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.

Surgery or physical therapy?

“Do I Need Surgery? “

If you’ve faced a significant injury and are anything like our sports physical therapy patients, this question probably crossed your mind.

It’s natural to think of ourselves like machines: when something breaks, we believe it needs fixing. But here’s the reality—you’re not a machine, and surgeons aren’t mechanics simply “repairing” broken parts.

In fact, surgeons are more like cleanup crews addressing the aftermath of accumulated wear and tear. And the truth is, many injuries don’t require surgical intervention to heal effectively.

A comprehensive review published in the prestigious Journal of Orthopaedic & Sports Physical Therapy (JOSPT) found no consistent evidence that surgery outperforms non-surgical care in nine different areas of the body. That’s huge!

Now, let’s be clear: surgery has its place. If you’ve suffered a major trauma—like a displaced fracture or a complete rupture of the ACL or Achilles tendon—surgery might be the only path to regaining functional mobility. In these cases, surgical intervention is necessary to restore structural integrity for sports or daily life.

But what about injuries that don’t fit this profile? Chronic pain, nagging injuries, or wear-and-tear issues often drive people toward surgery, believing it will “fix” the problem. Here’s where things get tricky: research consistently shows that surgery doesn’t always deliver long-term benefits, especially when it’s used to address conditions better managed with active, non-invasive approaches like physical therapy.

Surgery doesn’t address the root cause of injuries. If strength deficits, or movement limitations/compensations led to the damage in the first place, those same issues will persist post-surgery unless properly addressed. It’s like mopping up a spill without fixing the leak—temporary relief, but the problem will return.

Active interventions, such as physical therapy, strength training, and movement re-education, can often help you avoid surgery altogether. These approaches focus on restoring balance, improving function, and addressing the underlying factors contributing to pain or injury.

Here’s what you can do to take charge of your health and minimize the need for surgery:

Get Moving: Movement is medicine! A good physical therapist can create a scientifically designed plan tailored to your needs, helping you regain capabilities necessary for the activities that you love.
Address Lifestyle Factors: Stress, poor sleep, and inactivity can all affect your body’s ability to heal. Prioritizing holistic wellness is key.
Be Patient: Healing without surgery takes time, but the results are often more sustainable and come with fewer risks.

Even when surgery is the best option, it’s crucial to address the underlying issues during recovery. Comprehensive rehabilitation ensures you won’t be revisiting the operating room down the road. Think of it as “fixing the leak” while cleaning up the spill.

So, before you consider going under the knife, ask yourself: Have I explored every active option to restore my health?

If you’re dealing with an injury and unsure whether surgery or physical therapy is the right path for your recovery, we’re here to help you figure that out. Schedule an evaluation with one of our expert Doctors of Physical Therapy today and take the first step toward getting back to what you love. Click here to get started.

Traditional physical therapy advice resulting in a fragile spine

Have you been told to always keep your back straight and stiff when lifting? When it comes to preventing back pain, the truth is, it’s not as simple as that.

For years, the advice to lift with a “perfectly straight back” has been the go-to solution, but there’s no solid evidence that it reduces back pain or injury. Surprised? Let’s explore why this outdated advice might be holding you back and how back pain physical therapy can help you build a stronger, more resilient back.

Debunking the “Straight Spine” Rule

The idea of lifting with a straight, neutral spine has been considered the gold standard for decades. It seems logical: keep your back rigid to keep it safe. But studies reveal that this advice hasn’t reduced back injuries in the workplace. Why? Because back pain isn’t caused by a single factor like lifting posture.

Back Pain: A Multifactorial Issue

Back pain is influenced by many factors—age, fitness level, recovery habits, stress, and even sleep quality. If you’ve experienced back pain after lifting, chances are the issue wasn’t simply bending your spine. The root cause is often a combination of problems, like poor endurance, lack of strength, or inadequate recovery.

Physical therapy for back pain can help you address these factors by improving your overall strength and movement capacity, rather than just focusing on how you lift.

Why Avoiding Spinal Flexion Can Be Harmful

The advice to “never bend your back” can actually weaken your spine over time. Avoiding natural movements like bending or twisting may leave your back less prepared for real-world demands.

Think about it: everyday life involves movements like lifting a laundry basket, picking up a child, or twisting to grab something off a shelf. Avoiding these actions doesn’t protect you—it makes your back less adaptable and more vulnerable to injury.

Through physical therapy, you can safely reintroduce these movements and build the confidence and strength needed to handle life’s physical demands.

How to Build a Strong, Pain-Free Back

Preventing back pain isn’t about avoiding movement—it’s about building strength and resilience. Here’s how physical therapy can help:

Train for Everyday Life: Your physical therapist will guide you through exercises that mirror real-world movements, like squats, deadlifts, and rotational lifts.
Gradual Progression: With a personalized plan, you’ll start with lighter loads and progress over time, preparing your spine for various challenges.
Movement Variety: Learn how to lift using different techniques—straight back for heavier loads, rounded back for lighter ones—to build adaptability and confidence.
Listen to Your Body: If a movement feels painful, your therapist will help you modify it and reintroduce it as you get stronger.

The Role of Physical Therapy in Back Pain Recovery

If you’re recovering from a back injury, physical therapy for back pain can help you uncover the root cause of your discomfort and create a tailored plan to address it. This approach not only relieves pain but also prevents future issues by improving strength, mobility, and movement patterns.

Take Control of Your Back Pain Today

Rigid rules like “always lift with a straight back” oversimplify a complex issue. Instead of avoiding movement, embrace it. With the right guidance from physical therapy, you can prepare your back for life’s twists and turns while building strength and resilience.

If you’re ready to overcome back pain and get back to the activities you love—whether it’s the gym or everyday tasks—schedule an evaluation with one of our expert Doctors of Physical Therapy. Click here to get started!

Let’s build a stronger, pain-free back together. Because when it comes to your spine, you’re stronger than you think.

Avoid injuries with these sports physical therapy tips

What helps elite athletes avoid serious injuries and maintain peak performance? It’s not just skill or power—it’s their pillar strength. Pillar strength, commonly referred to as core strength, forms the foundation of efficient, injury-free movement. A strong pillar allows you to break through training plateaus, improve your performance, and significantly reduce your risk of injuries.

As the saying goes, “You can’t fire a cannon from a canoe.” Just like a cannon needs a stable base, your body needs a strong and stable pillar to generate and transfer power effectively.

What Does Pillar Strength Really Do?

Forget the idea of doing endless crunches or sit-ups to build a stronger core. Your pillar strength isn’t just about aesthetics—it’s about stabilizing the spine and pelvis while controlling forces generated by your arms and legs. When your pillar doesn’t do its job, energy leaks occur, reducing performance and increasing injury risk.

Example: The Sprinter

Picture a sprinter accelerating down the track. If their lower back arches excessively (anterior pelvic tilt), the spine can’t absorb or transfer the energy created by their legs. This results in their powerful hip extension being wasted. The root issue? Their spinal stabilizers aren’t working efficiently to counterbalance the forces from their hips.

Why Pillar Strength Matters in Sports Physical Therapy

Pillar strength is important in every direction of movement—not just forward and backward. Let’s break it down:

1. Rotational Strength (Transverse Plane)

Imagine a baseball pitcher winding up for a throw. They need to rotate their trunk efficiently to deliver a powerful and accurate pitch. Weakness in the transverse plane can cause “energy leaks,” reducing throwing velocity and increasing the risk of injury. This is a common issue we address in sports physical therapy, using rotational core drills to stabilize and strengthen this motion.

2. Lateral Strength (Frontal Plane)

Cutting, landing, or maintaining balance during sports relies heavily on frontal plane strength. Weakness here can lead to a hip drop (Trendelenburg sign) during single-leg movements, creating instability that puts stress on the knees. This instability is a key contributor to injuries like ACL tears, especially in youth athletes. In sports physical therapy, we include frontal plane exercises to improve single-leg stability and prevent these injuries.

Build a Strong Foundation with Sports Physical Therapy

At Cohen Health and Performance, our sports physical therapy programs in McLean and Bethesda focuses on developing pillar stability to enhance athletic performance and prevent injuries. Whether you’re recovering from an ACL reconstruction or aiming to reach new performance levels, building pillar strength across all planes of motion is critical.

Ready to Elevate Your Game?

Take the next step in your athletic journey with a Performance Physical Therapy Evaluation. Our expert team specializes in sports physical therapy to help you move better, perform stronger, and stay injury-free.

Click here to schedule your evaluation today!

Exercises that I don’t do anymore as a physical therapist

If you’re an active adult who values fitness and staying in peak condition, you’ve probably encountered the occasional advice on “must-do” exercises. But, as our bodies and needs evolve, certain exercises may no longer serve us as well as they once did, or they may come with risks that outweigh their benefits. At Cohen Health and Performance, we’re committed to helping clients in Bethesda and McLean stay active and injury-free with exercise choices that prioritize safety and effectiveness.

Recently, I was chatting with a former colleague about the early mornings we used to spend training professional athletes. Back then, our routines were packed with intense, high-demand exercises designed to build serious strength and endurance. But over the years, I’ve fine-tuned my approach and adjusted my own workouts, replacing some exercises with alternatives that are safer and yield excellent results—especially for those of us who aren’t competing professionally but still want to stay strong and healthy.

Here are two exercises I no longer include in my routine, along with the safer, more efficient alternatives I recommend to clients who want to build strength and minimize injury risk.

1. Moving Beyond the Plank: Core Stability Without the Strain

Planks are a classic core exercise and have become wildly popular for strengthening the abdominals and shoulders. However, planks aren’t always ideal for everyone. Holding a plank for extended periods or performing them without perfect form can put excessive strain on the lower back, which is especially risky if you have existing back issues or aren’t engaging the right muscles.

Instead of traditional planks, I now recommend bear variations, like the bear crawl or bear plank. Bear variations are dynamic and can be modified to target core stability and strength without placing undue stress on the lower back. The bear plank, for example, involves holding a position on all fours with knees hovering just above the ground. This position naturally activates your core muscles while keeping the spine in a better position, significantly reducing the risk of back strain.

For active adults in Bethesda looking to maintain core stability and train safely, bear variations are a great choice. They challenge the core in a more effective way, promoting good posture and balance—skills that are essential not only in the gym but in everyday activities.

2. Replacing the Barbell Back Squat: Safer Alternatives for Building Lower Body Strength

Another staple of strength training is the barbell back squat, an effective exercise for building lower body strength and muscle mass. However, barbell back squats lots of mobility and solid form to avoid injury, especially to the lower back. For many people, this level of mobility and movement competency isn’t practical without extensive preparation, and the risks may outweigh the benefits.

Safer alternatives like goblet squats and safety bar squats offer the same benefits with less risk. Goblet squats, which involve holding a weight in front of your chest, are accessible for most people and help engage the core, which can further protect the lower back. Safety bar squats, which use a specially designed bar to keep weight distributed more comfortably, allow for better form and greater ease in maintaining an upright posture. Both exercises are fantastic for strengthening the legs, glutes, and core while minimizing the risk of injury associated with traditional back squats.

For active adults focused on maintaining mobility and avoiding injury, these squat alternatives offer a way to build lower body strength without the complexity and potential drawbacks of a barbell squat. If you’re working with a physical therapist in Bethesda, they may even recommend these variations as a part of your strength-building routine, especially if you’re managing previous injuries or aiming to improve overall stability and function.

The Power of Purposeful Exercise Selection

When designing a workout program, one of the most important questions to ask is: What is the goal of this exercise? For most active adults, the goal is to build strength, look good, and avoid injury—keeping you strong and capable for years to come. At Cohen Health and Performance, we focus on exercises that provide maximum results with minimum risk. By selecting exercises that target the right muscles without overloading the joints, we create workouts that help you achieve your goals safely and sustainably.

Our philosophy is simple: every exercise in your program should have a clear purpose, whether it’s improving strength, boosting flexibility, or enhancing functional movement. This approach guides all the programs we create, from personal training sessions to physical therapy in Bethesda and McLean, helping clients stay active and reduce the likelihood of injury.

Build a Safe, Effective Training Program with Physical Therapy in Bethesda and McLean

If you’re an active adult looking to refine your workout routine, avoid injury, or just get a professional’s perspective on your training, we’re here to help. Our team of physical therapists and exercise specialists in Bethesda and McLean have the expertise to create a program that’s tailored to your goals and abilities, using exercise strategies designed to keep you moving, strong, and injury-free.

Questions about how to build a safe, effective training program? Contact us today at Cohen Health and Performance to schedule an appointment. Together, we’ll design a plan that fits your lifestyle and keeps you active, healthy, and ready for whatever physical challenges come your way.

Speed Kills: tips to gain that extra edge

As a parent of a high school athlete aiming to compete at the collegiate level, you understand that speed can make all the difference. Faster athletes often outshine their competition, even in physical sports like football, where speed is a game-changer. Fortunately, there are proven ways to help your athlete enhance their speed and give them a competitive edge, whether they’re on the field, track, or court. Below are drills that we incorporate with our sports physical therapy and performance training clients.

Speed Training Essentials for Aspiring College Athletes

Boosting speed requires a comprehensive approach that goes beyond simply moving faster. Here are three key areas to focus on for your athlete’s speed development.

1. Master the Basics

Just like any other skill, sprinting has specific techniques and the mechanics are where we start as sports physical therapists and performance coaches. Practicing sprint mechanics, such as proper foot strike, forward knee drive, and core activation, is fundamental to achieving an efficient stride. Incorporate drills that reinforce these mechanics, such as marching, skipping, and high-knee runs. These simple yet effective drills provide a strong foundation and encourage form that can help increase speed safely.

Recommended Drills:
– A March

– A Skips

– Stepover Drills (Shin Height)

2. Build Strength in Key Muscle Groups

Running fast requires strength, especially in muscles like the quads, hamstrings, calves, and core. Building strength in these areas is essential not only for speed but also for power, endurance, and injury prevention. Compound lifts and single-leg strength exercises targeting these muscle groups are highly effective in making strides more powerful and reducing the likelihood of injury.

Strength Training Exercises:
– Standing Hip Flexion With Band

– Front Foot Elevated Heel Raise

– Copenhagen Hold with Reach

3. Practice Accelerations and Sprint Drills

A well-rounded speed training program includes work on both acceleration and top-speed mechanics. Acceleration drills help athletes reduce the time it takes to reach their maximum speed, while sprint intervals build stamina for sustained performance. Integrating these drills into regular training can drastically improve an athlete’s on-field performance.

Suggested Speed Drills:
– Wall Acceleration Series

– Sprinter Step Up

Sprint Workouts:
– Flying 10s: Build speed over 20-30 yards, sprint for 10 yards, then slow down.
– 10×10: Sprint for 10 yards, then decelerate quickly; repeat 10 times.

Performance U: A Program for Aspiring College Athletes

For parents of high school athletes dreaming of college-level sports, consider our Performance U small group training program. Performance U is designed specifically to help young athletes develop the speed, strength, and stamina needed to excel at the collegiate level. Your athlete will receive a personalized performance assessment and a custom-designed speed and strength program, coached by our expert team. They’ll train in a supportive, small-group environment that combines personalized attention with the camaraderie of a team.

Give your athlete the best possible foundation for their college sports career. Performance U offers everything they need to stay ahead of the competition and stand out to college scouts. If you are interested, contact us here!

Running Tips and Community Building with Coach Sweeney

Don’t miss this exciting edition of the CHP Spotlight Interview Series, featuring Dustin Sweeney, Co-Founder and Executive Director of Light Horse Track Club in Northern Virginia.

Light Horse Track Club is more than just a running team; it’s a vibrant community and a trusted resource for runners of all levels across Loudoun and Fairfax counties. Whether you’re just starting out on your running journey or you’re a seasoned marathoner, Light Horse offers a supportive and dynamic environment where every runner can thrive. Beyond building an inclusive team culture, the club hosts high-caliber races that unite the Northern Virginia running community.

In this interview, I sat down with Dustin to uncover how a strong culture and community can play a pivotal role in a runner’s experience and development. We discussed the ways Light Horse supports runners through community-driven training, social events, and tailored support, including advice on often-overlooked aspects of a runner’s regimen—areas where physical therapy for runners plays a crucial role. Dustin shared insights into how understanding the biomechanics of running and integrating effective running physical therapy can transform a runner’s performance, reduce injuries, and optimize endurance and speed.

We also dove into the importance of injury prevention and rehabilitation for runners, from novices to elites, emphasizing how running physical therapy can prevent common injuries, correct muscle imbalances, and improve running form. Dustin explained that Light Horse Track Club collaborates with local physical therapists to help runners address these challenges, ensuring they have the resources they need for sustained success.

One of the highlights Dustin shared was Light Horse Track Club’s upcoming Gala, a special fundraising event that supports their races and initiatives, which continue to elevate the running experience in Northern Virginia. This gala is more than a fundraiser; it’s a celebration of the local running community, offering a fantastic opportunity for members and supporters to connect, share their experiences, and support Light Horse’s unique programming.

Whether you’re a weekend jogger or training for elite competitions, this interview is packed with valuable insights into how community support and specialized running physical therapy can help you reach your goals. With practical takeaways for all runners, you won’t want to miss it!

Visit Light Horse Track Club’s website here for more information on their programs, races, and the upcoming gala!