Hydrotherapy & Aquatic Equipment for Lipoedema


How Water Therapy can assist those who live with Lipoedema.


Lipoedema is a condition that causes an excessive build-up of fat in areas along the legs, thighs, and buttocks. It typically affects women, but not exclusively.

Lipoedema is not to be confused with obesity, although it can be hard to differentiate between them without proper medical advice. Everyone’s body is different; some people may store fat differently than others, which can lead to a misdiagnosis. It is best to seek advice from a medical professional to get a formal diagnosis. Some indicators of Lipoedema may include:
• Obvious larger bottom, thighs, and legs, with the feet being unaffected
• Arms affected in some cases, being more evident in the upper arm region
• Observable change in skin texture - “Orange peel” look
• Soft appearance of fatty areas

The causes of lipoedema are not fully understood, but it's thought to be related to hormonal changes and genetics. It is often accompanied by heavy or painful periods and can worsen during pregnancy, menopause, or after taking certain medications.

Lipoedema can cause many issues; these can include:
• Swelling
• Pain and discomfort
• Social and psychological distress (due to the changes in body shape)

Lipoedema can often be confused with Lymphedema. While two completely different conditions, Lipoedema may cause Lymphedema due to a large amount of fat blocking lymphatic pathways. For more information check out our Lymphedema summary.


Lipoedema is simply the abnormal build-up of fat in the body. It generally starts during puberty or when significant hormonal fluctuations occur in life (Pregnancy, Menopause). It is different from obesity. While fat deposits can affect obese people, Lipoedema can as easily affect individuals of healthy weight.

There is evidence of a genetic predisposition to Lipoedema, as well as hormonal changes. While the disease onset is usually puberty, it is often not identified immediately and is often associated with chronic venous and lymphatic insufficiency, early degenerative articular disease, and obesity. Therefore, Lipoedema is usually diagnosed in its later-stage co-morbidities. Psychological issues are also prevalent then and are often what is diagnosed, whereby Lipoedema is the cause and primary disorder.


Due to the irregular build-up of fat and fluid, many symptoms can come into play that may significantly impact the quality of life (QAL) of those suffering from Lipoedema.

Symptoms may include:

• Build-up of fat - This is the main symptom of lipoedema, and it is often symmetrical (affecting both sides of the body equally). The fat may feel soft and spongy to the touch, and it may be accompanied by swelling.
• Pain and discomfort. - Lipoedema has been shown and reported to cause pain and discomfort. Pain can stem from the heaviness that worsens towards the end of the day or after standing for long periods. This has been reported as a significant issue for many people, as specific jobs require long-standing periods.
• Swelling - Can be seen to cause odd feelings of tightness and discomfort.
• Skin changes - Soft cool appearance of skin. The Orange peel appearance.

Recognising the symptoms

Lipoedema is often misdiagnosed in its early stages and recognising the symptoms can aid early intervention and treatment. Symptoms vary, and not all will experience all symptoms. It is common to see a combination that increases in severity as the disease has progresed.

• Symmetrical accumulation of fatty tissue in legs, most commonly from the waist to ankles. Feet are not affected, with distinctive fat rings around ankles (if Lipolymphoedema is also present, this may differ). Lipoedemic fat accumulation can occur in the upper arms, with a fat ring around the wrists.

• Legs that are hypersensitive to touch and pressure

• Lipoedemic fat pads accumulate on the either the upper outer thighs, inner thighs, and above, below, and inside of the knee – which often causes abnormal gait and joint pain.

• Hypermobility

• The loss of concave spaces on either side of the Achilles tendon

• Non-pitting edema with negative Stemmer’s sign on feet and hands

• Altered temperature, texture, and appearance of the skin.

• Restrictive diets have minimal effect on Lipoedemic fat.

• Bruising easily.


Water therapy, also known as aquatic therapy or hydrotherapy, is a natural therapy that involves movement in the water. It is a low-impact form of exercise that can be beneficial for people with lipoedema, by reducing swelling, improving mobility, and alleviating pain.

Water therapy can be a great way to reduce symptoms associated with lipoedema, improve mobility, and take back control of your life. Water therapy is preferred over many other types of training as the water’s unique buoyancy, hydrostatic pressure, and resistance properties make mobility and exercise sessions easier and more efficient for those suffering from lipoedema.

Why is water therapy suited?

1. Water therapy reduces gravity’s effects and supports the individual. Often people with Lipoedema feel heavier and find it challenging to move around. This makes land-based exercises much more difficult, with sessions tending to be shorter and less effective. However, water therapy sessions can last much longer and be more effective.

2. Promotion of blood and lymph flow. Lipoedema can cause blockage of lymph tissue, and increased fat has been shown in research to reduce blood flow. These effects are facilitated through the movement of water and the working of muscles.

3. Heart and muscular health - Water pressure provides resistance, allowing for exertion in exercise sessions without the added stress on body compared to land-based training.

4. Water has a unique property, Hydrostatic pressure, that provides a gentle pressure or massage on the body. This pressure can be beneficial for individuals with Lipoedema, as it can help to reduce swelling and improve circulation.

Hydrostatic Pressure

Hydrostatic pressure is the force exerted by a fluid (such as water) on an object (such as the body). The deeper you go in the water, the more pressure your body experiences.

Hydrostatic pressure can be used for those suffering from edema or swelling. For example, if you are submerged in 1 meter of water, the pressure is 1.4 psi or 72.4 mm/Hg. By comparison, T.E.D. anti-embolism stockings apply pressure between 10-18mm/Hg.

Hydrostatic Pressure & Aqua Cycling

In early versions of hydrostatic pressure therapy, the person with lipoedema would typically stand or sit in a pool or spa with water up to the waist or chest. Then the practitioner uses their hands or a handheld device to apply gentle pressure to the affected areas. At the same time, they floated with stretches, helping to move fluids out of the tissues and into circulation. However, we now have fantastic equipment like an AquaBike that allows us to work deeper in the water, legs at the bottom of the pool for the duration of the session, engaging more hydrostatic pressure. The cycling movement in water creates a gentle massage on the legs that delivers effective and fast swelling relief and is very helpful for those suffering from Lipoedema. The pressure level can also be increased with the speed of the cycling motion.


Water Therapy Equipment for the Lower Limbs

For the lower limbs, Aqua Cycling on a Hydrorider AquaBike or Running on a Hydrorider treadmill is the most effective water therapy for those suffering from Lipoedema.

Aqua Cycling
Aqua cycling, also known as water cycling, is a low-impact exercise involving riding a stationary bike in a pool called an Aqua bike. It is a form of water therapy that can be particularly beneficial for people with lipoedema, as it can help reduce swelling, improve mobility, and alleviate pain.

How long should I aqua cycle for?
30 to 45-minute sessions are typical. However, the frequency of hydrostatic pressure is more important than the session length regarding Lipoedema. Therefore, water cycling as often as possible, preferably 3 -5 times a week, in the beginning, is preferred.

How can I water cycle?
If you are on the Sunshine Coast, water cycling classes are a lot of fun and will support you on your journey. Check it out here. We also offer a range of Aqua bikes to suit your needs and enable you to aqua cycle at home or a pool near you. You can find them here.

Aqua Running
If cycling’s not your thing, an Aqua treadmill can also be a fun and effective alternative. An Aqua treadmill is a specialized treadmill designed for use in water. Aqua treadmill therapy involves walking or running on the treadmill while submerged in a pool or other body of water. The water provides resistance. Like aqua cycling, the buoyancy of the water can help reduce the impact on the joints, which can be beneficial for sufferers with joint pain or other mobility issues. Additionally, the water can help support the body and reduce swelling, which may help improve comfort and mobility, a key issue in Lipoedema. Principles regarding the dosages and where to purchase the equipment for aquatic cycling also apply to the aqua treadmill. See above.

Water Therapy Equipment for the Upper Limbs

For upper limbs, deep water fast movements with the arms using a Hyrorider Riderband leverage the properties of water to aid Lipoedema sufferers and can be found in the Water Resist Circuit Classes or shop. Swimming can also be beneficial. Alternatively a Water Therapist can put a program together for you at home.

Get Started

Aquatic therapy can be an effective treatment option for individuals suffering from lipoedema. Water Resist specialise in providing high-quality underwater therapy equipment that will not rust or deteriorate in water, including aqua treadmills, aquatic bikes, and water-based equipment, as well as classes and individualised sessions to help manage the condition and relieve their symptoms to improve the quality of life. Our products and services provide a range of benefits, including improved mobility, reduced swelling, increased muscle strength and endurance, and little impact on joints.

If you or a loved one is living with lipoedema, we encourage you to consider the benefits of aquatic therapy and consider talking to your medical team and incorporating it into your treatment plan. With the right equipment and guidance, you can take control of your condition, get Water Well, and take back control of your life!

Note: Please seek medical advice before exercising & always train under the advice your medical specialist.


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