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.

A physical therapist in the wild! 3 of my personal upper body warmups

Incorporating overhead pressing exercises into my weight training routine is something I really enjoy, but I often find them a bit challenging.

My overhead mobility isn’t as good as I’d like it to be, and a significant reason for that is my stiff chest. I have a mild case of pectus excavatum, commonly known as bowl chest. This condition causes the sternum-the bone at the center of the chest-to remain depressed, creating difficulties during overhead movements.

While this condition varies in severity, it often leads to difficulties during overhead movements due to the restricted ability of the sternum to rise when pressing or reaching overhead. In an ideal scenario, the sternum should lift as you inhale and lower as you exhale. However, for individuals with pectus excavatum or a generally stiff chest, this natural movement is hindered, making overhead exercises more challenging.

It’s not just those with pectus excavatum who face these challenges. Many people develop tight chest walls from modern lifestyle habits such as prolonged sitting, slouching, carrying heavy backpacks, or simply spending too much time hunched over a desk. These habits can cause stiffness in the chest, limiting overhead mobility and increasing the risk of injury during exercises like the overhead press.

Physical therapy offers a comprehensive approach to improving overhead mobility, particularly for those dealing with stiff chests. Traditional stretching methods might not be effective in addressing the underlying issues that restrict movement. Instead, targeted exercises and warm-up drills can be instrumental in loosening the chest, enhancing mobility, and ensuring that the body is well-prepared for the demands of weight training.

Three Effective Warm-Up Drills for Improved Overhead Mobility

To address these challenges, incorporating specific warm-up drills into your routine is crucial. Here are three exercises that can help improve overhead mobility, especially for those struggling with a stiff chest:

1. Crab on Elbows: This exercise is designed to open up the chest and promote better sternum mobility. By supporting yourself on your elbows in a crab-like position, you can stretch the chest and prepare it for the demands of overhead pressing.

2. Hooklying Overhead Reach: In this exercise, you lie on your back with your knees bent and reach overhead. The goal is to enhance the connection between your breathing and your chest movement, encouraging the sternum to rise and fall with each breath. This drill not only improves mobility but also reinforces proper breathing techniques that are essential during overhead movements.

3. Yoga Pushup*: Combining the elements of a traditional pushup with yoga-inspired movements, the yoga pushup is excellent for improving overall shoulder and chest mobility. It helps in engaging the entire upper body while emphasizing the importance of controlled breathing and proper form.

The Importance of a Tailored Warm-Up Routine

A tailored warm-up routine that addresses specific areas of stiffness or weakness can significantly improve your performance and reduce the risk of injury. In physical therapy, we emphasize the importance of being intentional about your warm-ups. By incorporating exercises like the crab on elbows, hooklying overhead reach, and yoga pushup, you can specifically target areas that need improvement, ensuring that your body is fully prepared for the workout ahead.

Moreover, these exercises are not just about getting ready for the workout; they are about making long-term improvements in mobility and strength. Over time, consistent practice of these drills can lead to better overhead mobility, reduced discomfort, and enhanced performance in your weight training routine.

For anyone facing challenges with overhead pressing due to a stiff chest or conditions like pectus excavatum, physical therapy offers a range of solutions that can make a significant difference. By incorporating targeted warm-up drills into your routine, you can improve your overhead mobility, reduce the risk of injury, and enjoy the full benefits of your weight training regimen. Remember, being intentional about your warm-up is not just a preparation—it’s a critical part of your journey toward better physical health and performance.

Why most sports physical therapy for ACL injuries is incomplete

Picture this: Four months ago, you underwent surgery to repair a torn ACL (anterior cruciate ligament) in your knee, and you’ve been diligently attending sports physical therapy ever since. Initially, you were on crutches, with a swollen knee that barely moved. But after several weeks of physical therapy, you regained full range of motion and relearned how to walk normally. You’ve even started running again and are eagerly anticipating the day you can return to practice or the activities that make you feel like an athlete!

But then, your physical therapist informs you that you’re being discharged from therapy…

This scenario is common because insurance companies often don’t classify return-to-sport activities as “medically necessary.” As a result, most traditional physical therapy clinics don’t offer return-to-play programs.

I refer to this crucial stage of recovery as “the gap.” The gap represents the period between completing physical therapy and beginning performance or personal training.

Many athletes aren’t actually ready to return to their sport when they’re discharged from physical therapy because they haven’t yet bridged this gap between rehabilitation and peak performance.

At this stage, athletes may be pain-free, have full knee range of motion, and even have regained much of their strength. However, they still need to train their knee to use that strength explosively and withstand the demands of cutting, jumping, and sprinting.

Unfortunately, many athletes skip this vital phase of ACL recovery, returning to their sport before their knee is fully prepared. This significantly increases the risk of re-injuring the repaired ACL or even damaging the other knee.

Programs designed to help athletes bridge this gap typically start with tests to assess how close they are to returning to their sport. These tests often include hops, agility drills, and movements specific to the athlete’s sport.

In our Bridge The Gap ACL program, we begin with the single-leg hop test. Research suggests that the surgically repaired leg should be at least 90% as strong as the unaffected leg before engaging in sport-specific activities. Ideally, both sides should be equal before an athlete resumes full practice.

Below is an example of a single-leg hop test.

Sports physical therapists use the results of these tests to create a tailored training program that combines elements of physical therapy, strength and conditioning, and sports performance.

Research indicates that the earliest an athlete can safely return to play after ACL surgery is around nine months (even longer for younger athletes). For this reason, most bridge-the-gap programs last between 2-4 months.

Interested in learning whether our Bridge the Gap ACL Program is right for you? If you or your child is recovering from an ACL repair, contact us to find out more!

Why We Need to Stop Comparing Adult Movements to Children’s

It has become common in fields of physical therapy and performance training to compare adult movement to the ways that babies move. You may have spoken to a professional that uses this comparison in their approach.

The logic usually goes something like this…“Humans were born with the ability to squat fully, and our modern lifestyles robbed us of that ability, so we need to regain it.”

Sounds understandable, right?

I thought so too. I even took a couple of continuing education courses based loosely upon this concept. The class instructors showed pictures of babies at various development stages and attempted to teach movements that mimicked these phases. The idea was to help adults gain back some of the movement capabilities that they once had as children and this new freedom of movement would help to alleviate pain and resolve injury.

Adults Are Not Babies

While I think we’d all love to be able to squat to the floor, crawl around all day, and never get tired, the truth is that we are not babies anymore.

Babies have a large amount of joint laxity that allows them to get into a variety of different positions, that we don’t have as adults. Babies also have a very large head in relation to the body, which helps to provide a counterbalance for easy squatting. In fact, according to Healthline, many of a baby’s bones are composed of cartilage, a type of connective tissue that is tough but flexible. This cartilage turns to bone as we grow.

Their bodies are still growing and changing. They fall often and make mistakes (essential for learning), which flexibility and mobility help with. Because of this, the ability to squat to the floor is normal for a baby. The same cannot always be said for adults.

Adults are not babies, and we cannot use a baby’s movement as a model for how an adult should move. Not only do babies have much different bone and structural compositions, but all adults have different movement capabilities due to variations in torso lengths and body proportions (among other reasons). Using singular movement standards would overlook this critical aspect.

It is nice to think that we could be able to squat to the floor like we once did when we were a toddler. However, adults are not babies, and our bodies are not the same as they once were.

Because of this, we do not expect our physical therapy patients to squat to the floor. It is essential for all of us to set realistic movement standards that will help to live pain-free and healthy lives. For help in the arena, talk to our experienced physical therapy team in Bethesda!