Since 1940, Lipoedema has been recognised as a valid medical condition in women (Mayo Clinic), and yet still women with this condition are stigmatised and told to increase exercise, and lose weight.
Sadly, this advice comes, not only from friends and families, but often from medical professionals, personal trainers and gym staff. Little wonder then, that depression and eating disorders are commonly experienced by women with Lipoedema.
What is Lipoedema?
An inherited adipose ( fatty tissue ) disorder, mainly experienced by women, which usually manifests at puberty. It has metabolic, inflammatory and hormonal elements and is often associated with chronic venous and lymphatic insufficiency. Men are very rarely affected by Lipoedema.
It is often the case that these symptoms are initially treated as the primary issue, and only much later is the Lipoedema recognised as the primary disorder.
How is it diagnosed?
Most commonly, Lipoedema is diagnosed by its visual characteristics. It is often first noticed following significant hormonal changes such as the onset of puberty, pregnancy and menopause.
Signs and symptoms
Waist is small compared to much larger bottom, hips and thighs. In initial stages, the legs are only affected as far as the knees, but as the condition progresses, it impacts the lower half of the legs.
Symmetrical increase in fatty deposits usually from the waist to ankles. Feet are not affected, and the condition is typified by “fat rings” around the ankles ( and if arms are affected, the wrists) known as the bracelet effect.
Lipoedemic fat pads accumulate on the upper thighs, and around the knees, resulting in abnormal gait, and knee and hip pain.
Legs are often very sensitive to touch and pressure and exercise is painful both during and after participation.
Non pitting oedema occurs, especially after long periods of sitting or standing. Skin is soft to the touch, as is the underlying fatty tissue.
Skin temperature is often lower on affected limbs, and can have an orange peel like appearance.
Affected areas bruise more readily than surrounding areas.
Generally diets and intense exercise have little effect on Lipoedema, though a healthy diet and moderate exercise is important in Lipoedema management.
Frequently Lipoedema is identified within families, ie, My Grandmother, mother, Aunts, had “heavy legs”, “childbearing hips” etc. Whilst these people might never have been identified as having had Lipoedema, it is more likely that this history implicates the current symptoms in a Lipoedema inheritance.
Remember not all women suffer all of these symptoms, each person will have a different array of these symptoms, and some will vary, daily and seasonally, but as the we age, more symptoms become an issue.
The important thing to do is to have plans in place to reduce the severity, to self manage, and to provide the best support for your body you are able to.
Implications of Lipoedema
In recent research, respondents to a lifestyle survey indicated the profound impact on how women with Lipoedema lived their lives.
95% reported difficulty buying clothes
87% a significant reduction on quality of life,
86% low self esteem
83% avoided having photos taken
60% restricted social lives
60% feelings of hopelessness
47% self blame
45% eating disorders
Other issues included, ridicule, financial pressures from discrimination, lack of exercise due to harassment, marriage breakdown, the hazards of yo-yo dieting.
In general a lack of freely available information, about treatments, self help, and management strategies among the general population, has lead to isolation and embarrassment for many.
However this is changing and awareness is growing.
The first step is to secure a diagnosis. This sounds simple, but as previously alluded to, it may be the most complicated step you have to take!
Join with us as we welcome Lanii Strong to the team at IC Sports Therapies, as a new trainee Massage Therapist!
Lanii is currently studying a Diploma of Remedial Massage and hopes to further her study by practicing with the team at IC Sports Therapies. She has a strong passion for sport, particularly touch football and soccer. She plans to enter into sports-specific massage as her career progresses. Lanii can practice Swedish Relaxation Massage efficiently as she is studying for her diploma, and hopes to help people manage any pain or stresses in their lives.
Lanii’s initial availability is 10am-2pm on both Tuesdays and Fridays. Her introductory rate is $50 for approximately an hour of Swedish Relaxation Massage.
You too can help welcome Lanii – make your booking quickly, so you can be one of the first! We are sure she will be popular with all our clients both young and old.
Sadly we say goodbye to Brigitte, our superstar Chiro. We have loved having her with us and are sorry to see her go. We wish her every possible success in her career. We have no doubt that she will be successful wherever she goes and in whatever she choose to do. It has been an absolute pleasure having her as part of our team.
No one likes it, right? The idea of plunging a tortured, ageing body into icy waters post game, is enough to send us into cardiac arrest. Yet, it is considered to be a rite of passage in many sports. The greatest test of sporting achievement is often perceived as being time spent in an ice bath.
But what if there was a better way, which provided all the perceived benefits, but without the profound discomfort?
In fact, there is little evidence that ice bathing, or Cryotherapy, has the benefits ascribed to it.
If we believe that the body functions optimally at 37 degrees Celsius, then it makes sense to maintain the core temperature at that level throughout the recovery process. Minimal increases in core temperature during exertion are expected, and, provided adequate hydration and nutrition are maintained, our body systems adjust accordingly. It follows then, that reducing the core temperature with cooling, will quickly return the body to homeostasis, but does that mean exposing the body to temperatures more than 20 degrees below core temperature?
Having been involved in Masters sport for almost two decades, as a therapist, it is my experience that Ice baths do the opposite of what is expected, and in fact, slow down the recovery process. In competition where more than one game is played per day, ice bathing has resulted in decreased performance, increased muscle stiffness and joint pain or discomfort and appears to have no benefit to the players beyond the adrenalin rush of removing a stressor from the body.
We also know from research, that heat, and alternating hot cold plunges are ineffective in reducing recovery time. So, it would appear that extreme ranges provide little value beyond team building benefits – the misery loves company, approach.
What is the ideal recovery plan?
Current thinking is that key ingredients are hydration, nutrition and rest. Of course there is the issue of the niggles or injuries requiring attention.
I will discuss the hydration and nutritional aspects elsewhere, but clearly there remains the need to deal with muscle soreness and how to freshen tired bodies post game. Proving optimal nutrition and hydration has many demonstrable benefits and coupled with warm up and cool down programmes is critical in competition.
Evidence in favour of pool work is strong. We know that water based exercise provides compressive support of around 20 mcg Mercury to muscles, so the equivalent of most commercially available compression garments… without the need to shoe horn yourself into one! This is widely regarded as being the most beneficial level of compression to reduce delayed onset muscle soreness ( or DOMS).
If we subscribe to the benefits of cooling, rather than shocking the body, assisting vasodilation by cooling the surface area slightly provides benefit by immersing in water below core temperature. Tepid, or cool water, at around 27 degrees, is comfortable for players. It provides compression, reduces the core temperature gently, supporting the innate recovery of body systems, without the systemic shock of ice bathing.
Adding warm down stretching, and movements such as walking, and resistance work appears to assist blood flow to large muscle groups, and assisting with recovery.Masters athletes report reduced stress, improved range of movement, and demonstrably less swelling in injured or arthritic regions.
We have found 10 -15 minutes to be effective, whilst longer is enjoyable. In competition this can easily be accomplished between games in most cases.
Does Pool based Recovery reduce Injuries?
The evidence at this stage is anecdotal. As a Sports Trainer/therapist, working at all levels, Nationally and internationally, over almost 25 years, I endorse a no ice policy. A concenus among the cohort I care for is strongly in favour of the cool water approach. It is invariably the case, in cricket, soccer and wheelchair sport that I have worked with, that the players carry fewer injuries, recover more quickly, demonstrate a greater range of motion, and enjoy the pool work.
At Masters level particularly, trainer/therapists are often dealing with chronic, long term issues, with resultant biomechanical or compensatory patterns entrenched in nature. Our role is clearly restricted to dealing with what we can influence in the time available. Teaching pool work allows players a take home approach. This is clearly an easy form of management with high compliance.
Ice bath is counter intuitive to all players at Masters level and beyond, compliance is difficult as a consequence. Tepid pool work however, has demonstrable benefits, and high compliance levels. It can be used multiple times a day, is inexpensive and simple to facilitate. It can be as simple as walking in chest deep water, or as complex as a full warm down routine.
Players report feeling fresher, and particularly, lighter in the legs, post session. Invigorated, recharged and relaxed bodies perform better in competition, and the teams that consistently employ this approach are definitely less injury prone.
Masters athletes, generally require more therapy, are more body aware, but also less likely to request treatment, toughing through their aches and pains, so pool work helps those players and adds a self-administered therapy to their tournaments.
Are the benefits sufficient to change the culture of your team?
The South African Rhinos team has unanimously decided to give <team mascot> Sydney to Nicki Cooke in appreciation of her support and service to the team and her passionate desire to make a difference to the rhino species.
We know that you will cherish and nurture her… thank you again.
— Roger Moult and the RHINOS