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.

3 Home Exercises to Help with Your Back Pain

Did you know that according to research, over 70% of Americans will experience back pain during their lives?

Surprisingly, this statistic remains high among active people. Sometimes their training even contributes to it!

One of the things you can do to help reverse this trend is to implement Pilates into your training. Dr. Ciara is a physical therapist and certified Pilates instructor. She has taught us how to incorporate Pilates into the treatment of physical therapy patients right here in Bethesda and Chevy Chase. These principles can also be used in performance training.

The good news is that Pilates doesn’t require you to go to a Pilates studio. Many Pilates exercises can be done from home and performed within your training regimen.

Begin with the 3 exercises below.

The goal of these activities are to teach you how to control your body using your deep abdominals and glutes. Therefore, it is essential to focus on quality of movement, rather than the quantity performed. There are no heros with these exercises!

To learn more about Pilates, check out last weeks article below!

What Actually is Pilates?

What actually is Pilates?

Has anyone ever suggested that you try Pilates, however you really don’t know what Pilates is? If you don’t really know what it is, how could you know if Pilates will help you?

The newest member of the CHP team, Dr. Ciara Petry, is a certified Pilates Instructor and specializes in helping, in addition to being a physical therapist. She utilizes Pilates in her physical therapy practice and within her performance training services for her clients in Bethesda and Chevy Chase. She even uses Pilates during her virtual physical therapy sessions! We are so grateful that she was kind enough to share this information with us.

Pilates is can be described as a conscious way back into our bodies, better connecting the mind and body. Pilates focuses on body alignment, controlled movement, and breathing. Joseph H. Pilates developed this movement system with the goal of improving the ability of the deep muscles of the body to guide and control movement.

Classic Pilates does not require any fancy equipment can be easily be performed on a mat. The focus of a typical session will be on quality of movement versus quantity (number of reps, amount of weight, etc.). Spinal movements, a properly engaged core, shoulder and pelvic stability, breathing, and working with oppositional energy are all key to Pilates work.

Contrary to popular belief, Pilates is very different from Yoga and it is important to understand these differences so that you can choose the right activity for you and your goals.

Yoga was founded as a sacred tradition over 5,000+ years ago with a focus on physical, mental, emotional, and spiritual health. Yoga is a meditative practice, where Pilates is not, and follows a sequence of poses that are often held for long periods of time to increase short-term flexibility.

Pilates was founded in the 1920’s with a focus on strengthening of the core, improvement of posture, stabilization and elongation of the spine, and development of balance and overall strength. Movements are shorts with an increased focus on control, precision and long-term mobility.

For these reasons Pilates is incredibly useful for anyone suffering from back, knee, or hip pain. Furthermore, it serves as a great alternative or adjunct to weight training or running.

Next week will be discussing how you can use Pilates to help overcome injury and improve your performance in a variety of settings!

Physical therapy for back pain often requires only 1 simple modification

Back pain remains as one of the leading causes of disability worldwide and according to research, over 70% of people will experience back pain at some point in their lives and likely require physical therapy.

When back pain is measured among such a large number of people, it is impossible for each person to specify the different ways in which their back pain presents.

When treating physical therapy patients with back pain, we see this pain present in many different ways. Since we treat such active people, our patients are very aware of the different movements that elicit their symptoms.

Many times, picking objects off the floor, aka deadlifts, produce their back pain. During these movements, the body bends over by folding at the hips. This moves the spine into a position that is horizontal relative to the ground, resulting in more shearing forces within the spine. Shearing force is the force of one vertebra wanting to move forward or backward relative to the one above or below it.

For many others, squatting movements are problematic, specifically when squatting with resistance (such as when lifting weights). When squatting the spine is vertically oriented (compared to a deadlift) resulting in more vertical compression against gravity.

Do you have back pain? If so, is it worse when picking things up off the ground or when squatting with resistance?

If it is worse when picking things up off the floor, aka deadlifting, you may want to consider replacing deadlift exercises with squatting variations within your performance training program. While this should not be a permanent solution, it can help you get out of pain while addressing the root causes of the issue in physical therapy.

If your pain worsens when squatting with resistance, you may want to consider switching to more single leg squatting variations in place of double leg squats. Once again, this should not be a permanent solution (although single leg exercises are awesome!), however it can help you get out of pain while addressing the root cause of your pain.

For help addressing the root cause of your pain, contact us!

Training with back pain may only require a simple modification

Back pain remains as one of the leading causes of disability worldwide and according to research, over 70% of people will experience back pain at some point in their lives.

When back pain is measured among such a large number of people, it is impossible for each person to specify the different ways in which their back pain presents.

Do you have back pain? If so, is it worse when picking things up off the ground or when squatting with resistance?

If it is worse when picking things up off the floor, aka deadlifting, you may want to consider replacing deadlift exercises with squatting variations within your training program. While this should not be a permanent solution, it can help you get out of pain while addressing the root causes of the issue.

For help addressing the root cause of your pain, simply contact us!

What you can do from home to accelerate your training

When the COVID-19 pandemic began I was feeling stressed and was anxious. Old aches and pains were even returning!

I was no longer prioritizing my own fitness routine, causing me to be more sedentary than usual. This combination of stress and decreased daily movement caused my old back injury from college to become slightly noticeable again.

This was a powerful reminder of the importance of taking care of myself.

I now make sure to prioritize my morning routine which includes meditation, journaling, and most importantly (at least for me), exercise.

While I do enjoy an intense workout, many days I simply go on a long walk followed by 10-15 minutes of light continuous movement using only my body weight.

My back feels great and the most importantly, I am reaping the positive physical and mental health benefits of exercise.

And while my workout routine works well for me, it might not work for others. Your self-care routine is specific to you. What activities help you to feel and function at your best?

Despite the differences, we often find that a variation of physical activity is helpful. I won’t bore you the science of why, however, if you are interested I am happy to share it!

Below are 3 exercises that are fantastic for you to try at home. They are helpful for anyone that suffers from a cranky lower back, is looking to feel better, and/or improve their fitness.

-Heels Elevated Goblet Squat (no weights at home? No problem! Simply hold a backpack filled with books or a jug of water): start with 3 sets of 8-10 reps

https://www.youtube.com/watch?v=i-os3nvr23s

-Bear Position Hold: 3 sets of 5 breathing cycles

https://www.youtube.com/watch?v=A9IJ2b_GbF4

-Goblet Split squat (use a weight or the same tool from exercise #1): start with 3 sets of 8-10 per side

https://www.youtube.com/watch?v=aazACzyUR-Q

-Dr. Zachary Cohen PT, DPT, CSCS

I wasted a lot of time stretching

My passion for the field of sports medicine and strength and conditioning began when I was 15 years old.

I was a solid athlete and football was my passion. At the time my dream was to play Division I college football. Although I was successful relative to my immediate peers, I knew that I would have to work my hardest to have any chance of getting to that level.

I trained hard and searched for every advantage I could find. I read books written by famous coaches, trainers, and athletes. One of the most common pieces of advice was to constantly be stretching.

Every morning upon waking, I would perform a 15-20-minute stretching routine. I would repeat a similar routine prior to and after training, as well as before bed.

I would feel more flexible for a short period of time after performing this routine, however, did not notice any improvement in my performance.

When looking back at this now I realize that I never asked myself one simple question. What am I trying to achieve by stretching?

I was simply stretching because people told me I should!

So, what are you trying to achieve when you stretch? Will stretching be helpful for you?

As with most things, the answer is that it depends.

A muscle will become stiff when it is consistently resting in a shortened position. This may be due to posture or a person’s daily activities. For example, someone that sits for an extended period of time is likely to have stiff muscles in the front of the hips.

Stiff muscles may also occur as a result of movement compensations or a lack of movement altogether.

Simply stretching a muscle without correcting the reasons it occurred in the first place, may result in a lot of wasted time. The first step may be to simply move around throughout the day. A simple walk to the water cooler can be enough to break up extended bouts of immobility.

Also, a muscle may become stiff in an attempt to protect against an injury. For example, those with chronic lower back pain often have stiff hamstrings as the hamstrings tighten to protect the lower back.

In this case, it is important to learn to protect the lower back with exercise. One of the first steps is to learn to properly “stack” the pelvis underneath the rib cage. You will feel your abs when you are “stacked” properly. Attempt to maintain this feeling during weight lifting drills.

Below is a great exercise to learn do just that! Have fun and let us know if you have any questions!

Heels Elevated Squat

-Dr. Zachary Cohen