Running is a physical activity that is gaining more and more fans in Brazil as it contributes to cardiovascular health, physical conditioning and well-being. However, for people with lipedema, it is common to have doubts about practicing this exercise. After all, can running continue to be part of your routine or is there a risk of worsening the symptoms of the disease?

The answer, according to physiotherapist Dr. Mariana Milazzotto, is not as simple as it seems. It all depends on factors such as the patient’s profile, the stage of the disease and the way exercise is introduced.

According to the physiotherapist, the first step is to understand that movement is part of the treatment. However, this does not mean that any exercise is indicated or that the same strategy works for all patients. “Exercise is one of the pillars of lipedema care. However, a sedentary woman should not start with running. The body needs to adapt, and the impact, at the beginning, can generate more discomfort than benefit”, he states.

What’s at stake?

Lipedema is characterized by the abnormal and symmetrical accumulation of fat, mainly in the legs and thighs, which can cause pain, sensitivity, swelling and frequent bruising. In recent consensus on the condition, physical activity appears as an important part of management, but not as an isolated solution, much less as a single recipe.

In this context, running becomes a point of attention because it is an impactful activity. For a woman who has never had an exercise routine, starting from scratch and starting with a more aggressive modality for the joints and lymphatic system can increase perceived inflammation and worsen symptoms such as pain and heaviness in the legs. “If the patient is inflamed, with sensitivity to touch, bruises and a feeling of heavy legs, the timing of running may not be ideal”, explains Dr. Mariana Milazzotto.

When the impact weighs more

The increase in events and races in several cities in the country and the growing female participation are also seen, by many women, as a symbol of health and autonomy. But, in lipedema, this image does not always translate into a good bodily response. High-impact modalities can be well tolerated by those who already have conditioning, muscular structure and progressive adaptation. For those just starting out, the risk of overload is greater.

According to Dr. Mariana Milazzotto, physical activity is useful for improving symptoms, quality of life, lymphatic drainage and inflammation, with emphasis on aquatic practices and strength training. “It’s not about banning running for every patient with lipedema,” he says. “It’s about understanding when it makes sense. An already active woman, who likes running and doesn’t worsen symptoms, can continue, but needs to be reevaluated periodically. Sometimes, all you need to do is adjust the training, volume, intensity or recovery”, he adds.

The most important point, according to the expert, is that women with lipedema who are going to start exercising need progression. Walking, water exercises and light weight training tend to be more suitable options at first because they help build muscle base, improve circulation and reduce overload without requiring high impact.

“I see a lot of women believe that they need to start running because they want to lose weight or get back in shape quickly. But, with lipedema, haste usually takes a toll. The right exercise is the one that respects the body and reduces symptoms, not the one that increases inflammation”, says the physiotherapist.

Running can be part of the routine

For Dr. Mariana Milazzotto, race should not be treated as an automatic enemy. In patients already conditioned, without significant worsening of pain or edema and with professional supportit can continue to be part of the routine. The alert is for continuous reevaluation.

If running increases weight in the legs, pain at the end of training or a feeling of inflammation, the program needs to be reviewed. This may mean reducing frequency, changing intensity, combining strengthening or replacing part of the impact with other modalities. The logic is to customize, not generalize.

“There is no single rule. What exists is a body that needs to be listened to. If running worsens the symptoms, the behavior changes. If the patient runs well, without clinical worsening, the exercise can be continued with monitoring”, he summarizes.

By Paulo Novais