Steven Cohen on Shoulder Injury

Tell me about your injury and how it began.

The injury I most recently faced, which was diagnosed in late 2017, was a small tear in the supraspinatus muscle of my left shoulder’s rotator cuff. The injury developed from long term repetitive use connected to playing the horn. It came from being in a fixed position for extended periods in both performance and in practice. The development of the injury was gradual. My doctor believes that its origins could go back to as early as 2010. 

Did you see any doctors or specialists? 

I am fortunate to have an incredible Physical Medicine and Rehabilitation doctor, Dr. Alfred Gellhorn, who is at Weill Cornell Medicine in New York. His role there has him serving as the Director of Sports Medicine for the Department of Rehabilitation Medicine. He took the time to understand my injury and work on a plan. His understanding of musicians, as well his vast knowledge of athletes, allowed him to see my injury from a light that not every doctor would see, and I’m thankful for that, as it allowed him to develop a well-formulated plan. My referral to Dr. Gellhorn came through Dr. Michael Stewart, an ENT, who is the director of the Center for Performing Artists at Weill Cornell. 

Did you do any therapeutic at-home treatments?

I found myself using heat and stretching a fair amount. The heat was certainly a temporary relief that I welcomed. With regard to the stretching, especially prior to practicing, I noticed that there was a longer period of time before I started feeling any pain during practice or performance.

How did this affect your work? 

I took some time off from the horn in December for about two weeks. It was a time I felt quite down on myself as I love making music, and being unable to share it during such a joyous time of year took a mental toll. 

What were the greatest frustrations?

My initial frustration came from the doctor I saw prior to Dr. Gellhorn. He didn’t take the time to understand what I was going though or the nature of exactly what it was that I did as a musician. His physical therapy recommendation was misguided, leading to poor and incorrect care of my injury.

During the time I spent dealing with the pain after leaving my initial physical therapist, a lot of time was expended questioning whether the end of my career as a horn player was closer than I could have imagined. 

The recovery itself through the second and proper round of physical therapy, as guided by Dr. Gellhorn, was difficult.  The sessions showed not only the weakness in my shoulder, but brought to light the tension and stress that had manifested in the corresponding and surrounding areas. Those sessions were a battle with myself on a weekly basis, but in the end proved to be exactly what I needed.

What seemed to help the most?

There is no question that the physical therapy helped. It helped turn me around and start me on the path to physical wellbeing. My physical therapist was in my corner every session. She pushed me for sure and loved digging her elbow into the various areas of tension that needed to be broken up, but she knew exactly what I needed. She also took the time to learn about me as a musician and even expanded her knowledge of PT skills and techniques to further my recovery. Outside of PT, the support of my family and colleagues was crucial. My wife, a horn player-turned-nurse, watched me struggle through this, and was incredibly supportive through every step. 

Did you change/tweak your approach or technique?

I have found myself sitting more both in practice and solo performance. While some might say that sitting for a recital or solo performance might be improper, I feel that it is important to recognize that those who might appear able-bodied might be unable to give their best performance standing because of injury. In addition to sitting more, I’ve spent time focusing on my posture.

Did you make any other changes in your lifestyle?

Through all of this, I have spent time focusing on building a better me through diet and exercise. While the PT I have is strengthening my shoulder, I feel that it’s important to ensure that my entire body is equally strong. 

If you had to take time off and rebuild, how did you structure your practice in rebuilding?

I made a plan that was based on incremental increases to my practice sessions over a 7-day period to assist me in getting back to my regular endurance level. For those practice sessions, I included etudes from Gallay and Kopprasch, as well as the Standley routine. Using those tools, I was able to hone in on what I needed to focus on in rebuilding after those two weeks away from the horn.

I have found that regaining trust in the body is no small task. Have you experienced this? If so, how did you regain trust in yourself? 

I was rather nervous about returning to the horn and how my shoulder would respond. I made myself sit down and just practice, focusing on making sure that I was in a good position and to just play. Yoda’s saying, “Do. Or do not. There is no try,” comes to mind. I’m in the process of a major recording project and, while my wellbeing is something I am focused on, I can’t let negative thoughts surrounding my injury infiltrate my thought process. I have to trust myself by knowing that I am doing everything I can for myself, not only to further myself in my musical work and my injury, but also in life.   

Did you come to feel like “yourself” again eventually?

Now, six months after the initial start to my recovery, and rehearsing for my recording in June, I feel like myself again, both as a player and a person. 

Has this injury changed you as a player? If so, how?

There is no question that going through this changed me. I would stay the it changed both my mental and physical approach to playing. I used to play with the pain and I knew that I was fighting myself, but my brain and body had to push on. Now that I am almost fully recovered, I feel as if I have more confidence in myself and I’m able to allow myself to go farther in what I am trying to have my performances say.

Were there any resources that you found particularly helpful in your recovery?

I found my physical therapist to be key to bringing myself back from my injury. She instilled a great deal of confidence in me and pushed me to believe myself.

Do you have any advice to those who have been injured and are recovering?

Stay positive! We are our own worst enemy through recovery and rebuilding. The drive back to normalcy is long and arduous, and is sometimes longer then we’d like, but having a resilient mental approach along with the physical recovery is crucial. Also, do not be afraid to reach out to friends or colleagues who have gone through a similar challenge. Some of the injuries that we are faced with as musicians can be terrifying, but having someone to walk alongside us through it all is something I feel is invaluable. – Steven Cohen, NYC Freelancer