Author: Zachary Cohen

Dr. Zac began his career working in professional sports. He noticed a large discrepancy between the quality of care that elite athletes receive when compared to the normal active public. This inspired him to create Cohen Health and Performance, a place that treats everyone as if they are a professional athlete! He graduated summa cum laude from Northeastern University in 2011 with his Doctorate in Physical Therapy, and also became a Certified Strength and Conditioning Specialist (CSCS). While at Northeastern he worked as a Physical Therapy Graduate Assistant for the New England Patriots, and served as a strength and conditioning coach for Northeastern University athletics. Prior to moving to Maryland, Zac was a Performance Physical Therapist with EXOS (formerly known as Athletes' Performance) in Dallas, TX where he treated and trained the world's most gifted athletes from throughout the NFL, MLB, NBA, MLS, and various Olympic teams.

Is Your Doctor (or physical therapy clinic) Taking Care of You?

Recently, I joined my mother-in-law for a visit to a physician’s office.

The physician she saw has a solid reputation and is known as a “go-to” expert in his field.

During the visit he spent a total of 5 minutes with my mother-in-law, glossing over test results and providing very brief recommendations.

He appeared to be speaking as fast as he could so that he could finish the visit and to get to his next patient. After his rushed explanation, we attempted to ask questions, which he answered while backing out of the room.

Sadly, experiences like this are very common in the world of healthcare and I do not blame the healthcare providers because they oftentimes are not left with much of a choice.

The health insurance industry consistently reduces reimbursement to health care providers, forcing them to schedule more patients within a fixed time period. As a result, the quality of care suffers, and everything becomes less personalized.

This also occurs in physical therapy, forcing many clinicians to resort to “cookie cutter” protocols.

If you go to Physical Therapy because of lower back pain then you get put on the lower back pain protocol, shoulder pain=shoulder protocol, etc.

Many times, this works, however, it is not the best choice for those looking to live an active, pain free, and healthy life.

For this reason I typically seek out practitioners that are out of network with health insurance as it enables them to provide me with the highest quality of care possible. In this approach I am treated like an individual and I get to ask all the questions that I would like so that I can a better understanding of my health.

We are out of network providers here at Cohen Health and Performance. We strive to get the best possible results for our patients in the least number of visits, while also providing the education necessary to prevent future issues from occurring.

People can feel better, move better, and enjoy an active lifestyle. Our mission at CHP will always be to take the best possible care of our patients and that is why we are out of network with health insurance.

Interested in learning more about how this approach can help you? Contact us here!

Why Are You Bench Pressing?

How often do you stop and think about how you want to perform an exercise and if that is conducive to your goals? Our physical therapy patients here in Bethesda often have the goal of learning to train without pain or discomfort. Training clients, most concerned with sports performance may have goals that include becoming stronger, faster, or building muscle mass.

There is not always a “correct” way to perform every exercise.⁣ Let’s take the bench press as an example.
⁣
Depending on your goals and capabilities, you may want to play around with the angle of your arms when bench pressing.⁣
⁣
Is your goal to build big pecs? Perform the lift with the arms closer to 90 degrees and do not allow the arms to drift past the body as you can see in the video here.
⁣
Do you want to lift more weight while keeping your shoulders and lower back healthy? If so, perform this lift with the arms closer to 45 degrees to take the stress off the front of the shoulders. Check out this bench press variation here.⁣
⁣
This is just one of many exercises that can be altered to change the focus.

The key is being clear on the outcome that you have in mind!⁣

Image Source

“Bench Press” by A. Blight is licensed under CC BY 2.0.

What All Rotational Athletes Must Be Capable Of (Part 2)

The best ability is availability.

Rotational athletes come to physical therapy for help for with a variety of different overuse injuries (for more information, check out part 1 here). These injuries are the result of an excessive amount of stress placed onto one area which exceeds the body’s ability to tolerate.

Excessive stress accumulates in a particular area (often the lower back) as it is forced to pick up the slack from another area of the body that is not doing its part. Injury rehabilitation often involves discovering what these areas are.

Many times, it is the hips.

The hips are large joints with powerful muscles (ex. The glutes) surrounding them. This area should be generating the power to make things easier elsewhere.

The med ball hip toss teaches the body to generate rotational power at the hips and ultimately propel the ball through the arms. Once you have mastered this drill, step things up and give the perpendicular med ball throw a shot!

Do you feel your body is getting beat up during golf, tennis, or baseball? Come discover the root cause of your discomfort and specific strategies to address it. Visit our website to schedule a FREE phone consultation with a member of our team! Link in bio.

What All Rotational Athletes Must Be Capable Of

Low back pain with golf or arm pain with throwing. At our performance physical therapy practice, we see this constantly.

Swinging a golf club, throwing a baseball and hitting a tennis ball involve a great deal of rotation. Many areas of the body should be involved in these movements, however that is not always the case.

It is common to see baseball pitchers that are experiencing arm issues demonstrate the habit of trying to “arm” the ball as they throw it. There is not much contribution from the legs which places a great deal of stress on the arm and over time results in overuse injuries.

Many golfers and tennis players experience lower back pain because they do not effectively link the power that they generate in the lower body through the trunk, into the upper body and ultimately to the head of the club. As a result they compensate elsewhere, placing increased stress onto the lower back.

The rotational row is a great drill to train the body to generate rotational power through the legs and connect it through the trunk. View this exercise here.

Once you have mastered the rotational row and learned how to link the power generated in the lower body to the trunk, we can now add in the upper body! The rotational lift trains the body to generate rotational power through the legs and connect it through the trunk and arms. Check this exercise out here.

Interested in learning more ways you can address lower back pain while enjoying your active lifestyle? Sign up for a FREE phone consultation today!

A More Scientific Approach to Shoulder Mobility

Many of the sports related shoulder injuries that bring patients in for physical therapy occur when the shoulder is at it’s end range of motion.

Many assume that stretching and other drills to increase shoulder flexibility are the best ways to address these issues.

However, the issue lies in the ability (or lack-thereof) to demonstrate strength in end ranges of motion.

When in these positions, the muscles that control the shoulder are not able to generate as much force as when they are in less extreme positions. They struggle to control the shoulder joint and this challenge increases the chances of experiencing an instability related injury (like a dislocation) and can wear down the joint over time.

The good news is that we can train strength in end ranges of motion where our shoulders are often most vulnerable.

I recently taught the 2 drills below to a group of Crossfit athletes. In Crossfit, athletes must be able to lift and control heavy weights overhead which requires a large amount of strength in extreme ranges of motion.

These are fantastic exercises to work on these capabilities and you do not need to be a Crossfit athlete to benefit from them. Give them a shot!

Shoulder Flexion PAILs with a Lift Off Challenge

Shoulder External Rotation PAILs with a Lift Off Challenge

How Focusing on Mental Health Improves Physical Therapy Outcomes

Can focusing on mental health improve outcomes in physical therapy?

Yup!!

This concept is challenging to grasp because the medical system often tries to attribute physical pain to a direct cause. However, it isn’t that simple and this is important for every physical therapist to understand.

Humans are complex and physical pain is influenced by several different factors. One of which is the brain.

An individual’s mental state has a large impact on their physical state and the effectiveness of physical therapy interventions.

Do not miss the latest episode of the CHP Spotlight Interview series with Dr. Kelly Forys Donahue and Dr. Danielle Miro from DC Health Psychology (http://www.dchealthpsychology.com and www.modernpsychologists.com) to learn this and so much more!

Check out the full interview here.

Photo Credit

“World Mental Health Day Observance” by United Nations Photo is marked with CC BY-NC-ND 2.0.