Lipedema & Hypermobility: Understanding the Overlap in Connective Tissue

Maya Illipse
Dec 4, 2025
7 min read

Updated: Dec 31, 2025

Living in a body that feels persistently heavy tender and misunderstood can create deep confusion. Many people spend years being told the solution is to diet or exercise more only to later discover that a real connective tissue condition sits underneath their symptoms.

If you recognise painful legs that bruise easily or a lower body shape that seems resistant to change you are not alone. And if you also live with hypermobile Ehlers Danlos syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD) the overlap between these conditions can make your body feel unpredictable and difficult to trust.

What you are experiencing has a physiological basis, even if it has been difficult to name until now. This article offers a clear explanation of what lipedema is, how it connects to hypermobility, and how you can begin to support your body with knowledge and compassionate simple strategies.

What Is Lipedema

Lipedema is a chronic connective tissue condition involving a specific buildup of painful fat tissue primarily in the legs and sometimes the arms. It is not caused by overeating and does not respond in typical ways to calorie restriction or standard weight loss.

Common features include:

Symmetrical disproportionate fat accumulation such as hips and thighs being much larger than the upper body
Pain tenderness and easy bruising
A feeling of heaviness tightness or fullness in the limbs
Tissue that often feels firm nodular or rubbery
A distinctive cuff or bracelet effect at the ankles or wrists where the swelling stops abruptly

Lipedema does not present the same way in every body. Clinically, it is often described using types, based on where the tissue accumulates. A person may fit clearly into one type or show features of more than one.

Commonly described lipedema types include

Type One: Fat accumulation is mainly around the hips buttocks and pelvis.

Type Two: Fat extends from the hips through the thighs but does not usually pass the knees.

Type Three: Fat accumulation continues from the hips through the thighs and below the knees into the calves and lower legs.

Type Four: The arms are also affected, often with fat accumulation from the shoulders to the forearms.

Type Five: Fat accumulation mainly affects the lower legs below the knees while the thighs may be less affected.

The types of lipoedema are meant as guidelines, not fixed boxes. In real life, many people do not fit neatly into just one type. It’s very common to see overlap between multiple types in the same person, changes over time, and even differences between the right and left side of the body. This simply reflects how variable lipoedema can be.

Because lipedema is frequently mistaken for simple obesity or lymph related swelling, many people go undiagnosed for years. This delay often increases both physical discomfort and emotional strain.

The Connection to Hypermobility hEDS and HSD

Emerging research and clinical observation point to a strong overlap between lipedema and joint hypermobility syndromes. These are distinct conditions but they appear to share common ground in connective tissue behaviour, circulation, and sensory processing.

Shared Connective Tissue Foundations

In hEDS/HSD, connective tissue is often more elastic and offers less passive structural support. In lipedema, the fat tissue and surrounding fascia become thickened, inflamed, and fibrotic. When both are present the body can experience the confusing combination of joint laxity alongside tissue tightness, heaviness, and tenderness.

What the Research Shows

Clinical studies consistently find that hypermobility is significantly more common in people with lipedema than in the general population. Earlier studies identified rates between 44-58%. A comprehensive 2025 Spanish study of over 1,800 patients found that 95.8% showed ligamentous hyperlaxity, with specific patterns of bilateral joint and soft tissue involvement that suggest shared underlying pathology rather than coincidence.

The large Spanish cohort study mentioned above found remarkably high rates of associated conditions. Beyond the near-universal ligamentous hyperlaxity, researchers identified that 97.4% of participants experienced bilateral trochanteric pain (pain at the hip) and 96.6% showed iliotibial band involvement—both indicators of connective tissue compromise affecting not just fat distribution but also fascial and muscular support systems.

Perhaps most significantly, the research revealed that 99% of participants showed signs of suspected high intestinal permeability, suggesting chronic low-grade inflammation may play a central role in lipedema. Additionally, 76% had inflammatory ovarian dysfunction and 59.5% had thyroid disease, pointing to lipedema as a complex, multi-system condition rather than simply a fat distribution disorder.

These findings help explain why lipedema can feel so unpredictable and why it often coexists with other inflammatory and hormonal conditions. The inflammation doesn't stay confined to one area, it affects connective tissue throughout the body, hormone regulation, gut barrier function, and immune responses.

Functional Impact on the Body

This combination creates unique movement and stability challenges such as:

Reduced joint position sense
Altered walking patterns
Knees drifting inward
Feet turning outward
Hip shifting
Lower limb fatigue and instability

Heavier tissue combined with joint laxity increases the work placed on stabilising muscles and the nervous system.

A Neurodivergent Friendly Perspective

For people who are autistic, ADHD, AuDHD, dyspraxic or otherwise neurodivergent the overlap between lipedema and hypermobility can carry extra layers.

Lipedema can heighten sensory sensitivity making touch clothing or compression uncomfortable. Differences in interoception can make it harder to detect swelling, inflammation or overexertion early. Executive function challenges may make it difficult to pace activity organise care routines or maintain consistency when symptoms fluctuate.

Your sensory and processing needs matter in how care is delivered. Support must be adaptive not rigid.

A Supportive Framework Understanding Treatment and Foundational Care

Supporting lipedema with co occurring hypermobility works best when approached in layers. Medical treatment addresses the physical disease process. Foundational care supports the nervous system connective tissue and movement system so that medical care can be better tolerated and more effective.

5.1 The Medical Treatment Pathway for Lipedema

Medical management is usually multidisciplinary and may include:

Complete Decongestive Therapy which combines Manual Lymphatic Drainage with compression garments skin care and therapeutic exercise
Surgical lymph sparing liposuction performed by specialist surgeons which is currently the only method known to reduce pathological lipedema fat
Physical and occupational therapy for compression fitting movement safety and daily function
Psychological support due to the high emotional burden of delayed diagnosis and body related distress

5.2 Foundational Support The ParaMotion Approach

While the treatments above address the physical structures of lipedema, they must be delivered to a living, feeling nervous system. This is where a gentler, awareness-based practice is not just helpful—it’s transformative. Our methods target the underlying physiological state (inflammation, nervous system stress, poor proprioception) that worsens all symptoms.

The table below shows how building this stable foundation directly supports your medical treatment goals:

Your Lipedema Challenge	Foundational Practice	How It Helps & Prepares You for Treatment
Pain, Inflammation & a Stressed Nervous System	Breath & Nervous System Regulation (e.g., gentle diaphragmatic breathing)	Calms the fight-or-flight response, lowering stress hormones that drive inflammation and heighten pain. Result: You enter treatments in a calmer state, where therapy is more effective.
Fluid Stagnation & Poor Circulation	Rhythmic, Joint-Gentle Movement (e.g., walking, aquatic therapy)	Creates a gentle "muscle pump" to support lymphatic and venous flow. Result: You actively maintain fluid movement between clinical sessions, making compression more effective.
Unstable Movement & Poor Body Awareness	Awareness-Based Alignment & Micro-Movements	Builds a better "body map" and strengthens stabilizers without strain. Result: You move with more stability, protecting hypermobile joints. This makes exercise therapy safer.
Sensory Overwhelm & Treatment Anxiety	Sensory-Adapted, Gradual Exposure	Uses a gradual, curious approach to touch, compression, and movement. Result: You build tolerance to necessary therapies without triggering a defensive nervous system flare.

The Spanish 2025 study identified near-universal signs of suspected intestinal barrier dysfunction in lipedema patients, suggesting systemic inflammation may be driving or worsening symptoms. This aligns with the finding that anti-inflammatory interventions, from dietary changes to nervous system regulation to specific botanical compounds, can reduce pain and tissue sensitivity. When we address inflammation at multiple levels, the body becomes more responsive to all forms of treatment.

5.3 Nutrition and Tissue Support

Nutrition cannot cure lipedema but it can support inflammation regulation, circulation, energy stability, and connective tissue health. An anti inflammatory whole food pattern is often supportive and may include

A wide range of vegetables fruits and fibre rich foods
Healthy fats such as olive oil seeds nuts and oily fish
Adequate protein for tissue repair
Reduced ultra processed foods refined sugar and excessive additives

Hydration is especially important since lymphatic movement depends on adequate fluid balance.

Supplements sometimes discussed for supportive care include vitamin C for collagen and antioxidant balance omega three fatty acids for inflammatory regulation and polyphenol rich plant compounds. These are not proven treatments and responses vary widely. Any supplementation should be introduced gently and ideally under professional guidance.

Recent clinical evidence suggests specific polyphenol compounds may provide measurable benefit. A 2025 Brazilian randomized controlled trial found that pine bark extract (Pycnogenol®) significantly reduced pain, swelling, and heaviness in women with lipedema over 60 days, while also improving body composition and quality of life scores. Participants reported improvements in bruising, burning sensations, fatigue, cramping, and overall leg comfort.

While this represents just one study and more research is needed, it suggests that targeted anti-inflammatory and antioxidant compounds may help manage symptoms. Pycnogenol® works through multiple mechanisms including reducing inflammation, supporting blood vessel integrity, and potentially influencing fat metabolism—all relevant to lipedema pathophysiology.

This doesn't replace established treatments like compression or manual lymphatic drainage, but it may offer additional symptomatic support as part of a comprehensive approach. These compounds should complement, not replace, whole-food nutrition and established medical care, and individual responses will vary.

5.4 If You Also Have POTS or Orthostatic Intolerance

Many people with hypermobility also experience autonomic nervous system conditions such as Postural Orthostatic Tachycardia Syndrome. In this case increased fluid and sodium intake is often recommended to support blood volume and circulation.

For people who have lipedema alongside POTS the balance can feel confusing. Higher sodium can help circulation and reduce dizziness but may also increase fluid retention and limb heaviness in some individuals.

The most important principle here is individualisation rather than rigid rules. Some people benefit from higher sodium intake while also using compression and regular movement to support lymph flow. Others may need careful titration based on swelling blood pressure kidney function and symptom response.

Guidance from a clinician familiar with both autonomic conditions and connective tissue disorders is strongly recommended before making large changes to fluid or salt intake.

Final words

Lipedema and hypermobility are real connective tissue conditions that affect structure, circulation, sensation, and movement. The challenges that come with them are physical and ongoing.

Understanding what is happening in your body can change the way you relate to your symptoms. Support does not come from ignoring what is difficult, but from responding to it with informed care, adaptive movement, and systems that respect how your body actually functions.

Progress rarely looks linear. What matters most is having access to accurate information, practical tools, and a framework that allows you to work with your body rather than constantly pushing against it.