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.

Don’t Be an Alligator

One of the most fascinating lessons I ever learned came from a course taught by a Louisiana native. He opened by describing how to wrestle an alligator—not exactly what I expected in a physical therapy context. But as he unpacked the metaphor, it turned out to be a great analogy for human movement and performance.

Here’s how it goes: When wrestling an alligator, you want to jump on its back, grab its snout, and make it arch and extend. Why? Because when the alligator arches, it can’t do its death roll. And if you get caught in that roll, it’s game over.

What does this have to do with physical therapy? As human beings, we’re surprisingly similar to the alligator in this regard. When we arch and extend excessively through our spine, we lose the ability to rotate effectively. This limitation has huge implications for activities that require rotation, such as golf, baseball, tennis, running, and even walking. Rotation is a foundational movement pattern that keeps us functional, efficient, and injury-free.

Avoiding the Alligator Trap

So, how do we avoid becoming the human equivalent of an alligator? It all starts with understanding how to stack our ribcage and pelvis properly.

Imagine a snowman with three balls stacked on top of each other:

Top ball: Your head
Middle ball: Your ribcage
Bottom ball: Your pelvis

For optimal movement, these three “balls” need to be aligned. When your ribcage and pelvis are stacked, your spine has the freedom to move in all directions—rotation, side bending, and flexion/extension. This alignment also allows you to build strength in functional positions, which has the greatest carryover to sports and everyday activities.

Practical Application: The Role of Load Placement

One key way we apply this concept in physical therapy and training is by being mindful of where the load or weight is placed relative to the body. Let’s take the squat as an example.

The traditional barbell back squat—where the barbell rests behind your head on your shoulders—often pushes the body into an arched and extended position. This makes it difficult to maintain a stacked posture, limiting your rotational capacity and potentially leading to back discomfort.

Instead, we recommend exercises where the load is placed more in front of the body. Two great options include:

Goblet Squat: Holding a kettlebell in front of your chest helps keep your ribcage and pelvis stacked.
Safety Bar Squat: A safety bar shifts the weight slightly forward, promoting better alignment.

A good indicator that you’re doing these exercises correctly is feeling your abs engage rather than your lower back. This feedback ensures you’re maintaining a stacked position and avoiding the “alligator trap.”

How Physical Therapy Can Help

If you’re experiencing pain, struggling with movement, or simply looking to optimize your training, physical therapy can provide tailored solutions. At Cohen Health and Performance, we ensure that your programming carries over to the activities that matter most to you. Whether you’re a golfer, runner, tennis player, or just someone who wants to move better, we’re here to help.

Don’t let poor movement patterns hold you back. Contact us today to take the first step toward pain-free, efficient movement—and remember, don’t be an alligator!

Core Training Reimagined

When I create training programs for our physical therapy or performance training clients here at Cohen Health and Performance, one of the most common requests I hear is, “Hey Zac, can you add more core training?” Or, “Can you give me a core circuit to put into my routine?”

But here’s the thing: Most of us don’t train our core as effectively as we could—at least not in a way that matches how our core is designed to function. Let’s rethink core training together.

What Does Your Core Really Do?

Your core—your trunk—is so much more than just a six-pack waiting to be revealed. Its primary function is to manage internal pressure and support your body against gravity. Think of it as your body’s central stability system.

To help you visualize this, imagine the iconic wacky waving inflatable tube man you see outside car dealerships. That tube man is held up by air pressure. If you fill it with maximum pressure, it stands tall and firm. But if you let some air out, it becomes more flexible and moves with the wind. Let out too much air, and it collapses entirely.

Your core operates in a similar way. When you need maximum stability—like lifting a heavy object—you brace hard to build internal pressure, stabilizing your spine and supporting the load. On the flip side, for everyday activities, you rely on just enough core engagement to keep you upright and mobile, without overexerting yourself.

Core Training: Beyond Crunches and Planks

So, how does this translate into smarter core training? It starts with understanding that the core’s role goes beyond traditional exercises like crunches or static planks. Instead, think of your core as a dynamic stabilizer, adapting to different demands in sport, exercise, and daily life.

During physical therapy or performance training at Cohen Health and Performance, we focus on exercises that challenge the core’s ability to:

Reposition the pelvis. For example, certain drills help align the pelvis in an optimal position for athletic performance or functional movement.
Maintain pressure and support the spine. Exercises like the body saw are excellent for this. The body saw challenges your abs to prevent your belly from sagging toward the ground—a movement gravity constantly encourages. The stronger your abs, the better they counteract this pull, giving your spine the support it needs.
Engage during full-body movements. Did you know that a perfectly executed squat or deadlift can give your abs a serious workout? Core engagement is critical during these exercises to stabilize your trunk and prevent injury.

One of the biggest mistakes I see in gyms is improper technique during “core” exercises. For example, take the plank. Many people let their belly sag toward the ground, leaning on their lower back for support instead of engaging their abs. Over time, this can lead to discomfort and even injury.

Proper core training requires awareness of your body’s position and the intent behind each movement. That’s why we incorporate a variety of drills in our programs—not just for the sake of variety but to train the core in ways that reflect its real-life function.

Ready to Elevate Your Core Workouts?

If you’re looking for inspiration, check out the exercises on our YouTube page. You’ll find everything from pelvis-positioning drills to challenging moves like the body saw. And remember, core training isn’t just about isolating your abs. It’s about integrating them into your movements—squats, deadlifts, and even overhead presses can be incredible core exercises when done correctly.

So, the next time you think about adding core work to your routine, ask yourself: Am I training my core to look good, or am I training it to function well? The best part? You don’t have to choose one or the other. With intentional training, you’ll get both.

Let’s build that pressure, stabilize that spine, and transform the way you think about core training.

Why Distance Runners Sprint in Physical Therapy

If you’re a distance runner training for a 5K, 10K, half marathon, or even a full marathon, the idea of sprinting might seem a bit strange. After all, why would you focus on short bursts of speed when your goal is to cover long distances? Surprisingly, incorporating sprints into your training can significantly boost both performance and injury prevention. As physical therapists often emphasize, sprinting can make a big difference in improving biomechanics and reducing injury risk. Let’s dive into why distance runners should sprint and how it can benefit your training.

Raise Your Speed Ceiling

Think of sprinting as raising the ceiling of what your body is capable of. Imagine you’re driving a car. If the car has a top speed of 100 mph, cruising at 60 mph feels easy. But if your car’s top speed is only 70 mph—like the 1991 Mercury Topaz I drove in high school—going 60 mph might feel like it’s about to fall apart.

The same principle applies to running. If you increase your top-end speed through sprinting, running at slower paces for longer distances will feel much easier and more efficient. In other words, sprinting improves your speed reserve, enabling you to sustain faster paces during races without exhausting yourself. In physical therapy we often recommend sprinting as a way to condition the muscles and nervous system to handle faster speeds efficiently.

Injury Prevention Benefits

Sprinting isn’t just about getting faster—it also plays a critical role in injury prevention. When you sprint, you naturally strike the ground underneath your body rather than reaching out in front of you. This reduces the braking forces that occur when your foot lands too far forward.

Remember Newton’s Third Law from high school science? Every action has an equal and opposite reaction. When your foot lands ahead of your body, the ground pushes back against you, creating extra stress on your feet, ankles, knees, hips, and lower back. Over time, this repetitive impact can lead to discomfort, inefficiency, and even injuries. Many physical therapy programs focus on drills and techniques similar to sprinting mechanics to retrain the body and reduce injury risk.

Sprinting teaches you to land underneath your center of mass, reducing impact forces and improving running mechanics. It also builds elasticity in your joints, making you more springy and bouncy. This elasticity helps you spend less time on the ground with each foot strike, which adds up to faster, more efficient running over long distances. Physical therapy principles emphasize the importance of joint elasticity to enhance performance and lower injury risk.

Simple Ways to Incorporate Sprinting

The good news is that you don’t need to overhaul your training plan to start reaping the benefits of sprinting. You can incorporate a few sprint drills into your warmups or cross-training sessions without adding excessive stress to your body. These drills are also often included in physical therapy sessions focused on improving running mechanics.

Some great drills to get started include:

A-March – Focus on proper posture and knee drive.

A-Skip – Adds rhythm and coordination to the marching movement.

Step-Over Drill – Enhances knee lift and foot placement.

Performing a couple of sets of these drills as part of your routine can make a big difference. These exercises help reinforce proper running mechanics and prepare your body for both speed and endurance. If you’ve ever attended a physical therapy session, you may recognize some of these movements as foundational drills to improve mobility and stability.

Take the First Step

Not sure where to start? Check out our YouTube page for detailed demonstrations of these drills. For those of you who have been training with us for a while, you might even recognize a familiar face in the videos!

Sprinting might not seem like the obvious choice for a distance runner, but it’s one of the most effective ways to elevate your performance and protect yourself from injury. Start small, stay consistent, and watch how your running transforms. If you’re struggling with any specific discomfort or mobility issues, consider reaching out to our physical therapy team to guide you through personalized strategies.

Break Free from Desk Stiffness: Physical Therapy Tips for Active People

Do You Feel Stiff After Sitting All Day?
If you’re like many of our physical therapy patients, you spend hours sitting at a desk for work or school. Whether you’re locked into meetings, answering emails, or studying for exams, long periods of sitting can leave your body stiff, sore, and uncomfortable. Sound familiar? You’re not alone!

Hopefully, you had a chance to break the cycle over the holidays, but now that you’re back in your routine, you might be feeling that tightness again. Don’t worry—there’s good news. Today, we’re going to share strategies we use with our physical therapy clients to help reset the body and get you moving comfortably again.

Why Sitting Can Make You Stiff
Think about what happens when you sit for hours on end. Your posture often slumps forward, and the muscles in the front of your chest stay in a shortened position. Over time, this can make them feel stiff and restrict their movement. And when those muscles don’t move as they should, they’re not prepared for activity later—like hitting the gym after work.

Picture it like taking a car that’s been idling all day and suddenly flooring the gas pedal. That’s a recipe for poor performance—or even injury. But don’t worry—there are simple ways to reset your body before you train, and we’re here to help!

The Role of Breathing in Mobility
Breathing may seem simple, but it plays a huge role in how your body feels and moves. Your rib cage is designed to expand and compress like an accordion with every breath. When you sit slouched for hours, your rib cage can’t expand fully. That leaves the muscles around it—especially in your chest, back, and neck—stiff and unable to move properly.

Good breathing mechanics not only improve mobility but also help your muscles reset, making you better prepared for activity. Let’s go over two quick breathing drills we often use with our clients to unlock stiffness and get their bodies ready for action.

Drill 1: Hook-Lying Overhead Reach

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Lie on your back with your knees bent and feet flat on the floor.
Roll your pelvis slightly underneath you so your lower back gently flattens against the ground.
Reach your arms overhead without letting your ribs flare up.
Focus on deep inhales that expand your chest and exhales that compress it back down.

This drill teaches your rib cage to expand and compress properly, reducing tightness in your chest and shoulders. Do 2-3 sets of 5 deep breaths before upper-body workouts.

Drill 2: Crab on Elbows

Sit on the floor with your knees bent and your hands behind you, resting on your elbows.
Press your chest up slightly, creating a gentle stretch in your pecs.
Inhale deeply, directing the breath into the front of your chest, and then exhale fully.
Focus on slow, controlled breathing, feeling your chest expand and compress with each breath.

This position exaggerates the stretch in your chest muscles, helping to reset them for movement. Aim for 2 sets of 5 breaths before workouts or whenever you feel stiff during the day.

Ready to Feel Better? We Can Help.
These drills are great for giving your body a quick reset, but if you’re dealing with ongoing aches, pains, or stiffness, a more customized approach might be what you need. At our clinic, we specialize in helping active people get back to doing what they love—pain-free.

Visit our website to learn more about how we can help you tackle your specific challenges. Whether you’re recovering from an injury or just want to move and feel better, we’re here to help you reach your goals.

Don’t let stiffness hold you back—take the first step toward feeling your best today and contact us!

Our most popular physical therapy article of 2024

Here’s a little gift—our most popular article of 2024, just for you!

“My Doctor Said I’m Cleared to Play!”

My patient was thrilled. After months of physical therapy, recovering from knee surgery, she finally received the green light to return to playing soccer.

Unfortunately, I had to bring her back to reality.

The surgeon had done an excellent job—the surgery went smoothly, the knee healed perfectly, and there was no swelling or pain. But while his job was complete, mine was far from over.

Despite making significant progress in physical therapy, the muscles around her repaired knee were still about 30% weaker than those on the other side. Our force plate technology (learn more about that here) revealed that her ability to absorb shock on the repaired side was compromised, and her reaction time was slower.

As much as I wanted to give her the news she was hoping for, allowing her to return to play immediately would have put her at high risk of re-injury.

This scenario is common and understandable. It’s easy to think that physical therapy is over when the doctor says, “you’re cleared.” But in reality, it’s just the beginning.

“Cleared” means the doctor’s role is complete, and now it’s up to us to ensure that you return to play, training, or your active lifestyle as safely as possible.

So, how do we determine when you’re ready to get back in the game? Here are a few key factors we continuously assess throughout the rehab process:

Range of Motion: Should be equal to the other side.
Strength Testing: The previously injured side should be within 10% of the uninjured side, but ideally, it should be equal. We utilize our technology to make it objective and take away any guesswork.
Functional Testing: Specific to your sport or activity.
- Hop or Jump Testing: Measures your ability to absorb impact and produce force on one side compared to the other. Should be within 10% of the uninjured side, but ideally equivalent. This also gauges how reactive or “bouncy” one side is compared to the other—the closer to equal, the better!
- Running Analysis: Learn more about that here!
- Throwing Assessment: For baseball players and other throwing athletes

The last thing anyone wants is a re-injury or a new injury because the body wasn’t 100% ready to return. A thorough return-to-play assessment is essential for anyone looking to resume their sport, activity, or active lifestyle as safely, quickly, and effectively as possible.

Contact us with any questions that you have about how you can ensure that you or your athlete is ready to get back in the game!

Why “corrective exercises” in physical therapy fall short

Back when I was in physical therapy school, I also worked as a strength and conditioning coach with athletes at Northeastern University. Part of our job was to include “corrective” exercises in every training session to address mobility limitations or movement issues. These were low-intensity stretches commonly seen in physical therapy, mobility drills, and other movements that athletes did as part of their warmup.

The idea was solid: reduce the risk of injury by fixing underlying issues. But with 15 years of experience now, I’ve realized that this approach wasn’t as effective as we thought.

The issue with these types of exercises is that they are often performed at an intensity that is too low to produce significant results. Whether you’re a competitive athlete or a recreational gym-goer, your body is used to exerting significant effort when you play, train, or compete. To be effective, corrective exercises need to match that intensity. Your body adapts to effort, not passive movements.

At Cohen Health and Performance, we approach corrective exercises differently. We design customized corrective exercises tailored to each individual. For our physical therapy patients, these are incorporated into their daily routines as “daily essentials” or performed independently before exercise. For our training clients, these correctives are strategically woven into warmups or the training session itself.

But here’s the thing: the best corrective exercise is simply exercise done correctly.

When you perform any exercise with proper technique and enough intensity to challenge your body, it becomes “corrective.” Progress happens when the body is forced to adapt, whether that’s by increasing resistance, moving faster, working through a broader range of motion, or training in a fatigued state.

A strong body is a resilient body—especially when it’s strong through a wide range of motion and capable of handling stress in various conditions. That’s why mastering foundational lifts and progressing them step by step is far more effective than running through a long list of low-effort exercises.

Take the barbell deadlift, for example. It’s a fantastic exercise that can double as a “corrective” for athletes with hip mobility issues or back pain. It challenges core, glute, and hamstring strength while teaching the body how to create intra-abdominal pressure to protect the lower back. It might take time to safely progress to heavier weights, but the payoff is immense: a back that’s strong, resilient, and ready to handle stress.

Watch our Deadlift Tutorial below for tips on how to perform this powerful lift safely and effectively.

We also emphasize high-level movement quality in the end stages of rehab. For athletes, this means testing their ability to maintain excellent form and strength, even under fatigue. This is a critical step to ensure they’re fully prepared to return to their sport or activity.

Check out the video below to see how we approach end-stage rehab for athletes.

If you’re ready to move better, feel stronger, and get back to doing what you love, let’s make it happen. Schedule an evaluation with one of our expert Doctors of Physical Therapy today. Click here to get started.