Maybe I Do Hate Stretching…

Zac, why do you hate stretching?

I received this question during a physical therapy session recently, which admittedly made me chuckle. I don’t hate stretching, but we overrate its importance (physical therapists included).

Like most people, when you think of stretching, you think of static stretching. This type of stretching involves holding a stretch for an extended period.

Come to gyms like the one I train at, and you will see most people doing this form of stretching before they exercise.

Research has shown that static stretching performed before physical activity may negatively affect performance and does nothing to reduce injury risk. It temporarily decreases muscle strength and power and reduces muscle stiffness, essential for joint control and protection.

But stretching feels good. I agree, so I recommend that you perform your favorite stretches when you are done with your workout.

So, what should I do to warm up before exercise?

Dynamic stretching and drills specific to the activity you are about to perform.

This type of warmup involves moving your body through its full range of motion, mimicking the movements of the activity you are about to perform. This helps increase heart rate and body temperature and improves coordination, balance, and neuromuscular control.

Below are 2 drills I often use on my upper body days, followed by 2 more that I commonly use on lower body days with both physical therapy and personal training clients.

Upper Body

Lower Body

Interested in receiving a custom-designed warmup routine from our Doctors of Physical Therapy to help you reduce your injury risk while preparing you to perform at your best? Contact us to learn more!

What is blood flow restriction training? Should I try it?

Think of the last time that you injured your arm or leg or needed physical therapy. If you haven’t had an extremity injury, or needed sports physical therapy, congratulations, and I guess you must use your imagination.

You saw your doctor for help, and they told you to rest your injured limb for at least 4 weeks. You have no choice but to relax and allow your injured limb to get small and weak.

This is where blood flow restriction (BFR) training is a helpful part of the physical therapy process. A cuff or strap is placed tightly around a limb to reduce blood flow but not entirely block it. Exercise is then performed in this state.

This allows you to exercise at a lower intensity but enjoy many benefits of high-intensity training, such as muscle growth and improved strength.

While BFR can’t replace regular training, it is an excellent option for people that want to speed up their return from injury or are searching for ways to exercise without beating up their joints.

But restricting blood flow sounds sketchy. Is it safe?

Yes. Research has shown that BFR is safe when used with patients with no contraindications to it. As with all things, it can be unsafe when misused or placed in the wrong hands.

At Cohen Health and Performance, we use BFR both in McLean and Bethesda to limit weakness and muscle atrophy after surgery. Our patients recovering from knee surgery, such as an ACL reconstruction, have seen great results. When more strength is preserved, people have a faster recovery.

But the benefits extend far beyond people recovering from surgery. People struggling with chronic and overuse injuries can use BFR to maintain their strength without interrupting recovery. This helps people to return to the entirety of their active lifestyles much quicker.

Interested in using BFR to speed up your recovery from an injury or help you with your training? Contact us!

This Made Me Roll My Eyes

The medical profession, sports physical therapy included, is good at giving out bandaids.

To illustrate this point, let me tell you a story about my best friend. He lives in LA and takes advantage of all it has to offer. The guy can’t sit still. He hops in the ocean to go open water swimming in the morning and goes on hikes or trail runs in the evenings/weekends. 75 degrees and sunny every day must be nice…

On another beautiful, 75-degree day, he was running on a dirt trail to the top of Runyon Canyon and suddenly felt a sharp pain in the inside of his right knee. As he kept running, the pain increased. He decided to turn around, limp down the trail, and make an appointment with his Doctor. He saw his Doctor the next week and was told to take Advil and “take it easy”. This was when he called his favorite performance physical therapist…

My friend has known me since I was 10 years old and could feel me rolling my eyes.

Have you ever been told only to rest as a solution to an injury? This isn’t bad advice but it is a band-aid. It stops the bleeding without solving the reason the bleeding is occurring in the first place!

Pain occurs when the amount of stress placed upon the body exceeds the body’s tolerance of it.

So what is causing this stress to accumulate? It could be over-training, insufficient sleep, poor nutrition or a variety of other factors. Most likely it is a combination of many different things.

The root cause of pain must be addressed if you hope to feel better, stay better, and exercise consistently.

It is essential for your Doctor or Performance Physical Therapist to answer these questions and provide a plan to address them. If you are ready to finally solve the root causes of your pain and injury, contact us now!

3 Easy Exercises for Happy Knees

I can’t stand doing warmups. There I said it. Even though I’m a sports physical therapist both in Bethesda and McLean (yup, we opened our new location in McLean, Virginia!), and I know better, I just want to get into my workout without spending 15 minutes doing boring drills.

If you are anything like me, you want to spend the least amount of time warming up without increasing your risk of injury.

One way to reduce the amount of time that you need to warmup your knees are with home exercises that prepare your knees to handle more stress. Our athletic physical therapy patients (both youth athletes and active adults) see us in Bethesda and McLean for help with knee pain that limits them in the gym and/or out on the field. We commonly recommend that people perform drills that build the capacity of what the knees can handle. This means that the knees will be capable of handling more stress and be ready to go as soon as you walk into the gym.

Check out the videos below where I breakdown 3 drills that you can do at home for happy, healthy, and strong knees!

These are just a few examples of drills that help you with knee pain. If you are serious about finally solving the knee pain that is forcing you to modify your favorite workouts, don’t hesitate and contact us today to schedule an appointment in McLean or Bethesda. The root cause of your knee pain is unique and it is unlikely that the cookie cutter program you found online will do the job. We will show you exactly where your knee pain is coming from and provide a customized performance physical therapy plan to address it!

For Weekend Warriors Wanting to Avoid Knee Surgery

I probably don’t need to tell you this, but the best surgery is the one that is avoided. Disclaimer, as a sports physical therapist, I am a bit biased!

After knee surgery, your knee is not the same. Tissue may have been removed or artificial parts/pieces may have been put in. Regardless of the procedure, the skin was cut open, scar tissue formed, and time is needed time to heal.

This impacts the function of your knee and your ability to run and exercise as you had previously.

Now, I am not saying that surgery should never happen. What I’m saying is that it should be a last resort.

In my 12+ years working as a sports physical therapist, I have learned that people commonly have knee surgeries when there are things they can do to delay or avoid them altogether.

In many situations, the knee cannot handle the stress required of it for sports or your active lifestyle. As physical therapists, we commonly prescribe exercises that train the knee to handle all of that stress. In other instances, the knees are dealing with too much stress because another area isn’t doing its job. A thorough sports physical therapy assessment will determine what these areas are so that a comprehensive plan can be prescribed to fix it.

Whatever the reason is, a sports physical therapy assessment may be the secret sauce to finally solving your knee pain and avoiding the surgery you have been worried about! To schedule that, contact us today!

Stop Standing Straight

“Stand up straight!”

If your parents were anything like mine, you heard that growing up and when I started my career as a physical therapist, I assumed that I would be telling my patients to do the same.

However, that has not been the case.

As a sports physical therapist here in Bethesda, I find this cue to be detrimental to how the body functions. In fact, correcting the need to stand up straight has been one of the most helpful suggestions during physical therapy sessions and throughout the injury rehabilitation process.

Standing up straight causes you to pull your shoulder blades down and back, which limits the amount of movement available to your shoulder blades. The shoulder blades are meant to elevate and abduct (move apart) as the arm is moving away from the body. Just try to keep your shoulder blades down and back as your reach for something!

The cue to stand up straight also commonly causes people to arch their back and tip their pelvis forward. This position places increased strain on the lower back and pelvis, while limiting the amount of motion that is available at the hips.

Correcting this posture is of particular importance for athletes. Every sport has an amount of movement that is necessary to perform it. Golf requires a large amount of rotation at the hips, serving a tennis ball requires a great deal of shoulder flexion, and sprinting requires lot of hip extension.

“Standing up straight” while performing these activities will limit the movements necessary to perform these activities and can often lead to injuries.

This is not to say that this cue is a bad thing. However, it is important to understand when this cue is helpful and when it is not.

Cues like “standing up straight” may work for drills such as deadlifts, rows, and farmers carries, however it is useful to forget this cue for other activities and when attempting to correct your posture!