The first drills that we teach to youth athletes

It is essential to understand the demands placed onto the body when working in a sports physical therapy, injury rehabilitation, and performance training setting.

Sports and weight training require athletes to control the body when moving rapidly.

If an athlete wishes to own the “stack” (stacking of our head, rib cage and pelvis over one another) and protect their lower back they must be capable of doing so when performing high velocity movements.

When youth athletes first train, we use medicine ball drills to teach this ability.

The medicine ball chest pass is a great drill to teach this capability. During this the drill, the athlete is generating enough velocity to propel the ball into the wall and back. As this occurs, it can be easy to lose the “stack” requiring the athlete demonstrate a higher of level of body control.

After mastering the chest pass, it is time to bring the arms overhead. More trunk strength and control are required with this movement and the ability to manage intra-abdominal pressure is further challenged. Check out this exercise here.

These are just a couple of the exercises that we incorporate into the training sessions and warmups for our youth athletes.

If you interested in learning more about the summer training options for youth athletes at CHP, please contact us!

What All Rotational Athletes Must Be Capable Of

Low back pain with golf or arm pain with throwing. At our performance physical therapy practice, we see this constantly.

Swinging a golf club, throwing a baseball and hitting a tennis ball involve a great deal of rotation. Many areas of the body should be involved in these movements, however that is not always the case.

It is common to see baseball pitchers that are experiencing arm issues demonstrate the habit of trying to “arm” the ball as they throw it. There is not much contribution from the legs which places a great deal of stress on the arm and over time results in overuse injuries.

Many golfers and tennis players experience lower back pain because they do not effectively link the power that they generate in the lower body through the trunk, into the upper body and ultimately to the head of the club. As a result they compensate elsewhere, placing increased stress onto the lower back.

The rotational row is a great drill to train the body to generate rotational power through the legs and connect it through the trunk. View this exercise here.

Once you have mastered the rotational row and learned how to link the power generated in the lower body to the trunk, we can now add in the upper body! The rotational lift trains the body to generate rotational power through the legs and connect it through the trunk and arms. Check this exercise out here.

Interested in learning more ways you can address lower back pain while enjoying your active lifestyle? Sign up for a FREE phone consultation today!

A different form of shoulder strength

Building Shoulder Strength in End Ranges: How Physical Therapy Can Prevent Injury

Many shoulder injuries that bring athletes to physical therapy are the result of overuse or instability when the shoulder reaches its end range of motion. Whether you’re lifting weights, throwing a ball, or performing overhead movements, your shoulder is vulnerable when pushed to its limits.

It’s common to assume that the solution to these issues lies in increasing flexibility through stretching and mobility drills. While flexibility is important, it’s only part of the equation. The real issue often lies in a lack of strength and stability when the shoulder is in these extreme positions.

Why Strength at End Range Matters

When the shoulder reaches its end range of motion—whether during an overhead press, a throw, or any extreme movement—your muscles can’t generate the same amount of force as they can when the shoulder is in a more neutral position. This weakness leaves the shoulder joint less stable and more prone to injury.

Without the ability to control the joint at these extreme ranges, you’re at an increased risk of instability-related injuries such as shoulder dislocations or subluxations. Over time, these challenges can lead to wear and tear on the shoulder joint, causing issues like rotator cuff tears, labral injuries, or impingement syndromes.

However, there’s good news! By incorporating targeted physical therapy exercises, you can train your shoulder to be strong even in these vulnerable positions. Strengthening the muscles that support the shoulder at end range can significantly reduce your risk of injury and improve your overall performance in sports and daily activities.

Strengthening the Shoulder in End Ranges with Physical Therapy

At its core, physical therapy is about improving movement quality and building strength where it’s needed most. For athletes and active individuals, this often means focusing on increasing shoulder stability in the ranges of motion where injuries are most likely to occur.

Here’s where physical therapy really shines—helping you develop strength at the edges of your mobility. Instead of simply increasing flexibility, we work to build strength and control in these end ranges. This approach not only enhances performance but also prevents injuries by ensuring that your muscles can stabilize the shoulder joint in even the most extreme positions.

PAILs and RAILs in Shoulder Rehab

One of the best ways to strengthen the shoulder at end range is through Progressive Angular Isometric Loading (PAILs) and Regressive Angular Isometric Loading (RAILs) exercises. These exercises involve applying tension to the muscles in both their stretched and shortened positions, helping to increase both flexibility and strength in end ranges.

For example, Shoulder Flexion PAILs with a Lift Off Challenge and Shoulder External Rotation PAILs with a Lift Off Challenge are highly effective exercises for targeting the muscles that stabilize the shoulder when it’s in its most extended and rotated positions. These exercises focus on developing strength while the joint is near its limit of movement, allowing for greater control and reducing the likelihood of injury.

I recently demonstrated these drills to a group of CrossFit athletes, who need exceptional shoulder strength and stability to lift heavy weights overhead and perform complex movements. However, you don’t need to be a CrossFit athlete to benefit from these exercises. Whether you’re involved in overhead sports like swimming, tennis, or volleyball, or simply want to improve your shoulder health, these exercises are fantastic for anyone looking to build strength and prevent injuries.

Exercises to Try:

1. Shoulder Flexion PAILs with a Lift Off Challenge

2. Shoulder External Rotation PAILs with a Lift Off Challenge

Why Physical Therapy is Key for Shoulder Health

Incorporating these types of exercises into your routine can dramatically improve your shoulder strength and stability, particularly in those vulnerable end ranges of motion. Working with a physical therapist ensures that you’re doing the exercises correctly and progressively, so you can safely build strength without putting your joint at risk.

A physical therapist will assess your specific needs, tailoring exercises to your unique shoulder mechanics and helping you regain control over your movements. With proper guidance, you can significantly reduce your risk of injury and improve your overall performance in your sport or daily life.

Ready to Strengthen Your Shoulders and Prevent Injury?

If you’re experiencing shoulder pain or instability, or if you want to improve your strength in end ranges of motion, physical therapy can help. Contact us today to learn how a tailored treatment plan can get your shoulders strong, stable, and ready for anything life or sport throws your way!

Secret to Avoiding Running Related Hamstring Injuries

Many runners and other athletes, like you, understand that strength training improves performance, reduces injury risk and decreases the likelihood that you will see us in physical therapy!

However, we have found that you may be strength training because you feel that you are supposed to but these workouts are more than simply checking a box.

It is important to think about how you are training a particular muscle group during your workout. This change in focus may be the secret to eliminating future hamstring injuries that cause many to look for a physical therapist.

Many people strengthen the hamstrings in a concentric (as the muscles shorten) fashion, however most hamstring strains occur as the muscles lengthen and work to slow down the swinging leg.

It is essential for any runner or athlete that performs a great deal of sprinting to develop a large amount of eccentric (muscle contraction that occurs as it lengthens) hamstring strength.

Eccentric hamstring curls are a great way to build this quality and the double leg variation on a physioball is a great place to start! Click here to see this exercise.

Once you have mastered the double leg eccentric glute bridge, it is time to step things up to the single leg progression.

How do you know if you are ready to move on? A great goal to shoot for on the double leg version is 10 FULL repetitions with a full 5 second lengthening period on each rep. The hips should not be dropping, and you should feel your abs throughout the set!

As we continue to build eccentric hamstring strength, this drill will add some additional challenges.

One leg will be flexed with the hip and knee at 90 degrees, mimicking a sprinting position. The result is one hip in a position of flexion while the other is in extension, much like sprinting or running. This will challenge your ability to control the position of the pelvis as you demonstrate hamstring strength.

Click here for the single leg progression!

Once you have mastered the single leg eccentric hamstring curl on a physioball, you can progress even further. To learn how to do that amongst other ways to optimize your strength training, click here.

Also, don’t forget to follow us on Instagram and facebook @cohenhealthandperformance!

Learn to Stack Like a Snowman

Learn to stack like a snowman….

The “stack” is one of the prerequisite positions to master in physical therapy or performance training. This position is essential for movements like squats, split squats, hip hinging and pretty much anything one might perform in the gym.

Think of the stack like a snowman. The 3 balls of a snowman represent the head (top ball), rib cage (middle ball), and pelvis (bottom ball). The goal of the stack is to center each of the 3 balls over one another.

The weight bearing surfaces of all 3 balls are larger when they are centered over one another. This means that the weight of the snowman is spread over a larger area (ie. less stress in each individual spot).

Now imagine that one ball starts to roll forward or backward. The ball above and below must roll with it to avoid falling to the ground and keep the snowman standing upright. This adjustment changes the weight bearing dynamics for each ball and more weight is now directed onto a smaller amount of space. This produces more stress onto these new weight bearing areas and may cause these areas to break down faster (think discs in our lower back).

This same dynamic happens in our body. As one of our balls (head, rib cage, or pelvis) rotates away from center, the other balls must accommodate. This places more stress onto the body as a whole and often results in discomfort.

Achieve the stack by practicing the following steps.

Imagine that you are wearing pants with back pockets. Without bending your knees further, roll your back pockets underneath your body (you should feel your abs turn on)
Without hunching over take a relaxed breath in, followed by a long and relaxed breath out. Feel your anterior ribs move down, back and in. Ensure that you can gently maintain this position while inhaling and exhaling
Imagine that someone is standing behind you pressing hard down onto your shoulders.

The stack can be a challenging position to master and integrate into your training routine. However it is often the secret to avoiding back pain with common activities in the gym.

Contact us to learn other adjustments to common exercises that may become your hidden secret to overcoming pain and optimizing your performance.