Why “corrective exercises” in physical therapy fall short

Back when I was in physical therapy school, I also worked as a strength and conditioning coach with athletes at Northeastern University. Part of our job was to include “corrective” exercises in every training session to address mobility limitations or movement issues. These were low-intensity stretches commonly seen in physical therapy, mobility drills, and other movements that athletes did as part of their warmup.

The idea was solid: reduce the risk of injury by fixing underlying issues. But with 15 years of experience now, I’ve realized that this approach wasn’t as effective as we thought.

The issue with these types of exercises is that they are often performed at an intensity that is too low to produce significant results. Whether you’re a competitive athlete or a recreational gym-goer, your body is used to exerting significant effort when you play, train, or compete. To be effective, corrective exercises need to match that intensity. Your body adapts to effort, not passive movements.

At Cohen Health and Performance, we approach corrective exercises differently. We design customized corrective exercises tailored to each individual. For our physical therapy patients, these are incorporated into their daily routines as “daily essentials” or performed independently before exercise. For our training clients, these correctives are strategically woven into warmups or the training session itself.

But here’s the thing: the best corrective exercise is simply exercise done correctly.

When you perform any exercise with proper technique and enough intensity to challenge your body, it becomes “corrective.” Progress happens when the body is forced to adapt, whether that’s by increasing resistance, moving faster, working through a broader range of motion, or training in a fatigued state.

A strong body is a resilient body—especially when it’s strong through a wide range of motion and capable of handling stress in various conditions. That’s why mastering foundational lifts and progressing them step by step is far more effective than running through a long list of low-effort exercises.

Take the barbell deadlift, for example. It’s a fantastic exercise that can double as a “corrective” for athletes with hip mobility issues or back pain. It challenges core, glute, and hamstring strength while teaching the body how to create intra-abdominal pressure to protect the lower back. It might take time to safely progress to heavier weights, but the payoff is immense: a back that’s strong, resilient, and ready to handle stress.

Watch our Deadlift Tutorial below for tips on how to perform this powerful lift safely and effectively.

We also emphasize high-level movement quality in the end stages of rehab. For athletes, this means testing their ability to maintain excellent form and strength, even under fatigue. This is a critical step to ensure they’re fully prepared to return to their sport or activity.

Check out the video below to see how we approach end-stage rehab for athletes.

If you’re ready to move better, feel stronger, and get back to doing what you love, let’s make it happen. Schedule an evaluation with one of our expert Doctors of Physical Therapy today. Click here to get started.

Surgery or physical therapy?

“Do I Need Surgery? “

If you’ve faced a significant injury and are anything like our sports physical therapy patients, this question probably crossed your mind.

It’s natural to think of ourselves like machines: when something breaks, we believe it needs fixing. But here’s the reality—you’re not a machine, and surgeons aren’t mechanics simply “repairing” broken parts.

In fact, surgeons are more like cleanup crews addressing the aftermath of accumulated wear and tear. And the truth is, many injuries don’t require surgical intervention to heal effectively.

A comprehensive review published in the prestigious Journal of Orthopaedic & Sports Physical Therapy (JOSPT) found no consistent evidence that surgery outperforms non-surgical care in nine different areas of the body. That’s huge!

Now, let’s be clear: surgery has its place. If you’ve suffered a major trauma—like a displaced fracture or a complete rupture of the ACL or Achilles tendon—surgery might be the only path to regaining functional mobility. In these cases, surgical intervention is necessary to restore structural integrity for sports or daily life.

But what about injuries that don’t fit this profile? Chronic pain, nagging injuries, or wear-and-tear issues often drive people toward surgery, believing it will “fix” the problem. Here’s where things get tricky: research consistently shows that surgery doesn’t always deliver long-term benefits, especially when it’s used to address conditions better managed with active, non-invasive approaches like physical therapy.

Surgery doesn’t address the root cause of injuries. If strength deficits, or movement limitations/compensations led to the damage in the first place, those same issues will persist post-surgery unless properly addressed. It’s like mopping up a spill without fixing the leak—temporary relief, but the problem will return.

Active interventions, such as physical therapy, strength training, and movement re-education, can often help you avoid surgery altogether. These approaches focus on restoring balance, improving function, and addressing the underlying factors contributing to pain or injury.

Here’s what you can do to take charge of your health and minimize the need for surgery:

Get Moving: Movement is medicine! A good physical therapist can create a scientifically designed plan tailored to your needs, helping you regain capabilities necessary for the activities that you love.
Address Lifestyle Factors: Stress, poor sleep, and inactivity can all affect your body’s ability to heal. Prioritizing holistic wellness is key.
Be Patient: Healing without surgery takes time, but the results are often more sustainable and come with fewer risks.

Even when surgery is the best option, it’s crucial to address the underlying issues during recovery. Comprehensive rehabilitation ensures you won’t be revisiting the operating room down the road. Think of it as “fixing the leak” while cleaning up the spill.

So, before you consider going under the knife, ask yourself: Have I explored every active option to restore my health?

If you’re dealing with an injury and unsure whether surgery or physical therapy is the right path for your recovery, we’re here to help you figure that out. Schedule an evaluation with one of our expert Doctors of Physical Therapy today and take the first step toward getting back to what you love. Click here to get started.

Traditional physical therapy advice resulting in a fragile spine

Have you been told to always keep your back straight and stiff when lifting? When it comes to preventing back pain, the truth is, it’s not as simple as that.

For years, the advice to lift with a “perfectly straight back” has been the go-to solution, but there’s no solid evidence that it reduces back pain or injury. Surprised? Let’s explore why this outdated advice might be holding you back and how back pain physical therapy can help you build a stronger, more resilient back.

Debunking the “Straight Spine” Rule

The idea of lifting with a straight, neutral spine has been considered the gold standard for decades. It seems logical: keep your back rigid to keep it safe. But studies reveal that this advice hasn’t reduced back injuries in the workplace. Why? Because back pain isn’t caused by a single factor like lifting posture.

Back Pain: A Multifactorial Issue

Back pain is influenced by many factors—age, fitness level, recovery habits, stress, and even sleep quality. If you’ve experienced back pain after lifting, chances are the issue wasn’t simply bending your spine. The root cause is often a combination of problems, like poor endurance, lack of strength, or inadequate recovery.

Physical therapy for back pain can help you address these factors by improving your overall strength and movement capacity, rather than just focusing on how you lift.

Why Avoiding Spinal Flexion Can Be Harmful

The advice to “never bend your back” can actually weaken your spine over time. Avoiding natural movements like bending or twisting may leave your back less prepared for real-world demands.

Think about it: everyday life involves movements like lifting a laundry basket, picking up a child, or twisting to grab something off a shelf. Avoiding these actions doesn’t protect you—it makes your back less adaptable and more vulnerable to injury.

Through physical therapy, you can safely reintroduce these movements and build the confidence and strength needed to handle life’s physical demands.

How to Build a Strong, Pain-Free Back

Preventing back pain isn’t about avoiding movement—it’s about building strength and resilience. Here’s how physical therapy can help:

Train for Everyday Life: Your physical therapist will guide you through exercises that mirror real-world movements, like squats, deadlifts, and rotational lifts.
Gradual Progression: With a personalized plan, you’ll start with lighter loads and progress over time, preparing your spine for various challenges.
Movement Variety: Learn how to lift using different techniques—straight back for heavier loads, rounded back for lighter ones—to build adaptability and confidence.
Listen to Your Body: If a movement feels painful, your therapist will help you modify it and reintroduce it as you get stronger.

The Role of Physical Therapy in Back Pain Recovery

If you’re recovering from a back injury, physical therapy for back pain can help you uncover the root cause of your discomfort and create a tailored plan to address it. This approach not only relieves pain but also prevents future issues by improving strength, mobility, and movement patterns.

Take Control of Your Back Pain Today

Rigid rules like “always lift with a straight back” oversimplify a complex issue. Instead of avoiding movement, embrace it. With the right guidance from physical therapy, you can prepare your back for life’s twists and turns while building strength and resilience.

If you’re ready to overcome back pain and get back to the activities you love—whether it’s the gym or everyday tasks—schedule an evaluation with one of our expert Doctors of Physical Therapy. Click here to get started!

Let’s build a stronger, pain-free back together. Because when it comes to your spine, you’re stronger than you think.

Avoid injuries with these sports physical therapy tips

What helps elite athletes avoid serious injuries and maintain peak performance? It’s not just skill or power—it’s their pillar strength. Pillar strength, commonly referred to as core strength, forms the foundation of efficient, injury-free movement. A strong pillar allows you to break through training plateaus, improve your performance, and significantly reduce your risk of injuries.

As the saying goes, “You can’t fire a cannon from a canoe.” Just like a cannon needs a stable base, your body needs a strong and stable pillar to generate and transfer power effectively.

What Does Pillar Strength Really Do?

Forget the idea of doing endless crunches or sit-ups to build a stronger core. Your pillar strength isn’t just about aesthetics—it’s about stabilizing the spine and pelvis while controlling forces generated by your arms and legs. When your pillar doesn’t do its job, energy leaks occur, reducing performance and increasing injury risk.

Example: The Sprinter

Picture a sprinter accelerating down the track. If their lower back arches excessively (anterior pelvic tilt), the spine can’t absorb or transfer the energy created by their legs. This results in their powerful hip extension being wasted. The root issue? Their spinal stabilizers aren’t working efficiently to counterbalance the forces from their hips.

Why Pillar Strength Matters in Sports Physical Therapy

Pillar strength is important in every direction of movement—not just forward and backward. Let’s break it down:

1. Rotational Strength (Transverse Plane)

Imagine a baseball pitcher winding up for a throw. They need to rotate their trunk efficiently to deliver a powerful and accurate pitch. Weakness in the transverse plane can cause “energy leaks,” reducing throwing velocity and increasing the risk of injury. This is a common issue we address in sports physical therapy, using rotational core drills to stabilize and strengthen this motion.

2. Lateral Strength (Frontal Plane)

Cutting, landing, or maintaining balance during sports relies heavily on frontal plane strength. Weakness here can lead to a hip drop (Trendelenburg sign) during single-leg movements, creating instability that puts stress on the knees. This instability is a key contributor to injuries like ACL tears, especially in youth athletes. In sports physical therapy, we include frontal plane exercises to improve single-leg stability and prevent these injuries.

Build a Strong Foundation with Sports Physical Therapy

At Cohen Health and Performance, our sports physical therapy programs in McLean and Bethesda focuses on developing pillar stability to enhance athletic performance and prevent injuries. Whether you’re recovering from an ACL reconstruction or aiming to reach new performance levels, building pillar strength across all planes of motion is critical.

Ready to Elevate Your Game?

Take the next step in your athletic journey with a Performance Physical Therapy Evaluation. Our expert team specializes in sports physical therapy to help you move better, perform stronger, and stay injury-free.

Click here to schedule your evaluation today!

Exercises that I don’t do anymore as a physical therapist

If you’re an active adult who values fitness and staying in peak condition, you’ve probably encountered the occasional advice on “must-do” exercises. But, as our bodies and needs evolve, certain exercises may no longer serve us as well as they once did, or they may come with risks that outweigh their benefits. At Cohen Health and Performance, we’re committed to helping clients in Bethesda and McLean stay active and injury-free with exercise choices that prioritize safety and effectiveness.

Recently, I was chatting with a former colleague about the early mornings we used to spend training professional athletes. Back then, our routines were packed with intense, high-demand exercises designed to build serious strength and endurance. But over the years, I’ve fine-tuned my approach and adjusted my own workouts, replacing some exercises with alternatives that are safer and yield excellent results—especially for those of us who aren’t competing professionally but still want to stay strong and healthy.

Here are two exercises I no longer include in my routine, along with the safer, more efficient alternatives I recommend to clients who want to build strength and minimize injury risk.

1. Moving Beyond the Plank: Core Stability Without the Strain

Planks are a classic core exercise and have become wildly popular for strengthening the abdominals and shoulders. However, planks aren’t always ideal for everyone. Holding a plank for extended periods or performing them without perfect form can put excessive strain on the lower back, which is especially risky if you have existing back issues or aren’t engaging the right muscles.

Instead of traditional planks, I now recommend bear variations, like the bear crawl or bear plank. Bear variations are dynamic and can be modified to target core stability and strength without placing undue stress on the lower back. The bear plank, for example, involves holding a position on all fours with knees hovering just above the ground. This position naturally activates your core muscles while keeping the spine in a better position, significantly reducing the risk of back strain.

For active adults in Bethesda looking to maintain core stability and train safely, bear variations are a great choice. They challenge the core in a more effective way, promoting good posture and balance—skills that are essential not only in the gym but in everyday activities.

2. Replacing the Barbell Back Squat: Safer Alternatives for Building Lower Body Strength

Another staple of strength training is the barbell back squat, an effective exercise for building lower body strength and muscle mass. However, barbell back squats lots of mobility and solid form to avoid injury, especially to the lower back. For many people, this level of mobility and movement competency isn’t practical without extensive preparation, and the risks may outweigh the benefits.

Safer alternatives like goblet squats and safety bar squats offer the same benefits with less risk. Goblet squats, which involve holding a weight in front of your chest, are accessible for most people and help engage the core, which can further protect the lower back. Safety bar squats, which use a specially designed bar to keep weight distributed more comfortably, allow for better form and greater ease in maintaining an upright posture. Both exercises are fantastic for strengthening the legs, glutes, and core while minimizing the risk of injury associated with traditional back squats.

For active adults focused on maintaining mobility and avoiding injury, these squat alternatives offer a way to build lower body strength without the complexity and potential drawbacks of a barbell squat. If you’re working with a physical therapist in Bethesda, they may even recommend these variations as a part of your strength-building routine, especially if you’re managing previous injuries or aiming to improve overall stability and function.

The Power of Purposeful Exercise Selection

When designing a workout program, one of the most important questions to ask is: What is the goal of this exercise? For most active adults, the goal is to build strength, look good, and avoid injury—keeping you strong and capable for years to come. At Cohen Health and Performance, we focus on exercises that provide maximum results with minimum risk. By selecting exercises that target the right muscles without overloading the joints, we create workouts that help you achieve your goals safely and sustainably.

Our philosophy is simple: every exercise in your program should have a clear purpose, whether it’s improving strength, boosting flexibility, or enhancing functional movement. This approach guides all the programs we create, from personal training sessions to physical therapy in Bethesda and McLean, helping clients stay active and reduce the likelihood of injury.

Build a Safe, Effective Training Program with Physical Therapy in Bethesda and McLean

If you’re an active adult looking to refine your workout routine, avoid injury, or just get a professional’s perspective on your training, we’re here to help. Our team of physical therapists and exercise specialists in Bethesda and McLean have the expertise to create a program that’s tailored to your goals and abilities, using exercise strategies designed to keep you moving, strong, and injury-free.

Questions about how to build a safe, effective training program? Contact us today at Cohen Health and Performance to schedule an appointment. Together, we’ll design a plan that fits your lifestyle and keeps you active, healthy, and ready for whatever physical challenges come your way.

What Performance Physical Therapist, Dr. Biddle, learned from breaking her leg

I’m thrilled to welcome Dr. Catherine Biddle to our physical therapy team in Bethesda. Dr. Biddle specializes in treating gymnasts, dancers, and athletes with hypermobility related conditions. As a former Division I gymnast at Northern Illinois University, she brings both expertise and personal experience in overcoming sports injuries.

She was kind enough to tell us about the injury that inspired her to become a sports physical therapist and what you can learn from her journey.

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At 15, I suffered a serious injury during gymnastics practice. While performing a skill called a blind full on bars, I turned too early, causing a fall from 12 feet onto concrete. The result? A broken fibula in three places and a dislocated tibia.

Two days later, I had surgery to insert a plate and eight screws in my leg. My doctors warned I might never compete at the same level again. As a gymnast for 13 years who was being actively recruited by colleges, this news was devastating. I felt lost—until I started physical therapy three weeks after surgery.

When I crutched into my first physical therapy session, feeling hopeless, my therapist did something powerful: she asked me how I was doing—not just physically, but emotionally and mentally. That conversation changed everything. She told me that while recovery wouldn’t be easy or fast, we would do everything we could to get me back to gymnastics. Thirteen months later, I joined a Division I gymnastics program and had a fulfilling collegiate career.

My injury taught me that the physical therapy journey is about more than just the body. It’s about mindset, support, and perseverance. The right therapist can make all the difference, helping you heal both physically and emotionally.

Most importantly, I learned that a surgeon’s prognosis isn’t the end of the story. With the right support system, a positive outlook, and hard work, you can overcome obstacles you never thought possible.

These lessons shape how I approach my work today. I focus on more than just my patients’ injuries—I consider how they’re feeling overall and what their goals are. Healing isn’t just about “fixing” the problem; it’s about helping people return to the activities they love.

So how do you know if you’ve found the right healthcare provider for you?

Ask questions!

Prior to your visit, prepare a list of the questions that are important to you. Your provider should be willing to answer all of your questions, even if they can’t give you a definitive answer at the moment.

Here are 3 questions that I advise asking.

1. Why did this happen, and how can we prevent it from happening again?
Understanding the cause of your injury helps ensure it doesn’t become a recurring issue.

2. What should I be doing at home?
Recovery extends beyond the clinic. Make sure you’re clear on what exercises or precautions you should follow at home.

3. How will we measure my progress?
Your goals should guide your recovery, not just standard benchmarks. Set clear expectations with your therapist to track meaningful progress.

Physical therapy is most effective when it’s a partnership. The more engaged you are in your recovery, the better your results will be. Asking these questions helps you take control of your health and build a stronger relationship with your therapist.

Interested in scheduling an appointment with me or a member of our team? Contact us!

-Dr. Catherine Biddle PT, DPT