From the Field to the Physical Therapy Clinic: Common Fall Sports Injuries We’re Seeing

The fall sports season is officially here in the DC area!

Athletes are returning from their summer break, easing back into practices, and—unfortunately—we’re already starting to see a familiar trend in our clinics: a rise in sports-related injuries.

At Cohen Health and Performance, with locations in McLean and Bethesda, we work with athletes every fall who develop issues as they ramp up their training and competition schedules. Whether it’s a cranky knee, a sore ankle, hip discomfort, or a soft tissue strain, these injuries can derail a season before it really gets going.

Why Are Athletes Getting Injured at the Start of the Season?

The start-of-season injury spike often happens for two main reasons:

Sudden Increase in Training Volume
Some athletes simply aren’t fully prepared for the jump in intensity that comes with daily practices, scrimmages, and games. Even if they’ve stayed active over the summer, their bodies may not be ready for the sport-specific demands of their season.
Mismatch Between Off-Season Training and In-Season Demands
Many athletes train hard in the summer—lifting weights, running, and following conditioning plans from coaches—but those workouts don’t always replicate the unpredictable, reactive movements of live gameplay. Without that sport-specific preparation, even well-trained athletes can still get hurt.

The Importance of Sport-Specific Preparation

The best off-season training programs start general and gradually become more specific to the sport as the season approaches. This ensures the athlete’s muscles, tendons, and ligaments are ready for the exact movements they’ll face on the field or court.

For example, football is highly reactive—players must change direction quickly in response to opponents. Our video above shows one hurdle based drill that we use in our McLean and Bethesda physical therapy clinics. The athlete reacts to an unpredictable cue, changing direction while clearing hurdles—just like they might have to do in a game. This type of training prepares the body for rapid deceleration, re-acceleration, and sudden direction changes.

Why Deceleration Training Matters

Many injuries, especially hamstring strains, happen during deceleration—when the body must slow down rapidly. The hamstring works hardest when it’s putting on the brakes during sprinting, and if it’s not prepared for that high force, injury risk skyrockets.

That’s why we integrate drills designed to strengthen the hamstring’s ability to decelerate quickly, reduce injury risk, and keep athletes competing at their best.

Free Injury Consultations for High School Athletes

Right now, our McLean physical therapy location is offering free injury consultations for high school athletes returning to play.

If your son or daughter is:

Complaining about pain in a joint or muscle
Recovering from a recent sports injury
Feeling “off” since the season began

…our team can help identify the problem, address it quickly, and get them back to playing without missing significant time.

These consultations are performed by our expert sports physical therapy team in McLean, including myself, Dr. Matt, and Dr. Sam. We’ll assess the injury, pinpoint the cause, and provide sport-specific drills to get the athlete back to full strength as quickly as possible.

Don’t Wait—Act Early

The earlier we address sports injuries, the faster athletes can return to pain-free performance. If you’re in the McLean or Bethesda area and want to make sure an injury doesn’t sideline your athlete this season, contact us today to schedule an appointment.

Why Shoulder Injuries Are So Complex

At Cohen Health and Performance, we specialize in physical therapy in Bethesda and physical therapy in McLean for active adults and athletes who want to get back to the activities they love. One of the most common mistakes we see in traditional care—yes, even among other physical therapists—is a failure to appreciate how complex the shoulder really is.

The shoulder is the most mobile joint in the entire body. That’s what makes it so essential: reaching, throwing, lifting, pushing, and pulling all require freedom of motion. But that same mobility also opens the door to a ton of possible compensations and dysfunctions when something isn’t moving well.

Your Shoulder Isn’t Just a “Ball-and-Socket”

Think of your shoulder like a golf ball sitting on a tee. The ball is your humeral head (upper arm bone), and the tee is the glenoid (part of your shoulder blade or scapula). But that “tee” isn’t grounded into the earth—it’s actually floating on your rib cage. That means your shoulder’s stability is influenced by your rib cage shape, position, and even how you breathe.

Most providers stop at the shoulder joint itself. But for us at Cohen Health and Performance, whether it’s physical therapy in McLean or physical therapy in Bethesda, we know that treating shoulder pain means looking beyond the joint.

If the shoulder blade doesn’t sit securely on the rib cage, the muscles around it—like the upper traps or rhomboids—often work overtime to stabilize things, leading to tightness, knots, and nagging pain in the upper back or neck.

The Rib Cage is the Unsung Hero

One of the foundational drills we use to retrain shoulder mechanics involves placing your forearms on the wall. Here’s the key:

Straight line from wrist to elbow
Externally rotate through the shoulders
Use your rib cage—not your arms—to press back into the shoulder blades. Perform 5 breaths in this position.

A cue we love: Imagine a hot poker hovering in front of your sternum. Your job? Pull away from it without slumping forward. This activates a crucial muscle called the serratus anterior, which helps anchor your scapula and sets the stage for clean, pain-free movement.

Getting the Shoulder Blade Moving Again

Once you’ve created a supportive rib cage, the shoulder blade (scapula) can do its job again—mainly rotating upward as your arm reaches overhead.

A simple but effective exercise to improve this scapular movement is Downward Dog:

Start in a push-up (or all 4’s) position
Press away from the floor with your hands
Drive your chest toward your knees
Focus on feeling the shoulder blades rotate upward and outward

This kind of targeted movement work is exactly what we emphasize in our programs for physical therapy in Bethesda and physical therapy in McLean. Without proper scapular motion, your rotator cuff is forced to overwork—and that’s when breakdowns happen.

What About the Rotator Cuff?

Only after we’ve addressed rib cage position and scapular movement do we move to the rotator cuff. By this point, rotator cuff exercises are finally in the right environment to be effective—rather than just throwing rubber band exercises at a deeper problem that hasn’t been solved yet.

Final Thoughts: There’s Hope for Your Shoulder

If you’ve had shoulder treatment in the past and it didn’t work—or if you’ve been dealing with shoulder pain for months or even years—don’t lose hope.

The truth is, shoulder pain is multifactorial. It can stem from poor rib cage positioning, scapular movement limitations, limited mobility, or underdeveloped rotator cuff function. And many healthcare providers simply don’t take the time to look at all of these layers.

That’s where we come in.

If you’re looking for expert-level physical therapy in Bethesda or physical therapy in McLean that goes beyond surface-level care, contact us today. Our team of Doctors of Physical Therapy will work with you to get to the root of your shoulder pain and get you back to doing what you love—stronger and smarter than ever.

Having a 6-Pack Is Overrated?!

When it comes to fitness, the six-pack — those visible abs known as the rectus abdominis — gets all the glory. But from a physical therapy and spine health standpoint, it’s time we set the record straight: having a 6-pack is overrated.

At Cohen Health and Performance, we frequently work with active adults and athletes who want to prevent or recover from back pain, improve their core stability, and get more out of their workouts. A key misconception many bring in is the belief that the rectus abdominis is the holy grail of core strength.

Let’s break that myth down.

What the Rectus Abdominis Really Does

The rectus abdominis runs from your ribcage to your pelvis, right down the front of your abdomen. It’s the most superficial abdominal muscle — meaning it’s closest to the surface — which is why it’s the one you see in the mirror. But it’s not the most functional when it comes to spinal support or back pain prevention.

Its attachment points on the ribcage and pelvis are small and weak compared to deeper abdominal muscles. This means it doesn’t do a great job controlling how your ribcage and pelvis align — a key part of keeping your spine supported during movement.

The Real Core Stabilizers: What Actually Helps with Back Pain

At Cohen Health and Performance, where we provide sports physical therapy in McLean and Bethesda, we focus heavily on training the deeper core muscles that make a real difference:

-Transverse abdominis: The deepest abdominal muscle, wraps around your torso like a corset.
-Obliques: Help with rotation, side bending, and crucially, stabilizing your ribcage and pelvis.
-Diaphragm and pelvic floor: Work in sync with your core to manage internal pressure and support the spine.

These deeper muscles have stronger connections to your ribcage and pelvis and play a much greater role in controlling spinal position — making them essential for back pain relief and injury prevention.

How We Teach Patients to Engage the Right Muscles

Many people struggle to “find” or activate these deeper muscles because they’ve been trained — often unknowingly — to only rely on superficial muscles like the 6-pack.

One of the first drills we teach many of our physical therapy patients in Bethesda and McLean is something you can try at home:

1. Lie on your back with knees bent and feet flat.
2. Breathe in through your nose.
3. Exhale slowly through your mouth — as long as you possibly can.
4. As you exhale fully, you should feel your ribs draw down and in — and your deeper abs engage.
5. Hold that feeling for 5 seconds at the end of the exhale.
6. Try to quietly breathe in without losing that muscle engagement and repeat this cycle 5 times

This is often the first step toward building true core control — and a key part of our rehab process for those dealing with chronic or recurrent low back pain.

How This Applies to Movement and Exercise

Once you learn how to activate those deeper muscles, we help you bring that control into movement:

-Lifting one leg at a time while lying down
-Overhead arm motions while continuing to feel your deep abdominals
-Transitioning to standing drills like squats or deadlifts
-Returning to sport or high-level athletic performance

This progressive, intelligent approach is what sets our physical therapy practice in Bethesda and McLean apart — and what helps our patients get long-term results, not just temporary relief.

Struggling with Back Pain? Want Smarter Core Training?

If you’ve been dealing with low back pain, poor posture, or feel like your workouts just aren’t translating to improved performance or comfort, it may be time to train your core smarter, not harder.

Our Doctors of Physical Therapy in Bethesda and McLean can help you:

-Eliminate chronic or nagging back pain
-Improve core strength and stability
-Optimize your breathing and movement patterns
-Return to sport, the gym, or simply a pain-free life

Ready to Get Started?

If you are looking to move and feel better, don’t waste time chasing six-pack abs. Schedule an appointment with our team at Cohen Health and Performance in Bethesda or McLean, VA and start building a strong, functional core that actually protects your back and enhances your performance. Click here to get started!

What Africa’s Maasai Tribe Can Teach Us About Movement

After recently returning from an unforgettable trip to Tanzania and Kenya, I’ve found myself reflecting on more than just the incredible wildlife we encountered on safari. The people also left an imprint — particularly the Maasai tribe, whose way of life offers some insights into human movement and performance.

As a sports physical therapist and business owner serving active individuals in both Bethesda and McLean, I’m always observing movement through the lens of biomechanics, environment, and long-term physical resilience. And the Maasai tribe? They’re a living example of how environment and development shape the human body’s capacity for movement.

The Barefoot Reality

The Maasai grow up immersed in motion — running, walking, jumping, and herding cattle amidst unpredictable terrain and wild animals like lions and hyenas. What’s even more fascinating? They do all of this in traditional sandals they make themselves — minimalistic by our standards, offering little support compared to today’s athletic shoes.

Yet despite the lack of external support, they move efficiently and powerfully, as they developed this way from birth. Their feet, ankles, and lower limbs were conditioned over years to tolerate the high forces of running and jumping — essentially barefoot.

What This Means for Us in Bethesda or McLean

In our society, we’re influenced by very different environmental forces. We spend most of our time on concrete and hard surfaces, not grasslands. Most of us wore structured shoes as children, so our feet developed differently from those of the Maasai.

That’s why trends like barefoot running, inspired by books like “Born to Run”, need to be approached thoughtfully. While the intention behind minimal footwear and natural movement is often positive, our bodies may not be ready for that shift without a smart, progressive plan.

At our performance physical therapy clinics in Bethesda and McLean, we help patients understand how to safely incorporate barefoot-style training — but we do so within the context of their unique background, history, and goals. What works for someone raised in rural Kenya might not be the best place to start for someone who’s been training on gym floors or running on paved roads their whole life.

Context Is Everything

Whether it’s about footwear, mobility drills, strength work, or running technique, context matters. What’s optimal for one person may lead to injury in another — especially when their musculoskeletal system hasn’t adapted to a new stimulus.

That’s where expert guidance can make all the difference.

Looking to Train Smarter?

If you’re experimenting with new training strategies, transitioning to minimalist footwear, or just looking for ways to optimize performance while preventing injury, our team at Cohen Health and Performance would love to help.

We specialize in physical therapy for active adults and athletes in both McLean and Bethesda, helping bridge the gap between rehab, performance, and long-term health.

Contact us today to schedule an evaluation and get expert guidance on how to move better, train smarter, and thrive in your own environment.

You Don’t Just Have a “Bad Back”

At Cohen Health and Performance, I’ve had the privilege of helping countless individuals overcome chronic back pain—pain that’s persisted for months, years, or even decades. One thing I hear often is:
“I just have a bad back.”

But what does that really mean?

Rethinking the “Bad Back” Mindset

Many people are told by well-meaning professionals—or after seeing a concerning X-ray or MRI—that they’ll just have to “live with” back discomfort. But here’s the truth: imaging findings don’t always match up with pain levels.
You can have a “perfect” MRI and still feel miserable. Or, your imaging might show disc herniations or degeneration, yet you feel completely fine. So if structure alone doesn’t explain back pain, what does?

Pain is more than a picture. It’s a response. And in the case of chronic back pain, your body may be responding by stiffening up the spine to protect it—like putting a cast on a broken arm. The problem? That constant “splinting” or bracing over time can cause its own set of issues.

Why Movement Matters in Back Pain Physical Therapy

Your spine isn’t one long, fragile bone—it’s a series of small vertebrae stacked like building blocks, designed to move segmentally, much like a slithering snake. When your back stiffens due to prolonged discomfort or fear of movement, you lose that segmental motion. This not only limits function but also reduces the nutrition your joints and discs receive through movement.

One of the first things we focus on in back pain physical therapy and back pain rehab is restoring this movement. I often teach clients a drill called spinal segmentation, where the goal is to regain control by moving one segment of the spine at a time. It doesn’t need to be perfect—it just needs to reconnect your brain to your body’s natural movement capacity.

Stability: Learning to Support Your Spine (Without Leaning on It)

Alongside restoring movement, spinal stability is just as important. Many people with long-term back pain unknowingly rely on their spine for support—even during basic daily activities—rather than using their core muscles.

A favorite exercise of ours to teach spinal stability is the bear position hold. In this position, the goal is to support your body using your abdominal muscles rather than “hanging” on your spine. We coach patients to keep their belly button from dropping and to create tension through their core—retraining them to stabilize without compressing or bracing their spine unnecessarily.

Once this is mastered, we integrate that same feeling of stability into more functional movements like squats or weightlifting, encouraging patients to “feel their abs” supporting them rather than overusing their back.

Breaking the Chronic Pain Cycle

If you’ve been dealing with back pain for a long time, you may have started to believe that nothing will change—that this is just how it is. But that belief is part of what holds people back.

At Cohen Health and Performance, we’ve found that the most effective approach to chronic back pain is an active one—helping you learn how to move better, build control, and load your body in a way that restores trust and function.

Back pain physical therapy and back pain rehab in McLean isn’t about avoiding movement. It’s about restoring movement—and giving you the tools to do the things that matter to you, without fear or limitation.

Ready to Reclaim Your Life from Chronic Back Pain?

If you’re tired of being told you have a “bad back” and want to explore what’s really possible with the right plan, we’re here to help. Reach out to schedule an evaluation or check out more of our educational content on our YouTube page, where we demonstrate exercises and share strategies that have helped countless people just like you.

Let’s stop managing your pain—and start changing your story.

Extension Related Back Pain with Hypermobility

If you’re an active adult or athlete with hypermobility, recovering from back pain can be especially frustrating. What works for most people—like stretching or simply “moving more”—can actually make things worse if your joints already move too much.

At Cohen Health and Performance, we often help hypermobile individuals recover from extension-related back injuries, which typically result from excessive compression of the spine during movement. You may have heard some of the more technical terms for these injuries—like spondylosis, spondylolisthesis, pars defects, or even stress fractures.

These types of injuries are common in athletes who spend a lot of time arching or extending through the low back—think gymnastics, dance, overhead lifting, and even running.

Why Hypermobility Needs a Different Approach

Hypermobility means your joints exceed normal range. While that can be an advantage in sports requiring flexibility, it places a higher demand on your muscles to create stability. This is especially important when it comes to the spine, where poor control can lead to repeated irritation or injury.

If you’re recovering from an extension-based back injury—one where backward bending has caused too much load through the joints in the spoine—your recovery needs to be just as specific as your condition.

How Physical Therapy Can Help

At Cohen Health and Performance, our physical therapists work directly with hypermobile patients to restore safe movement and prevent re-injury. Our approach focuses on:

Stabilizing the spine by improving deep core work
Distributing movement across the hips, shoulders, and thoracic spine rather than dumping into the low back
Progressively retraining lumbar extension, so it’s controlled and not reliant on end-range joint motion
Building strength to support hypermobile joints through all phases of movement

We don’t just chase flexibility or range—we build the foundation for controlled, purposeful movement that leads to long-term results.

Recovering Extension the Right Way

Extension is a normal and necessary part of athletic movement—but when it happens excessively or without control, it can lead to spinal compression and pain. Here’s how we approach it in the clinic:

Train Core Control First
Your core muscles are your spine’s best defense against compression. We teach you how to activate and coordinate these muscles—especially in positions of extension—so that your spine is protected, not overloaded.
Use the Hips and Shoulders
Movement should be shared—not isolated. Our physical therapists help you restore mobility and coordination in the hips and shoulders so that the lumbar spine isn’t forced to do all the work.
Control Mid-Range Before Deep Range
Hypermobility often comes with a tendency to hang out in end-range. We train you to control movement through more mid-range positions first, before carefully progressing to deeper extension with purpose and strength.
Build Strategic Strength
Strength is one of the most important tools in hypermobility rehab. We customize strength programs to support your spine and joints so you can move powerfully without pain.

Our Goal: Help You Stay Active, Pain-Free, and Performing

Whether you’re a gymnast, a weightlifter, or simply someone who likes to push yourself physically, we understand how important your activity is to you. At Cohen Health and Performance, we don’t just help you get out of pain—we help you move with confidence and longevity.