Bob’s rehab journey from injury to college athletics

Bob was a talented high school lacrosse player with dreams of playing at a Division 1 college. However, despite his ideal size and athletic ability, he wasn’t attracting any interest from college coaches.

The issue wasn’t his talent or drive—it was his injury history. Bob had been plagued by various injuries over the past two seasons, and it was affecting his ability to stay on the field consistently. His history of injuries was the major reason coaches were hesitant to recruit him.

He had already visited multiple doctors and physical therapists but couldn’t seem to stay healthy long enough to make an impact. Frustrated and doubting his chances of ever getting recruited, Bob came to us seeking help.

When we first saw Bob, he was dealing with both ankle and knee injuries that had been bothering him for months. Our sports physical therapy process started with a thorough assessment of his lower body’s range of motion, strength, and movement patterns. We also evaluated his ability to perform the specific movements required in lacrosse.

It quickly became clear that he had significant movement limitations in his ankles and hips, which were causing him to compensate during running and training. These compensations had become ingrained in his movement habits, further reinforcing his limitations and contributing to his recurring injuries.

We worked with Bob to restore proper motion in his ankles and hips, and taught him specific drills to retrain his body to move naturally without compensating.

Once his mobility improved, we shifted our focus to rebuilding his strength, speed, and explosiveness. Our role began to transition from physical therapists to performance trainers. We developed a tailored gym program to help Bob regain his athletic edge and enhance his overall performance.

Three months later, Bob was ready to return to the field for his high school lacrosse season. Although he was nervous about getting back to playing, he was eager to show his coaches the progress he had made.

After his first practice, Bob called me, excited. His coach had pulled him aside to ask what he had been doing during the off-season. Bob had completely outperformed his teammates, returning stronger, faster, and more explosive than ever before.

Fast forward a year, and Bob earned a Division 1 lacrosse scholarship, fulfilling his dream.

If your athlete shares similar aspirations of playing at the collegiate level, reach out to us and join our Performance U Training Program! Let us help your athlete stay healthy, improve performance, and reach their full potential.

Cryotherapy: Is It Really Worth the Hype?

A few months ago, I attended a conference with a group of physical therapists and personal trainers. Over a meal, we found ourselves discussing the day’s events. One of the highlights of the conference was a series of product pitches from various companies targeting healthcare providers like us. Among them was a cryotherapy company, and their representative happened to recognize our group.

He approached our table and confidently delivered his pitch:

“Cryotherapy can help your patients reduce pain, accelerate muscle recovery, decrease inflammation, and improve overall wellness.”

Sound familiar? If you’ve ever heard a similar claim and wondered if cryotherapy really lives up to the buzz, you’re not alone. At our physical therapy clinics in Bethesda and McLean, we receive many inquiries about the effectiveness of cryotherapy.

Let’s break it down.

What Exactly is Cryotherapy?

Cryotherapy involves exposing the body to extremely low temperatures for a brief period, usually just a few minutes. While there are several forms of cryotherapy, the most well-known is whole-body cryotherapy. This process involves standing in a chamber filled with liquid nitrogen vapor, where temperatures can drop as low as -200°F to -300°F (yes, you read that right).

The Ongoing Debate

The benefits of cryotherapy remain a topic of debate within the medical, physical therapy, and fitness communities. While some studies have shown promising results, others have found little to no benefit.

Proponents of cryotherapy suggest that it can help manage various conditions, including chronic pain, arthritis, inflammation, and even depression. The theory is that exposure to extreme cold triggers the release of endorphins—your body’s natural painkillers—while also reducing inflammation in targeted areas. In some cases, studies have indicated that cryotherapy may help alleviate pain and inflammation in people with conditions like rheumatoid arthritis. However, much more research is needed to validate these claims.

There are also suggestions that cryotherapy aids in **muscle recovery** after exercise. The idea is that cold temperatures cause blood vessels to constrict, reducing blood flow to the affected muscles. As the body warms up post-session, blood flow returns and promotes healing. While some studies support this, others have shown little to no significant effect.

So, What’s the Verdict?

Cryotherapy is still relatively new, and as with many emerging treatments, the evidence is limited and mixed. Early research shows potential, but more comprehensive studies are necessary to reach firm conclusions.

It’s also important to remember the risks. Exposing the body to such extreme cold comes with hazards, including potential skin damage and frostbite.

If you’re thinking about giving cryotherapy a try, it’s crucial to consult your physician first to ensure it’s a safe option for you.

What’s the deal with my ankle popping?

When your knuckles pop, your ankle cracks, or your hip makes that strange noise, do you ever wonder, “Is that bad?” Should you see a sports physical therapist or doctor about it?

Well, there’s no need to worry—it’s probably not a big deal if you’re not experiencing any pain when it happens.

I have this quirky habit every morning as soon as I get out of bed. I keep my right heel on the floor and move my knee over my toes until I feel and hear a pop in the back of my heel. It freaks out my wife, Deb, every time.

The cracking or popping in a joint is similar to the sound of pressure being released from a soda bottle. Over time, pressure builds up within a joint, and for some people, it feels good to release it. That’s the noise you’re feeling and hearing.

However, if you experience pain when the pop occurs or if the area feels unstable, it’s important to reach out to us. We can help determine the root cause of these issues and whether any treatment is necessary.

We’ll assess if your pain is related to arthritis, overuse, or another movement-related issue that we can address through physical therapy, with exercises you can do at home.

Here are a few questions to ask yourself. If you answer “yes” to any of these, it might be time to seek help:

1) Is the popping I feel painful?
2) Has there been a recent injury to this area?
3) Does this area feel unstable?
4) Do I have weakness in this area?

You might not even need to visit the office—a phone call could be enough. Check out our homepage here and click on the “free phone consultation” tab!

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!

What Sprinters Teach Distance Runners

Our physical therapists in Bethesda commonly teach sprinting drills to both distance runners and field sport athletes.

Although distance running and field sports are very different activities, sprinting drills help to correct running form within both groups of people and make a positive impact throughout the physical therapy process.

For runners, sprint training teaches the body to move fast. The greater the speed is that a runner is capable of running, the easier it is to run fast for extended periods of time.

For example, if someone wishes to run a marathon in 4 hours or less, this person needs to average 9:09 minutes per mile. Prior to incorporating sprint training into their routine, this person may have been capable of running 14 mph at maximum speed. After sprint training, this person is now capable of running 15 mph at maximum speed. Due to having a faster maximum speed, running a 9:09 minute mile is now less taxing on the body, therefore requiring less energy to sustain this pace.

For distance runners and field sport athletes, sprinting improves running technique by forcing an individual to pick their hips and knees up in front of their body to larger degree. This helps to change the common habit of kicking legs far behind the body, resulting in further compensations that increase the risk for hamstring injuries among many others.

Check out the video below to learn more about how we coach running technique here at Cohen Health in Performance Bethesda!

What Does It Mean To Be “Out of Alignment?”

“My body feel out of alignment.”

“My <insert healthcare professional here> said that my hips are off.”

“I think I just need to be adjusted.”

These are examples of a few of the comments that patients may express in physical therapy or other injury rehabilitations settings.

The belief that we are like a vehicle that needs to be re-aligned is often the fault of the healthcare industry, including physical therapy.

In the past, healthcare providers would tell their patients that a part of their body is out of alignment and needs to be adjusted to put it back in place. They explain that this is the reason for any discomfort that may be present.

Thankfully, this is no longer taught by most healthcare providers as this thought process has been disproven.

Our bodies are incredibly resilient.

Our joints do not simply fall out of alignment. In fact, our bodies are designed to move and if we were constantly “in line”, it would be impossible to move anywhere!

So, what is happening when an area of our body feels “off”?

As we perform a movement repetitively, compensations and movement limitations become more noticeable.

One area of the body may be moving excessively, while another area of the body may be moving too little. For example, if your ankle mobility is limited during a squat, you will move excessively at the hips to pick up the slack, causing more stress in that area. As a result, pain, or the feeling of being out of alignment may occur in the hips/pelvis.

If you feel “off” or have been told that you are out of alignment, the solution is likely to begin with discovering what movement limitations may have led to this feeling in the first place. This information can then be used to teach you strategies to move and feel better!

Are you interested in discovering what solutions may be right for you? Contact us to find out more about our physical therapy services!