Physical Therapy Restores Violinist’s Ability to Play

Professional athletes and musicians have something in common: They both live to play. And something else: The wrong injury means they never will again.

That's what happened—almost—to Linda Thomssen, a violinist with the Kansas City Symphony for 27 seasons. Not once, not twice, but three times.

The big crunch

The first time, Thomssen had been upstairs, at home, in high heels and a hurry to get out the door. She took a heart-stopping tumble down the stairs, flipping onto cement tile at the bottom, slamming her left arm—the one that holds her violin—through the wall.

“I heard some crunching and said to myself, ‘I think I did something bad,'” Thomssen recalled. “I figured I'd be just a hair late for my next appointment.”

Instead, she ended up in Saint Luke's Emergency Department, where staff called in a specialist surgeon upon learning of Thomssen's profession. She'd broken her upper arm, smashed a portion of it, and damaged the rotator cuff. Miraculously, she didn't need surgery. But after weeks of immobilizing it, she would need therapy.

Lots of it.

Saint Luke's North Hospital physical therapist Greg Douglas was the first to work with Thomssen in December 2000. “Linda's case was different because she had to function at a higher level,” he said. “She needed a lot more range of motion.”

Playing to win

Early into her four months of therapy, Thomssen gave Douglas a violin lesson. “It helped me to get a feel for the motion involved,” Douglas said. “I gained a greater appreciation of the range she needed to get back.”

And so began a teeth-gritting technique that Thomssen jokingly called “table tie-down time.” Douglas would gently tie Thomssen's left arm back and onto the table for about 10 minutes, once per session, as Thomssen would read from the book Mental Toughness Training for Sports.

“I described the technique to her first because I knew it would be uncomfortable, but Linda was a trouper,” Douglas said. “She told me she wanted to do whatever was needed in order to play again.”

Gradually Thomssen regained enough movement to play the top string of her violin for 30 seconds. Then began what Douglas called “music rehab.” Thomssen would play her violin for five minutes; rest for 60, play for another five, rest another 60. Over the weeks, she increased her playing time in five-minute increments, finally working up to her usual routine of eight hours of practice a day.

By April, she was back playing in the symphony. But in January 2005, she returned to therapy.

A portion of her damaged shoulder had disintegrated, requiring shoulder replacement surgery at Saint Luke's.

She and Douglas went back to work. He concentrated first on her range of motion and then on strengthening her muscles.

“She had the motivation and discipline of a professional athlete,” Douglas said.

Once again, Thomssen was back playing in the symphony by that September.

A big hand

Fast-forward to May 2006 and a farewell lunch for a friend. On Thomssen's back is her violin case, in her hands is a tray holding a huge salad, and on the restaurant floor that she's walking across is a slippery, wet spot.

She crashed, elbow first, onto the floor.

“My violin never went out of tune,” she said, laughing. “But where my right elbow had been, I felt this hole.” She had smashed the top of it, and it had moved an inch north of where it should be.

A surgery and six screws later, she was in therapy again— this time with Angie Schreck and Carla Duncan, occupational therapists at Saint Luke's North Hospital. Both are certified hand therapists, specializing in neck-to-fingertip therapy.

They made several splints for Thomssen—one for bending, one for straightening—and a movable apparatus that worked similarly to the table tie-down. “For as bad a break as Linda had, she got full return on her elbow, and it's a joint that's not forgiving,” Duncan said. (They have since used the bending splint, which they named after Linda, successfully for other patients.)

The nerve in Thomssen's elbow was nearly pinched, so at times they did less so she could heal more.

“Musicians are very motivated; it's hard for them to put that instrument down,” Schreck said. “At first, Linda would overdo it. Her exercise and her job entailed the same motion. It was a matter of balance, and knowing when to stop exercising.”

“I learned a lesson,” Thomssen said. “You always want to progress, but it's not smart to set a deadline in therapy.”

By September, she was ready, once again, to rejoin the symphony. Thomssen credits Douglas, Schreck, and Duncan with saving her career—not once, not twice, but three times. She gave them some therapy of their own, in the form of nights at the symphony as her guest. Said Schreck:

“All I can watch is her elbow.”