Paula Donahue, PT, DPT, MBA, CLT-LANA is an Assistant Professor in the Department of Physical Medicine and Rehabilitation at Vanderbilt University Medical Center and Physical Therapist Level IV at Vanderbilt Dayani Center for Health and Wellness. She specializes in the treatment of lymphedema, lipedema and oncology rehabilitation and engages in related clinical care and research.
It is lipedema month and thus, a perfect time to reflect on current trends in lipedema research, treatment and self-care strategies. The last five years have demonstrated a drastic increase in published manuscripts on lipedema, which includes more than 50% of all the published primary lipedema research (i.e., original research investigating a concept or treatment in lipedema). As a component of this published work, the United States Lipedema Standard of Care (SOC) was published, which summaries the current medical understanding and treatment options while also recognizing the unanswered questions and unmet needs.1
Exercise: Just Do It
Specific to lipedema treatment, the U.S. Lipedema SOC reports that exercise programs should be individually prescribed, started slowly and progressed as tolerated by each person. Why slowly? To avoid injury and optimize chances for consistency and adherence with regular exercise. If time is an issue, consider prioritizing 5-10 minutes daily to see how you fair. Something is always better than nothing and grandiose exercise plans that never come to fruition do not offer the body any help. Additionally, the SOC notes exercise components should include strengthening, flexibility, balance and conditioning, where the specific movements should provide enjoyment and fulfillment to the individual. This is a great example of how one size does not fit all. Some people thrive in group exercise environments versus on their own, and others prefer outdoor activities compared to indoor exercise. The SOC recommends consistency with exercise over time where impact levels may vary but need to be tolerable and sustainable for long-term adherence. To quote the Nike ads with Michael Jordon, it’s key that we find a way to “just do it.” For some, that means changing up the exercise every season or month to avoid boredom, while others find solace and personal consistency when keeping to a particular exercise routine.
Get in the Water
If you have not yet tried getting in the water for some aquatic exercise, this may be your year to do so. Water exercise does not necessarily mean swimming. You can perform most exercises in water, such as walking or moving your arms and legs under the resistance of the water. Water movements give the body a huge break from the pains experienced by gravity. However, do not be fooled into thinking your body is not really exercising since it feels so good. Start slow and gradually work up your time exercising in the water!
Other benefits of exercising in water include having a safe environment to try more impact movements, such as jumping or jogging, challenging your balance while being supported in the water or holding onto the pool wall. You can experience the calming, yet invigorating, feeling that comes from being in water.2 '
Also, know that it is not important what anyone wears while in the water. Please don’t be concerned about purchasing or wearing a bathing suit. Simply wear clothes you are willing to get wet. The clothes do not matter, and your body will still love you for the experience. Ideally, try to get in the water 2-4 times a week, if not daily. Find yourself an indoor pool for a year-round experience.
Set Realistic Goals
When it comes to setting and achieving personal goals that may pertain specifically to lipedema management or personal wellbeing, it can be helpful to set SMART goals.3 Specific goal setting to break up your long-term goals into short-term goals can be instrumental in making small little changes that amount to a huge impact over time. SMART goals stand for “Specific, measurable, attainable, relevant and time-bound.”
For instance, if your goal is to walk more to ultimately have more stamina, here’s how you might work through setting a good goal. You already specified it will pertain to walking. The specific goal would involve walking, but also could also involve other relevant activities such as going up and down steps. Measurable means you can easily determine if and when you are meeting the goal, such as time or distance walked. Let’s say you come up with the goal, “I will walk 20 minutes each day without stopping or sitting.”
Next, see if the goal is attainable. You want to reflect on how confident you are going to be able to achieve it to avoid failures and keep yourself motivated and energized with successes. Ask yourself, how confident are you 0-100% that you can walk daily for 20 minutes. Now, let’s give it a time frame. For this example, let’s use one week. If you are anything less than 80% confident that you can walk daily for 20 minutes over the next seven days, then it would be important to adjust to the goal to increase your confidence in achieving the goal. Perhaps, you adjust the goal to, “I will walk 15 minutes daily for one week without stopping or sitting.” Once again, check on your confidence to achieve this new goal. Let’s say you now feel 90% confident in achieving the goal. That’s a good goal! For a goal to be attainable, you need to feel fairly confident (80% or greater) that you can achieve it. When writing goals, you want them to be relevant to what you are interested in doing and able to do at the time. If the weather is poor for the next week, and you can’t walk outside, make a goal that allows you to walk both indoors or outdoors so it doesn’t derail your plans.
Lastly, the goals need to be time-bound, so indicate when you will achieve the goal. Ideally, goals will be reviewed and edited every week. Perhaps your long-term goal with walking is to progress yourself to being able to comfortably hike 30 minutes at a nearby trail that involves hills, unlevel surfaces and steps. Start small and then adjust the goal as you progress to keep the experience fun, motivating, relevant and achievable.
- Herbst, Karen L et al. “Standard of care for lipedema in the United States.” Phlebology vol. 36,10 (2021): 779-796. doi:10.1177/02683555211015887
- Nichols, Wallas. Blue Mind: The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected, and Better at What You Do. Little, Brown and Company, New York, 2015.
- SMART Goal Setting Guide. Available online. Accessed 06/02/2022.
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