Sara Landau is an internationally renowned and sought-after artist. She has also been, for many years, a sufferer of chronic pain. Throughout her life, Sara has had to contend with significant health obstacles. She was born with childhood epilepsy. The seizures began at birth and ended when she was nine. Both of her two most memorable seizures involved her elbow: it became caught in a door when she was six, and it was hit by a competitor’s tennis racket when she was nine.
Epilepsy is a neurological condition that affects the nervous system. Seizures seen in epilepsy are caused by disturbances in the electrical activity of the brain. In most cases, people grow out of childhood epilepsy before adulthood, as did Sara.
Epilepsy didn’t stop Sara from taking up ballet early in life. At eight, she joined a professional ballet school. At fifteen, she had to make a decision between a career in ballet or academics. She chose academics, which meant leaving the ballet school and joining a regular school, where she chose running as her physical activity. The strong, flexible muscles she had developed in her ballet training made her a star runner.
In those two years of high school, she did almost no preparatory physical training and still won every race. Then she went off to college, where she resumed taking daily ballet classes.
When she was regularly attending ballet classes, she never experienced knee pain. However, during her six-week summer holidays, when she stopped dancing, she always suffered from knifelike knee pain. When she resumed her ballet classes, the pain would disappear and she’d be fine.
After college, she began her career as a painter. Her companion was a large friendly dog who required lots of daily walks. She’d sit for hours cross-legged, with a canvas leaning against the wall in front of her, and her palette and other tools spread out on either side. She’d reach, twist, turn, and bend all day as she went from palette to canvas. From ages twenty-two to twenty-nine, this is how she spent most of her waking hours—painting cross-legged.
During this period, Sara’s knees were generally pain-free. Then she started to feel knee pain when she ran for a bus, played tennis, or moved quickly, which included walking her rambunctious dog. She stopped all running and sports, believing that she had bad knees. Still, it was impossible to stop her dog from pulling as they walked—which was when she began experiencing back pain. By age twenty-eight her back pain became impossible to ignore: she experienced numbness in one foot and acute back spasms, immobilizing her in bed. An MRI showed a minor bulging L4-L5 disc.
By then both her knee and back pain had progressed to a level of 5 on a scale of 1 to 10. “I just coped with all the different things that came my way, the bad knees, the bad back,” Sara recalled. “I had physiotherapy. I went to see if I needed surgery, but it was never bad enough to need that. They suggested that I wear knee braces, which were cumbersome, so I didn’t wear them. I really became inactive because things just hurt. I never ran. I would mostly walk or swim because everything else bothered my knees or my back.”
At age thirty-one, her life changed with a diagnosis of Graves’ disease, an autoimmune disease characterized by the overproduction of thyroid hormones (hyperthyroidism). The recommended treatment, which Sara underwent, was to completely destroy the thyroid gland through radiation and replace the thyroid function with daily medication.
Then in 2011, when she was thirty-seven, Sara’s life changed once again, professionally and personally. She gave birth to twins—a healthy girl and boy—and unveiled her most famous work to date, a painting titled Twin Children.
Sara’s pregnancy did not run smoothly; it had been extremely difficult. She was on strict bed rest for her early pregnancy. After five months, she was allowed to walk, but her muscles had atrophied to the point where she could barely stand. And just as she was regaining enough muscle mass to begin walking again, she experienced early labor contractions, common in women carrying twins. To prevent premature delivery, her doctor again ordered Sara to stay in bed throughout the remainder of her pregnancy.
By the time she was ready to deliver, her muscles had shrunk from extreme atrophy and were completely devoid of the strength required for a natural delivery. She gave birth by Cesarean section, which made recovery slow and painful. The combination of nine months in bed and a cesarean birth left her weak and in chronic pain. “I was almost completely atrophied,” Sara recalled. “I had stayed in bed for almost a year. At first I could barely stand up. I could barely walk a block. When I eventually went to a grocery store, just to walk down one aisle left me completely out of breath. I had lost so much muscle mass that I had no strength. I had to have help to bathe the babies. Even assuming a bending position was extremely hard.”
A physiotherapist who regularly treated Sara during her bed rest suggested that she try Essentrics after she delivered the babies, as a way to regain her strength. As soon as she could, Sara paid a visit to a studio where our classes are offered. “I loved it,” Sara said. “The classroom setting was a familiar environment. Also, some of the stretching was similar to the movements suggested by my physiotherapist to maintain my back. So there was crossover.”
However, with two babies to care for, there was no time left to care for herself and take regular classes. “I loved the classes, but there was no way I could go on a regular basis. I was breast-feeding and I didn’t have the time or the strength.” She dropped out of the classes, as motherhood was all she could handle. Sara, however, is nothing if not stoic: “I think we are all given what we can handle and we just have got to get through it. When you have two small babies, you don’t have time to think about your pain. You only think about what is next to be done.”
Then an accident forced her to focus on her own health. Her children were about two when Sara took them on their first airplane trip. “They were so excited that they ran to find their seats. As I ran after them I hit my knee on one of the seats. I felt a sharp pain and heard a loud pop.” She sought medical attention at her destination, and an MRI when she got home showed that she had torn her meniscus (a band of cartilage within the knee joint).
Sara’s doctors recommended that she bicycle to strengthen her knee. She was desperate to regain strength, but rather than bicycling she started doing Classical Stretch DVDs and eventually returned to our classes. Soon she was back exercising on a daily basis, and experiencing significant relief from both the knee and back pain. Still, her doctors recommended surgery to repair her torn meniscus. She considered it but ultimately decided to keep with her exercise program a little longer and see if she could avoid such an invasive procedure.
A year after rejecting the operation, Sara said the program not only helped her naturally repair her knee injury but also dramatically lessened her chronic knee and lower-back pain. Two years after starting the classes, she was close to being pain-free. Not only was she physically stronger as a result of Essentrics, but she had finally assumed control of her physical health.
“Essentrics has really helped,” she said. “It has helped my back pain tremendously. I am definitely much stronger, although my knees are still a problem, but nothing like what they were. I do almost all the movements, but I don’t do deep lunges or a deep plié. I wear knee braces to all the classes because I don’t want to injure myself further. When I start to feel pain, I stop at that point.”
What’s interesting to me is that during her tenure as a ballet student, Sara had neither knee nor back pain. Her knee pain started and became acute when she was on vacation, not when she was exercising. As a ballet dancer, she could easily do the splits and had great flexibility. She complained of having difficulty in holding her legs in the high positions because her leg muscles were too weak. As a former ballerina, I know that holding your legs above hip height is difficult, so that was not relevant. But Sara’s pain was affecting her whole life.
Sara’s core issue was that she was constantly suffering from muscle atrophy. Her pain was all joint related: in her knees, elbow, and L4-L5 vertebra. The meniscus tear and other ligament tears were all in the joint.
It’s important to look at Sara’s muscles to understand why atrophy was causing her joint pain. Think of a muscle like a giant rubber band and the tendons as two ridged ropes attaching the muscle to the bones, making a joint. If the giant rubber band shrinks, it will pull on the ridged ropes. If the shrinking is sufficient, it will cause a dangerous pulling on the attachment points, squeezing the joints together. This is one reason why atrophy is extremely painful. Muscle atrophy becomes more common as we age, and without proper exercise it can become a serious issue (usually after age fifty).
It is rare for an active young person to suffer from atrophy unless the atrophy is triggered by a neurological disorder—which is, I believe, what happened in Sara’s case. When she went back to ballet classes, where she stretched and strengthened her muscles, the pain disappeared. The times in her life when she did not regularly stretch and strengthen, she was in acute pain. Her college vacations and her bed rest during pregnancy led to her greatest pain. Everybody’s muscles shrink when they stop doing regular exercise, but the normal rate of change is over years—not days, as in Sara’s case.
The human body is mysterious. I believe that Sara’s knee and back pain were triggered by a malfunctioning neurological message that caused her muscles to prematurely atrophy. She has a family history of neurological conditions, and she herself suffered twice from neurological disorders: childhood epilepsy and an autoimmune disorder of hyperthyroidism. Her conditions led to premature muscle and connective tissue atrophy. Many people who suffer from combinations of neurological disorders can use Essentrics to help relieve the symptoms.
When you are exercising to relieve pain related to connective tissue, it’s important to move very slowly, giving the many paper-thin layers time to warm up and regain their essential sliding ability. Remember: When we don’t use all of our muscles, the connective tissues surrounding them don’t move either. As a muscle atrophies, the connective tissue around it congeals and hardens. The slow movements in this workout safely return the sliding action back to the connective tissue layers as the atrophied muscle regains its shape, strength, and flexibility. Make sure to have a chair nearby for support.