returned to the activities they enjoyed, without surgery.

Other studies show that even when rotator cuff repairs are performed, the repaired tissue often re-tears. Surprisingly, many patients still feel better functionally after rehab. This suggests that the real difference-maker may be the physical therapy and rehabilitation process, not just the surgery itself.

Why Rotator Cuff Physical Therapy Works

So how does physical therapy help when the rotator cuff itself is damaged? At CHP, our shoulder physical therapy programs focus on much more than just the torn tendon. We work to strengthen and coordinate the entire shoulder complex, including:

Rotator cuff strengthening: Targeted exercises to build resilience in the cuff itself.
Scapular control: Training the muscles around the shoulder blade to support the shoulder joint effectively.
Trunk and core integration: Teaching your body how to move as a unit so your shoulder isn’t overloaded during sports or daily activities.

By improving strength, mechanics, and control, we help the shoulder function more efficiently, reducing pain and restoring performance, even in the presence of a tear.

When Surgery Still Makes Sense

Of course, surgery isn’t off the table for everyone. In cases of traumatic injury (like falling directly on the arm), or when physical therapy fails to provide relief, surgical repair may be the right option. But in many cases, trying shoulder physical therapy first is the safer, more effective, and less invasive choice.

Should You Try Physical Therapy Before Surgery?

If you have shoulder pain or a diagnosed rotator cuff tear, you don’t have to rush into surgery. The best next step is often a structured program of shoulder physical therapy.

The worst-case scenario? It doesn’t solve the issue, and surgery becomes necessary.
The best-case scenario? You avoid surgery altogether and get back to the activities you love—stronger than before.

If you are ready to take the next step, contact us and schedule your evaluation to solve your shoulder pain and return to the activities that you love.

Get It Girl (new program announcement)!

Today we have a special guest post and announcement from Dr. Catherine Biddle!

Dr. Biddle here. As a former collegiate gymnast, I know firsthand how essential weightlifting and targeted strength training are to athletic success—both individually and as a team. Unfortunately, when I was a high school athlete, those benefits were not emphasized. At the time, the common misconception that females shouldn’t—or didn’t need to—be in the weight room was still very present. Looking back, I believe that missing out on proper strength training contributed to the major injuries that sidelined me and kept me away from the sport I loved (at least this gave me more experience on the patient side of physical therapy!).

That’s exactly why I created Get It Girl—a small-group strength training program designed specifically for girls ages 11–14 who want to build confidence, train safely, and unlock their full athletic potential.

In this program, your daughter will get:

8 Weeks of In-Person Coaching — Focused on strength, technique, and safe movement.
4-Week At-Home Plan — To keep making progress between sessions.
Exercise Video Library — Step-by-step demos with form cues she can use anytime.

Spots are extremely limited—only 5 spots remain—so don’t wait. Click here now to learn more, reserve your daughter’s place and give her the foundation she needs to stay safe, grow stronger, and thrive in her sport.

If you have any further questions, feel free to reply to this email as well.

Don’t let this opportunity pass by—help your daughter build the strength and confidence she deserves!

-Dr. Catherine Biddle

Shoulder Pain Physical Therapy: Understanding and Managing Shoulder Instability

In just a couple of weeks, I’ll be part of a panel at the Mid-Atlantic Shoulder and Elbow Society Conference, sitting alongside several orthopedic surgeons as the lone physical therapy representative. Our panel topic: shoulder instability—a complex condition that affects many active adults and young athletes.

Why Shoulder Instability Matters

Shoulder instability is a challenging issue because it can be caused by a variety of factors and present in several different ways. The shoulder is the most mobile joint in the human body, but that same mobility makes it the most unstable.

With great mobility comes great responsibility. When the ligaments and tendons that normally stabilize the shoulder can’t provide enough support, the demand shifts to our muscles and nervous system to keep the joint under control. This is where physical therapy becomes essential.

How Physical Therapy Helps with Shoulder Pain and Instability

A well-designed rehab program for shoulder instability doesn’t just treat pain—it addresses the underlying mechanics that protect the joint and restore performance. Proper physical therapy can:

Improve ribcage and shoulder blade control – helping reduce stress on the shoulder joint.
Strengthen the rotator cuff – allowing it to more effectively stabilize the joint during activity.
Integrate improvements into movement strategies that carryover to sport – ensuring athletes and active adults can safely return to the demands of their sport or daily life.

Rehab vs. Surgery: Making the Right Choice

While there are times when surgery is necessary, physical therapy for shoulder pain and instability can often help determine whether non-surgical care is a viable option. The best surgery is the one you can avoid. Once a shoulder has been operated on, it’s never quite the same—the tissue has been altered, and function changes over time.

That’s why early intervention is so important, especially for young athletes such as baseball players who place high demands on their shoulders. Addressing pain and instability early can make all the difference in avoiding long-term damage and reducing the likelihood of surgery.

Take Action Early

If you or your athlete is dealing with shoulder instability or persistent shoulder pain, don’t wait. Getting evaluated by a skilled physical therapist can help you understand the cause, create a personalized plan, and in many cases, avoid the need for surgery.

Athletic Physical Therapy for Hypermobility

I’ve been practicing as a physical therapist for nearly 15 years, and one of the biggest changes I’ve seen in that time is the increasing number of people coming in with concerns about joint hypermobility. Some have been formally diagnosed with conditions like Ehlers-Danlos Syndrome or Hypermobility Spectrum Disorder, while others simply recognize that their joints are “loose” and it’s causing pain or limiting their performance.

The increased awareness is a good thing. Many people now understand that hypermobility can create unique challenges — but also potential advantages — especially for athletes and active adults. Let’s break down what that means, and how physical therapy for hypermobility can help.

What Is Hypermobility and Why Does It Matter?

Hypermobility refers to joints that move beyond the normal range of motion. Some people are naturally stiffer, while others are naturally looser — and this is all normal. But when joints are excessively mobile, problems can arise.

For example:

Benefits: In sports like gymnastics, dance, or baseball, extra mobility can be a huge asset. A pitcher’s ability to throw, or a gymnast’s ability to achieve extreme positions, often comes from this mobility.
Risks: Without proper strength, those same joints may lack stability. This can lead to pain, frequent sprains, hyperextension injuries (such as knees that bend backward), or even dislocations in vulnerable joints like the shoulder.

Why Stretching Isn’t the Answer

If you’re hypermobile, you don’t need more stretching. Your tissues are already like loose elastic bands — they can lengthen easily, but they don’t always provide enough support or rebound.

What you really need is protective stiffness. Think of it as giving that elastic band more “snap” so it can put on the brakes when stretched too far. This stiffness not only protects your joints but also adds athletic qualities like spring, bounce, and efficiency.

The Role of Physical Therapy for Hypermobility

When our physical therapists at Cohen Health and Performance work with athletes or active adults who are hypermobile, our focus is on strength training and joint control rather than flexibility. A tailored hypermobility physical therapy program may include:

1. Foundational Strength Training

Building muscle strength around joints is the first step. Strong muscles provide the support that loose ligaments and tendons can’t.

2. Isometric Exercises

Isometric holds — such as wall sits or split squat holds — help build protective stiffness in specific positions.

3. End-Range Strength Training

Athletes with hypermobility often have extreme ranges of motion. But can they control those ranges? Strengthening at the end of a joint’s range (such as the shoulder in overhead positions) helps protect against dislocations and injuries where the joint is most vulnerable.

Signs You May Benefit from Physical Therapy for Hypermobility

You may want to seek out a physical therapist if you:

Experience joint pain in multiple areas
Notice your knees, elbows, or fingers hyperextend past straight
Have a history of recurrent sprains or dislocations
Feel like your joints “give out” during activity
Want to safely improve performance in a sport that demands extreme mobility

Hypermobility isn’t always a problem — in fact, it can be a real advantage in the right sport. But without strength and stability, it can quickly become a source of pain and injury.

At Cohen Health and Performance, we specialize in helping athletes and active adults with hypermobility build strength, develop protective stiffness, and optimize performance. Whether you’ve been diagnosed with a hypermobility-related condition or you’ve simply noticed your joints feel “too loose,” we can create a personalized physical therapy and strength training program to help you stay healthy and strong.

If you’re ready to take control of your hypermobility, contact us today to schedule an evaluation.

From the Field to the Physical Therapy Clinic: Common Fall Sports Injuries We’re Seeing

The fall sports season is officially here in the DC area!

Athletes are returning from their summer break, easing back into practices, and—unfortunately—we’re already starting to see a familiar trend in our clinics: a rise in sports-related injuries.

At Cohen Health and Performance, with locations in McLean and Bethesda, we work with athletes every fall who develop issues as they ramp up their training and competition schedules. Whether it’s a cranky knee, a sore ankle, hip discomfort, or a soft tissue strain, these injuries can derail a season before it really gets going.

Why Are Athletes Getting Injured at the Start of the Season?

The start-of-season injury spike often happens for two main reasons:

Sudden Increase in Training Volume
Some athletes simply aren’t fully prepared for the jump in intensity that comes with daily practices, scrimmages, and games. Even if they’ve stayed active over the summer, their bodies may not be ready for the sport-specific demands of their season.
Mismatch Between Off-Season Training and In-Season Demands
Many athletes train hard in the summer—lifting weights, running, and following conditioning plans from coaches—but those workouts don’t always replicate the unpredictable, reactive movements of live gameplay. Without that sport-specific preparation, even well-trained athletes can still get hurt.

The Importance of Sport-Specific Preparation

The best off-season training programs start general and gradually become more specific to the sport as the season approaches. This ensures the athlete’s muscles, tendons, and ligaments are ready for the exact movements they’ll face on the field or court.

For example, football is highly reactive—players must change direction quickly in response to opponents. Our video above shows one hurdle based drill that we use in our McLean and Bethesda physical therapy clinics. The athlete reacts to an unpredictable cue, changing direction while clearing hurdles—just like they might have to do in a game. This type of training prepares the body for rapid deceleration, re-acceleration, and sudden direction changes.

Why Deceleration Training Matters

Many injuries, especially hamstring strains, happen during deceleration—when the body must slow down rapidly. The hamstring works hardest when it’s putting on the brakes during sprinting, and if it’s not prepared for that high force, injury risk skyrockets.

That’s why we integrate drills designed to strengthen the hamstring’s ability to decelerate quickly, reduce injury risk, and keep athletes competing at their best.

Free Injury Consultations for High School Athletes

Right now, our McLean physical therapy location is offering free injury consultations for high school athletes returning to play.

If your son or daughter is:

Complaining about pain in a joint or muscle
Recovering from a recent sports injury
Feeling “off” since the season began

…our team can help identify the problem, address it quickly, and get them back to playing without missing significant time.

These consultations are performed by our expert sports physical therapy team in McLean, including myself, Dr. Matt, and Dr. Sam. We’ll assess the injury, pinpoint the cause, and provide sport-specific drills to get the athlete back to full strength as quickly as possible.

Don’t Wait—Act Early

The earlier we address sports injuries, the faster athletes can return to pain-free performance. If you’re in the McLean or Bethesda area and want to make sure an injury doesn’t sideline your athlete this season, contact us today to schedule an appointment.

Are You Really Out of Alignment? What You Need to Know Before Your Next Adjustment

“I think my hips are out of alignment.”
“My pelvis feels shifted.”
“My sacrum must be twisted.”

These are phrases we hear all the time at Cohen Health and Performance. If you’ve ever said something similar—or been told this by a friend or provider—you’re not alone. The idea of being “out of alignment” is a commonly held belief and often used to explain nagging pain or movement issues. But here’s the truth:

Your body is built to move—and that includes your pelvis.

Understanding “Misalignment”

Let’s clear something up: your pelvis, hips, and sacrum are supposed to move. With every step you take, your pelvis naturally rotates, shifts, and adapts. This isn’t dysfunction—it’s a sign of a healthy, dynamic system.

The sensation of being twisted or “off” often comes from the body favoring one side over the other. It’s not that you’re structurally broken. It’s that your movement patterns are biased—and over time, those biases can create imbalances that feel like misalignment.

Why Do We Get Stuck in These Patterns?

Most people have a natural tendency to favor one side, especially the right. Why?

We’re mostly right-handed
We carry kids, bags, or groceries on the right
Even society is designed for right-handers (think door handles, tools, etc.)

This daily repetition subtly trains our bodies to prefer the right side. Over time, this can show up in the gym—like when one leg feels stronger during a leg press—or in daily life, where you feel “off” or stuck on one side.

But here’s the important part: you don’t need to be cracked, popped, or adjusted repeatedly to fix it.
You need a plan to address the underlying cause.

A Smarter Approach to Feeling “Realigned”

One of our go-to exercises at Cohen Health and Performance (see the video at the beginning for a demonstration) is a drill that retrains how the body pushes off the right side to shift weight to the left. Here’s what it looks like:

Lying on your back with your right foot on a wall
Left leg lifted with the hip in flexion
Pushing through the arch of the right foot to activate the right glute

This simple but effective movement mimics what your glute should do during walking, sprinting, or cutting—helping you get off the right side and balance your body’s movement patterns.

Done consistently, drills like this can help you:

Reduce your reliance on constant adjustments
Improve strength and control in underused muscles
Feel more balanced and symmetrical in daily life and workouts

Physical Therapy That Addresses the Root Cause

At Cohen Health and Performance, our goal isn’t just to “fix” you temporarily.
We help you understand why you feel off in the first place—and give you the tools to stay better aligned through movement, not manipulation.

Whether you’re looking for physical therapy in Bethesda or physical therapy in McLean, our team specializes in performance-based care that empowers you to move better, feel stronger, and stay pain-free.

Ready to Stop Chasing Adjustments?

If you feel like your body is out of alignment—or you’ve been told that it is—it’s time to dig deeper. Contact us today to schedule an evaluation. We’ll help you understand what’s really going on and create a plan that actually sticks.