Improving physical activity
Many lipoedema patients suffer with pain (especially in the affected limbs), loss of muscle strength and as a result, a reduction in daily activities and physical exercise. This can lead to further deterioration of lipoedema and may increase general body weight.
Interventions to try and regain and maintain an improved active lifestyle is vital and often done under the guidance of health care professionals (such as physiotherapists and lymphoedema practitioners). Building muscle strength/tone and improving general fitness is the first priority, so specific exercises and advice is generally helpful in the first instance; once an active lifestyle is regained, then further guidance is generally unnecessary.
Interventions to support and regain
Increased physical fitness and activity will produce numerous health benefits (reduced rates of obesity, cardio-vascular disease and diabetes) as well as an improved mental health and quality of life (important for lipoedema patients to overcome negative feelings often associated with the condition).
Current UK NHS guidelines recommend adults should be active every day and should undertake at least two and half hours of moderate intensity activity each week. This should include muscle strength exercises at least two days a week. This information is very useful for those with lipoedema, but it should be noted that activity should be gradually introduced and increased as time goes by to try and prevent aggravating any pain and/or bruising. Exercise should generally be of low impact/intensity (especially if knees/hips are painful) and may include yoga, Pilates, cycling and water-based exercises. Resistance bands should be gradually introduced over time to improve muscle strength. More active (high intensity) exercise should be continued if it is well tolerated.
Exercising in water (swimming or water aerobics – or even just walking in water) is particularly helpful for lipoedema because this form of exercise helps reduce the strain on joints and muscles and also helps to improve venous and lymphatic return due to the hydrostatic pressure against the skin. Embarrassment about the appearance of lipoedema is often given as an excuse not to do it, but solutions can be found (see motivational tips below to help) – and will help start improving the lipoedema and negative feelings associated with it.
Even those who hate exercise can (should!) be encouraged to participate with simple chair-based exercises, using a ‘Wi’ machine at home, walking instead of driving to work, using stairs rather than the lift/escalator (however slowly).
The following may also prove helpful when starting a new lipoedema exercise regimen:
Motivation to help with exercise
- Be realistic. Remind yourself that you want to become more active because it will help you become healthier and lose weight. But that results will not be achieved over night!
- Schedule it. Plan your exercise at the start of the week and put it in your diary. Planning when, how and where you will exercise may increase your chances of making physical activity a normal part of your lifestyle.
- Pat yourself on the back. Look back at your weekly food and activity charts to remind yourself how much you’ve already achieved.
- Spread the word. Share your plans and achievements with other people; you’ll feel obliged to keep going!
- Phone a friend. Find a friend or a relative (or fellow lipoedema sufferer) to exercise with, or perhaps join a group or club. A workout buddy can provide feedback, support and entertainment – they also put pressure on you to turn up!
- Pump yourself up. Music is a great motivator so pick your playlist, plug your headphones in and listen to your favourite workout songs while you exercise.
- Be flexible. Change activities if you’re not enjoying them. If cycling isn’t doing it for you, why not go swimming or even try some fitness classes at the gym.
- Remember, the hardest part of exercising is getting out of the door, so once you’ve passed that hurdle, it should be plain sailing!
- Set goals. They don’t need to be grand achievements. For instance, try to walk a little bit more every day, take the stairs instead of the lift, or walk part of the way to work. Keeping a written record of these mini-goals can help you to see your progress over time. Using a goal chart every week may also help.
- Reward yourself. Set yourself non-food rewards for achieving stages along the way. There’s nothing like an incentive to spur you on!
Remember to start with, progressive exercise (i.e. starting with gentle exercise and increasing the intensity gradually over time),
Aside from the specific daily, simple remedial exercises (relating to the affected area), given by your therapist or clinic, extra added exercise should also be incorporated into your weekly schedule. This should ideally include a mixture of:
- Strength - this may just involve you doing push-ups OR lifting weights (kettlebells or free weights) – remember to gradually increase the weight over time. Strength exercises (using resistance such as power-bands) will help to improve/tone muscles and help to increase the strength in ligaments, tendons and bone density. Pilates maybe a useful option for many as it uses your own body weight, helps you to develop a strong core AND conditions your body.
- Flexibility which involves you gently stretching muscle, skin and other tissues - particularly scars and joint contractions. Yoga (e.g. Hatha Yoga - ideal for beginners) with its slow, rhythmical movements also mimics lymphatic flow, whilst Vinyasa Yoga gives more of a workout! Stretch classes can also help and often use a variety tools such as stability balls, yoga bricks and poles. T’aiChi can also be useful, combining deep breathing with slow, graceful moves helping to improve balance, posture and mobility.
Whatever exercise you decide to do, don’t forget to wear your compression garment (if you have one) to ensure an improved lymphatic return.