Hi, Libby-

As a Certified Lymphedema Therapist, I understand the impact of having lipedema. With lipedema, it’s often hard to get a diagnosis. It can be years of frustration because diet, exercise, and lifestyle changes have little effect on the fat. Since lipedema often becomes worse with hormone changes, like puberty or pregnancy, a doctor may not be willing to look at lipedema as a first option for diagnoses. It is often the patient who does their own research and asks the doctor specifically about lipedema.

Because the fat makes it hard for the lymphatic system to work efficiently, there is often swelling. While the lymphatic system is not damaged in lipedema, it’s important to manage swelling. Swelling can be managed with Manual Lymphatic Drainage (MLD) and compression garments. Some people find pneumatic compression pumps to be a helpful aid, especially when the swelling makes it difficult to reach lower legs to perform self MLD. When the swelling is not managed, the lymphatic system becomes chronically strained. This leads to the lympahtic system can become damaged. That’s when lipedema can evolve into lipo-lymphedema.

Manual lymphatic drainage is part of the gold standard of care for both lipedema and lipo-lymphedema because it helps the vessels within the lymphatic system to contract and move lymph fluid. While many massage therapists are trained in MLD, MLD is not massage. Massage is kneading of the muscles, while MLD stretches just the skin. Traditional massage is too much pressure. The difference in pressure is the difference between making bread and stroking a newborn’s head.

MLD requires special training to be done properly. There are both online and hands-on training for therapists to learn MLD. Some classes are as little as 18 hours of training. The standard MLD course is 40 hours of hands-on training to ensure that therapists know the pressure and technique. Basic MLD courses do not equip therapists to work with lipedema or lymphedema. The standard course for therapists to learn to work safely with lipedema and lymphedema is 135 hours. When you are looking for a MLD therapist for lipedema, ask what the therapist’s credentials are. It’s important to work with a therapist knowledgable about your condition.

-Bailey