A Personal Trainer’s Guide to Lipedema

A Personal Trainer’s Guide to Lipedema

by Kathleen Lisson, CLT

“I can’t seem to lose weight on my legs, no matter how much I diet.”

“I can’t find clothes to wear - I am different sizes on the top and bottom.”

“My family tells me I have my grandmother’s legs.”

Has a client ever come to you with these complaints? If so, she may be suffering from lipedema, an adipose tissue disorder thought to affect around ten percent of the female population in America. Lipedema was first described by Doctors Allen and Hines of the Mayo Clinic in 1940. Almost 80 years later, the condition is often mistaken for obesity and not well known in the medical community. For many women, lipedema tissue starts appearing on the butt, thighs and calves at puberty. Childbearing and menopause may also bring an increase in this type of tissue.

What makes lipedema tissue different from other adipose tissue? It is extremely resistant to diet and exercise.

These facts set up the perfect storm for our client. She may have been suffering since childhood with tissue on her lower body that will not respond to diet and exercise and all to often, advice from her health professionals, well meaning friends and family is just to diet and exercise. This is where you can make a difference! Movement and mind-body practices can help her to live a healthy life.

What is Lipedema?

Lipedema is a word used to describe an adipose tissue disorder that is characterized by:

• Excess adipose tissue that collects on the lower half of the body.

• Tissue that collects on both left and right equally.

• The lower body looks much larger than the upper body.

• The feet are spared, which gives the ankles a ‘cankle’ or pantaloon appearance.

• In 15 - 45% of cases, a family member is also affected.

• Skin may feel smooth or underlying tissue may have a nodular or beanie baby like feeling and in extreme cases feel like a walnut shell.

• Joint hypermobility may be present.

• Lipedema can also affect the upper arms.

• There is pain in the affected area when pressure is applied and legs bruise easily.

Lipohypertrophy sometimes looks the same as lipedema, but the pain that happens with lipedema is not present.

How can personal trainers help clients with lipedema?

Exercise will not reduce lipedema tissue, but movement throughout the day is essential for maintaining health. Exercises that support the lymphatic system for lipedema clients include:

• Aerobics focused on joint movement

• Cycling

• Dancing and other rhythmic whole body exercise that is easy on the knee joints

• Deep breathing

• Elliptical machine

• Lymphatic yoga

• Pilates

• Stretching

• Swimming

• Tai Chi and Qi Gong (minimize deep knee bends)

• Walking

• Water Aerobic exercises

• Weight lifting and bodyweight exercises with exercise bands

Intense exercise may increase swelling in these clients, and personal trainers and coaches should be sure to emphasize that these exercises will not reduce or cure lipedema.

Often, the most valuable thing we can say to our client on that first visit is that she is not crazy and it is not her fault. She will likely have tried and failed to diet away the weight for years if not decades. Diet and exercising may have resulted in changes in her upper body but no reduction in her lower body. If she cannot undergo liposuction treatment to remove lipedema tissue, giving her the tools and support she needs to add healthy exercise to her life, combined with conservative treatments like compression garments, dry brushing, manual lymphatic drainage massage, pumping and vibration may make it easier for her to live with lipedema.

Further Resources:

More information on vitamins and supplements for lipedema: http://treat.medicine.arizona.edu/sites/treat.medicine.arizona.edu/files/medicine-and-supplements-handout-fdrs-2016_without_color.pdf

Photos of lipedema from the Lipedema Foundation: https://www.lipedema.org/photo-gallery

List of medical professionals that treat lipedema patients from The Lipedema Project: http://lipedemaproject.org/lipedema-lipoedema-lipodem-provider-directory/