Supinated Feet: When a High Arch Can Be a Problem

If you’re an active adult who deals with a high arch, also known as a supinated foot, you may be unknowingly putting extra stress on your body—especially during running, jumping, and other high-impact activities. As a physical therapist (and someone with this exact foot type), I’ve seen firsthand how a rigid, high-arched foot can lead to aches, pains, and limitations from the ground up.

Let’s break down what’s really going on—and more importantly, what you can do about it.

Supination: What It Is and Why It Matters

Supination is a normal part of how we walk and run. As we push off from one foot to the other, our foot naturally shifts into a supinated position to create rigidity and drive forward momentum. But when that position becomes our default—not just a brief phase of gait—it can become a problem.

A supinated foot has an elevated arch that shifts most of your weight to the outside edge of the foot and the heel. This reduces your ability to absorb shock efficiently and limits how well you distribute force across your foot and up the chain to the knees, hips, and spine.

Over time, this pattern can lead to:

Foot and ankle pain
Knee irritation
Hip tightness or instability
Low back discomfort
Increased injury risk during sports or exercise

Why Physical Therapy Looks at the Whole Chain

At our physical therapy clinic, we don’t just look at the foot—we look at how your body moves as a whole. A rigid, supinated foot places the lower body in a position of external rotation, making it harder for your joints to absorb impact. This sets the stage for chronic stress and eventually injury.

Our goal is to help restore balance—both literally and figuratively—by teaching your body how to load more evenly and absorb force more effectively.

Choose the Right Shoes

One of the easiest places to start is your footwear. If you have a naturally high arch, it may be structural and unlikely to change. But the right shoes can help you feel more evenly grounded, which is essential for stability and performance.

Look for shoes that:

Provide cushioning
Let you feel your entire foot—not just the outside edge
Help you connect with the ground without feeling unstable

Think of it like lying on a bed of nails: when the pressure is evenly distributed, it’s safe. But if you take away some of that support? Ouch. The same applies to your foot—spread the load, reduce the risk.

Train Your Body to Shock Absorb

Beyond shoes, it’s critical to train your body to handle impact. Supinated feet often go hand-in-hand with limited internal rotation in the lower body—a movement pattern that’s essential for shock absorption.

One of our favorite starting exercises in physical therapy for this is a flexion-based squat with a ball or yoga block between the knees.

This helps:

Encourage proper knee alignment
Drive internal rotation through the hips
Teach your body how to enter a loaded, shock-absorbing position

From there, we’ll progress into dynamic drills like jumps, hops, and landing mechanics, all with a focus on controlled loading and healthy joint positioning.

Don’t Ignore the Signals

If you’ve had a history of ankle sprains, foot pain, or feel like your body just “can’t land well,” you may be compensating for a foot type that needs attention. The good news? There’s a lot we can do to help.

At Cohen Health and Performance, we specialize in physical therapy that addresses the root cause—not just the symptoms. If you’re tired of rigid feet, stiff joints, or recurring injuries, let’s talk. I’ve been able to treat this in myself, and we’ve helped countless athletes and active adults find relief and move better.

Need help with your foot mechanics or injury prevention?

Contact us today to schedule a consultation and learn how physical therapy can help you move, feel, and perform better—starting from the ground up.

Why Objective Strength Testing Is Essential in Physical Therapy

In the world of physical therapy, precision is everything—especially when it comes to helping athletes and active adults recover from injury and return to peak performance. Yet, many rehabilitation programs still rely heavily on outdated tools like manual muscle testing (MMT) to assess strength.

While MMT can offer a general idea of a patient’s capabilities, it lacks the objectivity, consistency, and sensitivity required for high-level performance and injury prevention. At Cohen Health and Performance, we believe it’s time to stop guessing and start measuring.

The Limitations of Manual Muscle Testing

Manual muscle testing is a common practice in many physical therapy clinics. A therapist applies pressure to a limb and grades the patient’s strength based on resistance. While this method may help screen for gross weakness, it’s highly subjective.

Key limitations include:

Lack of precision
Inability to detect small, yet important, strength deficits
Inconsistent results between therapists
No ability to track subtle changes over time

When returning an athlete to sport, especially after a major injury such as an ACL tear, rotator cuff strain, or ankle sprain, relying on manual testing alone can lead to premature clearance—and an increased risk of reinjury.

Objective Strength Testing in Modern Physical Therapy

Today’s leading physical therapy practices (like Cohen Health and Performance if I don’t say so myself) use objective strength testing tools to deliver data-driven care. Whether through isometric testing devices, force plates, or handheld dynamometers, the goal is the same: measure what matters and act on real data.

Benefits of objective testing include:

🔹 Identify muscular imbalances
Catch asymmetries or deficits in strength between limbs, which are often invisible with manual testing.

🔹 Set clear, measurable goals
Define baseline numbers and establish precise strength benchmarks for return-to-sport decisions.

🔹 Reduce risk of reinjury
Research shows that inadequate strength—especially side-to-side deficits—increases reinjury risk. Objective testing ensures no major gaps are left unaddressed.

🔹 Optimize recovery timelines
Tracking strength improvements over time allows therapists to adjust training loads and progressions with confidence, ensuring that recovery is both safe and efficient.

Why It Matters for You

Whether you’re an elite athlete or an active adult who wants to stay in the game, data matters. When your recovery is based on objective strength testing, you’re no longer relying on a therapist’s best guess—you’re following a personalized plan grounded in science.

At Cohen Health and Performance, our team uses cutting-edge tools and technology to assess your progress and guide your recovery every step of the way. We don’t just help you feel better—we ensure you’re performing better.

Ready to Get Measured?

If you’re serious about your recovery, performance, and long-term health, physical therapy with objective strength testing isn’t a luxury—it’s a necessity.

Reach out to us at our Bethesda or McLean clinic to schedule your evaluation and experience the difference that data-driven physical therapy can make.

Why Are Young NBA Stars Getting Injured?

It’s a tough time for Boston Celtics fans. Star forward Jayson Tatum ruptured his Achilles during the playoffs—effectively ending this season and possibly the next. But what’s even more concerning is that Tatum’s injury is not an isolated case—it’s part of a much larger and troubling trend in professional sports.

As a physical therapy practice focused on performance and injury prevention, we’re seeing patterns that mirror what’s happening in the NBA: young athletes are breaking down earlier than ever before.

Achilles Injuries Are Happening Earlier—and More Often

Tatum is only 27 years old, yet he suffered an injury typically reserved for players in their mid-to-late 30s. He’s now one of six NBA players to tear their Achilles this season—and five of them are still in their 20s:

James Wiseman (24)
Dejounte Murray (28)
Dru Smith (27)
Isaiah Jackson (23)
Jayson Tatum (27)
(Damian Lillard was the only exception, at a more expected age for this type of injury)

These numbers are highly unusual. Achilles tears and other serious injuries used to be far less common among young, elite athletes.

All-Star Absences Are Surging

In addition to the Achilles tears, six NBA All-Stars missed games due to injury in just the first two rounds of this year’s playoffs. For comparison, from 1995 to 1999, only four All-Stars missed time during the entire playoffs over that five-year span.

Even more alarming: since 2008, the rate of injury among NBA stars has increased fivefold.

What’s Causing This Spike?

The issue goes beyond just bad luck or harder training. According to NBA insiders and medical professionals, the answer often starts much earlier—in youth sports.

1. Year-Round Competition with No Off-Season

Many young athletes, especially in sports like basketball, participate in year-round leagues such as AAU. They may play 3–5 games in a single weekend, and their bodies never get a true off-season to recover.

2. Early Sports Specialization

Specializing in one sport too early limits the body’s movement diversity. This repetitive stress on the same joints, muscles, and tendons builds up over time, making injuries more likely. When athletes don’t cross-train or play other sports, they don’t develop the balanced resilience that helps protect them from breakdown.

3. Wear and Tear by Age 18

As a result of #’s 1 and 2 above, medical teams at the NBA combine have noted that 18-year-old prospects often show the wear and tear of much older veterans. This is not normal—and it highlights just how early these issues start.

What Can Be Done?

As physical therapists, we believe injury prevention starts long before an athlete turns pro. Here are a few key recommendations for youth athletes and their parents:

Incorporate an off-season: The body needs time to recover, rebuild, and adapt.
Delay sports specialization: Stick with multiple sports through at least middle school.
Monitor playing volume: Be mindful of back-to-back tournaments and long weekends.
Prioritize movement quality: Incorporate strength, mobility, and recovery work into training.

How Physical Therapy Can Help

At Cohen Health and Performance, our goal is to keep athletes healthy—both in the short and long term. We work with youth athletes, collegiate hopefuls, and even professionals to:

Develop individualized injury-prevention programs
Monitor physical load and movement patterns
Guide athletes through proper recovery protocols
Provide strength and conditioning support tailored to each athlete’s body

If you’re a youth athlete (or the parent of one) with dreams of playing in college or beyond, the time to act is now. Reducing the risk of injuries today can mean avoiding setbacks that derail your career tomorrow.

Want to learn more or schedule an evaluation? Contact us here. We’d love to help you stay healthy and strong for the long haul.

Why Are ACL Injuries So Common in Female Athletes—and What Can Be Done?

This weekend, I came across an article that caught my eye: “A WNBA Veteran Becomes the Latest Player to Suffer an ACL Tear.” The athlete mentioned was Katie Lou Samuelson of the Seattle Storm—shockingly, the third player on her team to suffer an ACL tear before the WNBA season even begins.

As a physical therapist who works with athletes of all levels, this hit home. ACL injuries are far too common, especially among female athletes. According to the American Journal of Sports Medicine, females are 4 to 8 times more likely to suffer an ACL tear compared to their male counterparts playing the same sport. Even more alarming—over 70% of these injuries are non-contact. That means they’re not the result of a collision, tackle, or fall. They just happen—or so it seems.

But these injuries are not freak accidents. There are clear biomechanical and muscular risk factors that we, as physical therapy professionals, can help address.

Understanding the Risk Factors

One of the most commonly discussed reasons for higher ACL injury rates in females is anatomical structure, particularly the Q-angle—the angle formed by the hip and knee. Due to a generally wider pelvis, many female athletes have a more pronounced Q-angle, which can result in the thighs angling inward (valgus alignment). This creates a greater tendency for the femur to internally rotate and adduct, particularly during high-speed or high-impact movements like jumping, cutting, or landing.

When combined with muscle imbalances, such as strong quadriceps and weak hamstrings or glutes, the risk increases. A poor quadriceps-to-hamstring strength ratio can reduce the knee’s ability to stabilize itself, leaving the ACL vulnerable to tearing under stress.

How Physical Therapy Can Reduce the Risk of ACL Injuries

Preventing ACL injuries is not just about stretching or doing a few leg exercises. A comprehensive physical therapy approach includes:

1. Strengthening the Right Muscles

To protect the knee, we must target the muscles that slow down internal rotation and adduction of the femur—primarily the glutes and deep hip rotators. Strengthening the hamstrings, calves, and core also plays a vital role in protecting the knee joint.

2. Improving Muscle Coordination and Timing

Being strong isn’t enough. Athletes must be able to generate force quickly, particularly during sport-specific movements. That means physical therapy needs to go beyond the weight room.

We bring our athletes to our turf space to practice jumping, landing, cutting, and acceleration drills that simulate real-game scenarios. We analyze landing mechanics and correct faulty movement patterns before they show up on the court or field.

3. Using Data to Guide Programming

Every athlete we work with is evaluated using force plates and other sports technology to understand how their body handles force and movement. This data helps us create a personalized plan to address the specific deficits or imbalances that could lead to an ACL injury.

The Bottom Line: ACL Injury Prevention Starts with Smart Physical Therapy

ACL injuries are devastating. They can take an athlete out of the game for a year or longer. But the good news is—there are things you can do to reduce the risk.

If you are the parent of a female athlete or an athlete yourself and you’re serious about protecting your knees, now is the time to take action. Our ACL prevention programs at Cohen Health and Performance are tailored to each athlete and built on the principles of scientific assessment, personalized physical therapy, and performance training.

📞 Contact us today to schedule an assessment and give yourself the best shot at staying healthy, strong, and on the field.

How Isometric Exercises Can Boost Your Physical Therapy Success

If you’ve been through physical therapy with us at Cohen Health and Performance — especially after an injury like a tendinopathy or surgery — there’s a good chance you’ve experienced the power of isometric exercises firsthand.

Isometric exercises are a unique and valuable tool we often incorporate into the rehabilitation process. Unlike traditional exercises where muscles actively lengthen or shorten, isometric drills involve maintaining a static position. The muscle remains engaged without changing length, helping it work safely and effectively during early stages of healing.

While these exercises can be surprisingly challenging, one of their biggest benefits is that they’re gentle on healing tissues. This makes them an ideal starting point for anyone recovering from soft tissue injuries like patellar tendonitis, Achilles strains, calf strains, or even surgical repairs. However, as with any aspect of physical therapy, it’s crucial that these exercises are only performed when appropriate for your specific injury.

Why Are Isometric Exercises Important in Physical Therapy?

Isometric drills offer several key benefits during the rehabilitation process:

Reduced Pain Sensitivity:
Research shows that isometric exercises can help decrease pain around an injury. For many patients, this makes it easier to start moving again confidently and safely.
Muscle Strength Preservation:
When other forms of exercise aren’t possible due to injury limitations, isometric holds can help maintain muscle strength, preventing significant deconditioning during the recovery phase.
Joint Angle Specificity:
The strength gains from isometric exercises are specific to the joint angles in which they are performed. That’s why, in physical therapy, we tailor isometric drills to match the needs of each patient — whether you’re a gymnast requiring deep flexibility or a football player needing powerful joint stability.
Improved Joint Stiffness:
Building joint stiffness is vital for high-performance activities like running, cutting, and jumping. Isometrics play an important role in rehabilitating injuries to structures like the Achilles tendon, calf muscles, and more.

How We Use Isometrics at Cohen Health and Performance

Here’s a look at two isometric drills we commonly use in our physical therapy programs:

Wall Sit with Heel Raise:
In this variation, the patient performs a wall sit while staying high up on their toes. This position strengthens the calf and Achilles tendons in a shortened position, while also loading the patellar and quadriceps tendons — critical areas for knee health.
Isometric Split Squat Hold:
When appropriate, we add a split squat hold to further strengthen the Achilles, calf, and knee tendons. This drill also builds valuable foot and ankle stiffness, setting the foundation for more dynamic athletic movements later in rehab.

We adjust the frequency and intensity of these drills depending on how sensitive the injured tissue is, ensuring that patients progress safely through their rehab journey.

Isometric Drills Are Just One Piece of the Puzzle

While isometric exercises are powerful, they’re most effective when combined with dynamic drills — exercises where the muscles lengthen and shorten through full ranges of motion. A well-rounded physical therapy program will gradually transition patients from static strength work to dynamic, sport-specific movements to ensure a full and confident return to activity.

If you’re currently dealing with a soft tissue injury like tendinitis, a calf strain, an Achilles injury, or even an upper body strain like a pec or bicep tear, we’re here to help. Our expert team can design a customized rehabilitation plan that helps you heal effectively and get back to the activities you love.

Need Help with Your Recovery?

At Cohen Health and Performance, we specialize in helping active individuals recover from injuries through expert-guided physical therapy and performance programs.

Why We Don’t Cue “Shoulder Blades Down and Back” (And How Physical Therapy Can Help)

Growing up, my Grandma Barbara was one of my favorite people. She lived right next door in a guest apartment, and every afternoon when I came home from school, she was there to greet me. If I walked in with a bit of a slouch—maybe from lugging around a heavy backpack all day—she’d call out, “Stand up straight! Pull your shoulder blades down and back!”

I know she meant well, and I bet you’ve heard similar advice from someone in your life too.

But here’s the thing: as much as I hate to say it, Grandma was wrong.

Why “Shoulder Blades Down and Back” Can Do More Harm Than Good

In physical therapy, we see a lot of people who have been told to constantly brace their shoulder blades down and back to “fix” their posture. While that advice might sound helpful, it often causes more problems than it solves.

The reality is that posture isn’t about locking your body into one rigid position. Slouching often happens because we’re tired or trying to conserve energy—not because our shoulder blades are out of alignment. Trying to force them into place just adds unnecessary tension and restricts healthy movement.

In our physical therapy clinics in Bethesda and McLean, we frequently help active adults correct these habits so they can move better, perform stronger, and live pain-free.

Your Shoulder Blades Were Built to Move

In sport, fitness, and life, your arms need freedom to move—whether you’re lifting weights, throwing a ball, or reaching overhead. Your shoulder blades are designed to support that movement by gliding up and out—not staying pinned back.

As physical therapists, we help patients retrain how their shoulder blades move with their body instead of against it. This improves posture, relieves shoulder pain, and supports stronger performance in the gym or everyday life.

3 Physical Therapy Exercises to Improve Posture and Shoulder Function

These are three of the most effective drills we use at Cohen Health and Performance to teach better posture, improve shoulder control, and support strong, pain-free movement.

1. Core Push-Up with Serratus Activation

Most people perform push-ups with their shoulder blades pulled back and their chest puffed out—but that’s not how your body naturally moves.
In physical therapy, we coach patients to reach their chest away from the floor to activate the serratus anterior. This helps stabilize the shoulder blades in a healthy position.

2. Overhead Press with Scapular Movement

Rather than bracing the shoulder blades, we encourage our patients to let them rotate upward naturally during pressing movements. This protects the shoulder joint and mimics how your body moves in real-life tasks and athletic performance.

3. Dumbbell Pullover for Trunk Positioning

This simple but powerful drill reinforces good trunk posture while allowing natural shoulder motion. We often include this exercise in warm-ups or between sets as part of a customized physical therapy or training plan.

Rethink Posture: A Better Cue

Instead of constantly thinking “shoulder blades down and back,” try this:
Imagine a string gently pulling you up from the top of your head.
This subtle cue can reorient your posture without adding tension or compromising your shoulder mobility.

And here’s the kicker—perfect posture isn’t the goal. At Cohen Health and Performance, our physical therapy team focuses on helping you move efficiently, stay strong, and avoid injury—because those things are what actually matter.

Physical Therapy Can Help You Move Better—Not Just Stand Straighter

If you’re struggling with shoulder pain, poor posture, or feeling like your workouts are hitting a wall, we’re here to help. Our physical therapy approach is personalized, movement-based, and designed for athletes and active adults who want to keep doing what they love—without pain or limitations.

Book an appointment here at our Bethesda or McLean location to get started.