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.

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.

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.