Exercising with Lipedema is a topic that makes those of us with Lipedema cringe. It’s not because we hate to exercise. It’s the associated pain, swelling and bruising that accompanies most attempts of traditional exercise routines that deters us from trying to exercise.
What we need to know and understand is that our bodies are different from others. The disproportionate weight distribution in our abdomen, hips, thighs, legs and arms creates balance, gait and mobility issues which can lend to falls, sprains and unusual bruising situations. In the later stages of the disease it may be a struggle just to walk never mind consider an exercise routine.
In addition to the weight distribution issue we need to think about our knees. With most of our weight between the hips and thighs our knees are being taxed trying to carry much more of a load than non-Lipedema or Lymphedema people. In the later stages of Lipedema or Lipo-Lymphedema the knees may have developed osteoarthritis (wearing down of tissue (cartilage) at the end of your bones until bones rubs against bone), where just walking a short distance hurts the knees and legs. I have severe osteoarthritis in both my knees and get cortisone injections as needed to help manage the pain. Strengthening our knees early in the disease is key to continued mobility!
Connective Tissue Issue
Another issue we face is poor connective tissues. Connective tissues essentially hold the body together, from skin, bone, tendon, cartilage, tendons, to blood vessels and more. Most of this connective tissue is made from collagen and runs through 80% of our body. (1)
Weak or faulty collagen can cause us to become lax, which can cause joints to move in and out of place or giving us a very “bendy” or hypermobile ability. (Note: weak connective tissue and hypermobility are also signs of Ehlers Danlos Syndrome (EDS), specifically the hypermobile EDS (or hEDS), which could very well be a co-morbid condition to our Lipedema.) At my size of a stage 4 person with a huge amount of weight from the abdomen down to my feet I can still bend down and pick something off the floor without bending my knees! I am hypermobile, which explains why my knees, elbows, hips and shoulders pop in and out with little effort and movement.
Speaking of tissue issues be careful of bruising, which damages your skin. Some of us can bruise from the slightest bumps into objects or from a light touch or squeeze from someone. My 15 pound dog can easily bruise my leg if he stands or sits on me the wrong way. And some of us bruise so easily we can’t even remember how we got a newly formed bruise!
Low impact workouts can cause bruising. If you see bruising after a workout, seriously consider toning down the stress you are putting on your muscles and skin. I was doing some simple stretching exercises and overstretched my right leg causing a seven inch oblong bruise right above my knee. It hurt for a couple weeks and a year later the bruise outline is still visible. You need to be the best gauge of your limits. Any exercise that hurts, causes swelling or creates bruising should be avoided!
Another good point to remember is the impact of heat on a Lipedema or Lipo-Lymphedema body. Gravity will force fluid build-up, usually in the lowest parts of your body, and combined with the heat generated from movement will cause your affected area to swell. The longer and harder the workout the more swelling (and pain) will be generated. Be mindful of this and choose exercises that are in cool places, using cold technology or even a cool water solution.
Now that we have looked at the things to consider before choosing an exercise regimen, you will want to stay away from any pounding, hitting or high impact workouts to avoid further damage to your body. And no, we are not just talking about going for a walk as our only exercise option. There are several things you can do to help maintain muscle tone, weight, and good body form. Again, choose a form of exercise that works best for your body type and ability that does not cause pain, swelling and bruising!
Building Your Core
Before moving into a specific exercise regimen, I believe everyone should develop a strong muscle core where your back, hips, pelvis and abdomen work together to provide stability and balance to your entire system. I’m not talking about trying to get those 6-pack abs, but building enough mid-body strength where walking and daily tasks are safer and easier, not to mention improve lower back pain.
You should wear your compression garments during exercise or stretching regimens (except swimming) as they will aid in blood circulation and lymph flow. Since your lymphatic system doesn’t have a pump, like your circulatory system (the heart), it is important to move your muscles to generate a “squeezing” action that keeps lymph fluid moving out of the damaged areas. The extra compression will help keep affected areas from swelling and provide a massaging action similar to a lymph pump.
If you already have a strong core skip to one of the programs below. If not, read on to learn how to build your core muscle group.
You do not need to do aerobics, ab crunches (unless you can), join a gym or buy special weights, balls or tension bands to help work on your core unless you want to for a change in routine. In fact, I do my in bed and when I first sit up. After I injured my back in a fall in March of this year and was bedridden for over week, I realized I had very little strength in my mid-section to try and get myself out of bed and into my bathroom. My therapist advised me to start working my core so walking would be easier and I could heal quicker. So here is my first exercise for the core.
While laying flat on your back raise your right arm stretched out fully in front of you while lifting your left leg. You just need to lift them a little to feel the tight pull diagonally across your body. Hold for a count of five seconds, more when you’re stronger, and repeat with the opposite side.
Exercising in a pool or chest deep water makes good physiological sense as movements are low impact, meaning there are no pounding, jamming or twisting moves that can damage affected Lipedema body parts, especially the knees. The hydro-static pressure of the water provides great resistance against any movement and acts as a natural compression to the lower body. This pressure increases circulation and helps to reduce swelling. It’s like getting a free water massage!
Many women report feeling more toned and refreshed when exercising in water. Some women actually report a reduction in the size of their Lipedema areas when exercising regularly in water. Cooler water temperatures are better for your system than warmer water, which can facilitate unnecessary swelling or edema.
If you don’t have your own pool check with your health provider to see if they have a therapy pool in their network you could use. Therapy pools have a greater chance of employing special lifts, ramps ad rails to help those needing additional safely enter and exit the pool. You could also use a local community pool, semi-private pool in a housing community or take a vacation at the beach where you can get some water exercise time. If you are reserved about public pools (like me) you might be able to pull together a group of Lippy women to rent a pool for an hour or so for some dedicated exercise time.
Plain old walking is a great low impact means of exercise. Make sure you wear your compression garments for extra support and find a comfortable sneaker that will provide adequate support for you feet, legs, knees and back. Start out slow and build your endurance. Remember to pull back if walking causes any pain or swelling. Some Lipedema folks may be able to walk a marathon while others can barely walk around their house. That’s okay. We all have to start somewhere.
Don’t like walking alone? This is a great exercise to share with the family. Take the dog or babies for a walk. Get together with a group of friends or Lippy ladies to walk as a group. Find a park track, hike a forest trail, walk along a beach, use a school track, walk the mall or local fair or just walk around your block. Wherever your walking pleasure takes you, be mindful of any pain or swelling and scale back as necessary to maintain your Lipedema health.
Walk as much as you safely can even if it is two times around the house. Moving is key to keeping those muscles working and pumping blood and lymph around your body!
Cycling, including actual biking on a path or street, using a stationary bike or using an elliptical machine, could be a good form of exercise for those in early Lipedema stages. The pedaling action is great for working leg and gluteus muscles not to mention burning some calories. However, for others it may cause pain in the muscles or knees performing the repetitive cycling action. And it could also cause rubbing or knocking of the ankles on the frame if you have large cuffs (overhang of skin folds) that hit the bike frame.
Choosing a type of bike or whether to bike at all is an individual decision. Remember, biking should be a comfortable exercise and not cause pain, bruising or swelling when engaging in this activity. Since our goal is creating and maintaining good muscle tone rather than burning calories, make sure this activity works for you. Otherwise, find another form of exercise that is safe and works for your body.
Pilates and Yoga
Pilates and Yoga exercise programs are great low impact mind-body movements that can help in toning and strengthening your body. These programs are about changing the way your body feels, looks and performs. They build strength without bulk by helping tone troublesome body areas. You just need a mat with the option to purchase additional equipment for advanced moves.
Since Pilates and Yoga are not about burning calories most people with Lipedema can achieve non-impact moves that work with Lipedema affected areas. You will benefit by strengthening your core, creating good posture, body awareness, additional flexibility and agility, and graceful movements. With certain moves you can even help alleviate back pain.
As with all exercise programs do not engage in moves that create pain, bruising or further swelling.
Whole Body Vibration (WBV) exercises have been shown to help those suffering from Lipedema, Lymphedema or Lipo-Lymphedema. There are many benefits associated with using a vibration plate depending on your health goals.
Benefits may include:
Increasing lymphatic flow and drainage
Reducing fat stores (and overall weight)
Reduce inflammation and fibrosis
Increase muscle strength
Reduce joint stress
Note: those with with heart or joint conditions should consult their doctor PRIOR to purchasing or engaging in WBV therapy to avoid injury.
WBV therapy is not for everyone and should be thoroughly discussed with your physical therapist to see if it is a safe option for you and what type works best for your needs. Some require a full size WBV platform with hand supports while other work well with a simpler floor model.
There are a couple types of vibration plates. You will want an oscillating machine, one that essentially moves up and down like a playground see-saw, if trying to stimulate your lymphatics. It is also important to note the weight limits of the machine and not exceed them for your safety.
Here are some examples of oscillating vibration plates successfully used by people with Lipedema. Again, you and your physical therapist should discuss the pros and cons of using WBV and which type of platform works best for your needs.
Swimming and cycling are not the only forms of exercise you can choose for yourself. Keep in mind that excessive standing or sitting, hot temperatures and not wearing compression garments will cause your body to swell, so choose an exercise that doesn’t produce negative consequences.
Remember, do not choose an exercise or sport that has jumping, twisting, joint jamming or physical contact with others as it can be harsh on already taxed knees and cause additional damage to your Lipedema areas. These include activities like football, tennis, basketball, step aerobics, running, jogging, etc.