Rotator Cuff Tear Sidelines Conductor

By Shelagh McNally for Shoulder1

Both the Boston Symphony and the Metropolitan Opera will temporarily be without its maestro because of a shoulder injury. Conductor James Levine was injured on March 1 when he fell onstage at Boston Symphony Hall during an ovation. A MRI exam and X-ray revealed that he had a torn rotator cuff in his right shoulder. Maestro Levine holds his conductor’s baton in his right hand and is unable to lift his arm to conduct.

Take Action

Taking Care of Rotator Cuff Injuries Symptoms of a shoulder cuff injury: Pain, sometimes vague and hard to pinpoint Weakness Inability to raise your arm over your head Inability to extend your arm directly to the side or in front Recommended treatment for shoulder cuff injuries: The earlier the shoulder is treated the better The first 48 to 72 hours are crucial Do the RICER regime (rest, ice, compression, elevation and referral) Increase the blood supply to the area with heat-based creams Follow your doctor’s advise should surgery be required Did you know? Four main muscles of the rotator cuff: Supraspinatus Infraspinatus Teres Minor Subscapularis

Rotator cuff tears are a common source of shoulder injuries and most frequently occur when the tendon begins to degenerate with age, rather than from injury or trauma. It’s an injury most commonly seen in baseball players who put their shoulders under tremendous pressure pitching and hitting.

The rotator cuff is a group of tendons connected to the four muscles referred to as the "SITS": Supraspinatus, Infraspinatus, Teres minor and Subcapularis. These four muscles surround the humeral head (ball of joint) of the shoulder and allow the arm to rotate and lift while giving stability to the shoulder joint (glenohumeral joint). While more than one tendon can be involved, it is usually that of the supraspinatus that is most commonly torn. A rotator cuff injury results in a great deal of inflammation and pain, and it’s estimated that between 5 and 40 percent of the population have some form of this injury. The highest incidence is among people over the age of 60.

Treatment varies from patient to patient depending on the patient’s functional requirements and severity of symptoms. Less severe injuries can be treated with physical rehabilitation while the more serious injuries require surgery to repair the torn tendon(s). James Levine needed surgery and was operated on at New York's Lenox Hill Hospital by a shoulder surgeon who has worked with other leading musicians. He will need at least three months to recover.

“The doctors are not going to let him start early,” said Met general manager Joseph Volpe. “The problem is raising your arm. But he has every intention of being able to begin our season on July 7 in Lenox.”

James Levine has enjoyed a long career with the Metropolitan Opera conducting more concerts than any other conductor in the company’s 123-year history. Levine was appointed principal conductor in 1973, music director in 1976 and artistic director in 1986. His title was downgraded back to music director for the 2004-2005 year when he took a job with the Boston Symphony Orchestra.

Levine remains optimistic about his recovery. “The doctors all agreed that I should have the operation sooner rather than later, and they seem to think that after therapy my arm and shoulder will not be like they were before, but even better,” said Maestro Levine. “Nobody regrets this more than I do and I can only express the enormous disappointment and frustration I feel. The music I make with my wonderful colleagues at the Metropolitan Opera and the Boston Symphony is absolutely central to my life, and I hope my recovery will go smoothly and quickly. I look forward to taking up the baton again as soon as humanly possible, and am looking forward to conducting in Tanglewood this summer and my first Met ‘Madame Butterfly’ on opening night, September 25.”

Last updated: 19-May-06