"It's like torture," said Cohen, who immerses herself in freezing water for nearly 15 minutes as a form of physical therapy.
Cohen, who lives in Huntingdon Valley, also practices yoga and works out with a personal trainer. She has struggled with bouts of tendonitis in her forearm and hand, and previously tore a muscle in her leg.
But with pain comes glory. Cohen has been ranked as high as eighth in the United States in the 12-and-under division for girls singles, winning four tournaments against the best players from Pennsylvania, New Jersey and Delaware.
Training and competitions take the preteen to Florida, San Francisco, Kentucky, Ohio and California; so much traveling means she's absent from school quite a bit.
"I missed 75 days of school out of 180 last year," said Cohen, who managed to get straight A's in sixth grade at Murray Avenue School after getting extra help from teachers and working at home to learn the material she missed in class.
"The teachers are very supportive," said her mother, Robin Lyons. "When she comes back, they help her catch up on everything."
Cohen also takes time to train with a private tutor for her Bat Mitzvah this coming December.
Since she does not fly alone, all the traveling can be tough on Cohen's parents as well. "One of us always accompanies her," said her father, Mario Cohen. "It's demanding -- it really is."
Since he is a contractor and his wife owns a clothing store, their schedules remain flexible enough so that one or the other can accompany their daughter during her budding tennis career.
Her strong play has landed Cohen a sponsorship with Wilson, a sporting-goods company that provides racquets, strings, sneakers and luggage.
"Everything's expensive because you have to buy court time, pay the coaches, so anything anybody's giving helps," said Mario Cohen.
Madison's not the only one with talent in the family. Her 16-year-old brother, Taylor, has emerged as a tennis success as well, winning the state doubles championship in only his sophomore year at Lower Moreland High School.
Although he doesn't travel for tennis as much as his sister, he still finds that he must make social sacrifices.
"I missed our freshman dance and the back-to-school dance earlier this year because of tournaments," said Taylor, who also competes against players from neighboring states.
While some who excel at a particular sport at a young age may be restricted from playing anything else -- in order to risk preventable injuries -- Madison and Taylor are encouraged to play other sports.
"The footwork in basketball is the same as tennis," said Taylor. "Playing tennis is by yourself and basketball is a team, so you get to hang out with your friends during the game, and the pressure is not all on you."
That said, Lyons is happy that her children find time for themselves; her daughter sacrificed a national training session to attend a friend's Bat Mitzvah.
"We really make sure it stays balanced," added Mario Cohen, "and there is some semblance of a social life."