19 August 2013,13:59:56 BST
Wellicious promotes wellbeing for all people. Our objective is to raise consciousness around a misunderstood medical condition so that you, the fitness professional, can offer all your clients a pathway to health.
You're presented with a new client. A woman comes into your clinic and you immediately determine she is overweight or obese. Chances are you've misdiagnosed your client.
The clinical condition called lipedema is difficult to identify and often misdiagnosed as obesity or lymphedema. This article is to help you learn how to recognize lipedema, offer treatment and maintenance. We will also explain why Wellicious is making an important contribution for women's overall health and fitness.
According to Fife et al. (2010), lipedema is a pathological deposition of fatty tissue, leading to progressive lower limb enlargement. In 1908, the Journal of the American Medical Association described one of the first cases of lipedema yet articles from the 1800s suggest lipedema has been around for over 100 years. It's estimated 1 in 11 women have the condition and it effects women ranging from extremely underweight to morbidly obese.
Physical features common in lipedema patients include: symmetry in the legs; abnormal tapering of the limbs; and a small waist with a trunk-like appearance from the hips downward towards the ankles. As lipedema is vastly unrecognized by the medical profession, make sure your client receives an accurate diagnosis. Send her to an endocrinologist, physical therapist, MLD therapist, or to the National Lipedema Network.
So, what do you do when lipedema fat, unlike normal fat, cannot be *lost* through diet and exercise?
Offer exercises to your client that stimulate the lymphatic system. The more you stimulate the lymphatics, the more you reduce inflammation. Teach her yoga, which will build strength in her muscles. Yoga, offers a great means to stretch the muscles. Yet as a fitness expert, emphasize stability in the joints as your lipedema client will demonstrate hypermobility. Incorporate cardiovascular exercises into her fitness routine utilizing the pool and the trampoline. Tone her abdominal muscles, such exercises will allow for greater drainage through the thoracic duct. Since lipedema creates a major strain on the lymphatic system, muscular contraction creates the necessary pumping action needed to move lymph.
Some exercises are not appropriate for patients with lipedema. Exercises with high ground reactions forces cause pain. Although your client may have the drive to work through the pain, differentiate pain from ability. High impact exercises create more inflammation and further compromise the lymphatic system. Advise your client that she will not see immediate physical changes in her body but she will feel more energized and motivated to move. A sample exercise lesson is outlined below.
Advanced stages of lipedema will create a condition called lipo-Lymphedema. Medical science not sure if lipedema is what causes the lymphatic strain, or if it's a defect in the lymphatic system that causes lipedema. To keep your client healthy, keep them moving!
1. Full Body Plank (full body plank engages all the core muscles and stimulates lymphatic drainage)
2. Yoga Cat & Cow Pose (great for pumping the lymphatic fluid in the abdominal region)
3. Pilates Bicycle (targets the lower abdominals and facilitates the pumping mechanism of the lymphatic system)
4. Bridge (the partially inverted angle creates a change in direction for the lymphatic fluid and the position strengthens the abdominal muscles)
5. Camel (stretches the abdominal region to allow fluids to move more freely)
6. Modified Squat (trains the gluteal muscles and activates the lymph nodes in the inguinal region)
7. Downward Facing Dog (a great way to stretch the hamstrings and relieve the pain associated with stagnated tissue in the legs, it also functions to correct hyperflexibility in the hip joints)
8. Foam Roller (helps to loosen the connective tissue in the legs and IT band)
Suggest your client wear a full-body compression garment designed with extra compression on the abdomen and upper thighs. Advocate an extreme anti-inflammatory diet (see Diet section below). Facilitate her adherence to regular exercise (aqua-therapy, whole-body vibration, yoga, swimming, walking, bicycling, etc.).
If your client asks about nutrition, advocate avoiding grains, dairy, salt, sugar and soy and drinking plenty of water. Suggest a diet high in bioflavonoids, such as highly colorful vegetables and leafy greens. Have her include lean meats and organic berries into her meal plans. Recommend she supplement with omega-3 fatty acids from clean sources (flax seeds, chia seeds, sesame seeds, coconut oil, fish oil, etc). Your client must maintain regular meals and meet her caloric quota (1200-1500 kcal per day). Caloric restriction can increase lipedema fat tissue accumulation.
Lipedema women try to hide their legs and attractive, loose fitting active wear is hard to find. Many athletic clothing manufacturers restrict the size of their products for already fit women. Companies who only target physically in-shape women succumb to the anti-fat bias. This is disheartening for a women trying to get in shape and struggling with the ability to maintain an attractive appearance despite diet and exercise.
Fortunately, Wellicious offers a Loungewear line and pants such as the Wellicious Flair Yoga Pant that flatters the waist and is breathable around the calf. The Bellini Cover Up and Holly T-Shirt can be stylish without clinging to the upper thighs. These products are ideal for lipedema women who want to de-emphasize the disproportion from the waist to the hips. It's refreshing and motivating for large women to have an active wear line that respects their physical condition and offers hope for a change of confidence in their body's abilities.
By Jessica Medros & Jennifer Wright
Fife, C.E., Maus, E.A., and Carter, M.J. (2010). Lipedema: A Frequently Misdiagnosed and Misunderstood Fatty Deposition Syndrome. Adv Skin Wound Care, 23: 81-92.
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