Physio-Pilates Approach for Women Living With Pain, Stress and Lipedema
A physiotherapist and lymphedema therapist explains why slow, adaptable pilates can calm the nervous system, reduce pain, support lymphatic flow and help women rebuild trust in their bodies.
Ingrid Steen is a 44-year-old physiotherapist, lymphedema therapist, pilates instructor, and mother of two from Arendal, Norway. She runs PilatesUniverset and works at Helsekilden Fysioterapi AS.
She graduated as a physiotherapist in 2007, became a physio-pilates instructor in 2008, and has been teaching groups and working with patients ever since. In 2022 she completed training as a lymphedema therapist.
What ties her work together is simple:
A holistic view of health — and a belief in what we can do ourselves.
Nutrition, movement, joy, and stress management are central to her approach and to what she teaches.
From hating gym class to finding a form of movement that felt right
As a child and teenager, Ingrid disliked gym class. She felt slow, uncoordinated, and never quite “good at” the types of exercise that involved speed or competition.
That feeling stayed with her — and it shapes how she teaches today.
She knows how it feels:
to struggle with exercise
to dread movement
to feel like your body isn’t on your team
When she discovered pilates during her studies, she felt something shift. The pace was slower, the movements more controlled, and the focus far less on performance. After one class in physio-pilates during physiotherapy school, she knew she needed to learn more.
That experience — of movement that actually felt good — is what she now tries to give others.
What physio-pilates is — and why it works so well for “bodies with a history”
Ingrid describes pilates as slow, dynamic strength training with focus on control and breathing.
Where many experience yoga as positions and stretches that can feel uncomfortable or painful, her pilates classes revolve around:
movement rather than poses
strength and control rather than perfection
adaptation rather than pushing through
The physio-pilates approach breaks down classical exercises into simpler pieces. You start low. You build gradually. The goal isn’t a flat stomach or advanced positions — it’s a body that:
tolerates more in everyday life
has softer joints
develops stronger, more coordinated muscles
feels safe and predictable to live in
A common comment at the end of her classes is:
“Wait — are we finished already?”
That says everything about the pace, the presence, and the sense of mental pause the classes create.
Adaptation as the core principle
Ingrid is not driven by diagnoses; she is driven by people. She often says that “everyone has something.”
Her work is about seeing each person and adjusting the exercises to their needs:
hip pain when lying sideways? Then the exercise is done standing, on the back, or with a resistance band.
knee pain? Then exercises are done lying down, seated on a chair, or standing — not in deep knee bends.
shoulder pain? Then the arms stay lower.
stretching hurts? Then you stop before the discomfort appears.
The pace stays intentionally slow so participants have time to feel, adjust, and learn their bodies over time. Her rule is always the same:
You should not leave a pilates class with more pain than you came in with.
Lipedema, pain, and difficult training histories
Ingrid works with many women with lipedema — through physio-pilates, lymphedema treatment, and private sessions. Their stories often share the same patterns:
a heavy, dragging sensation in the legs
pain with certain movements or load
a body that doesn’t respond to traditional exercise
years of trying to train and lose weight with little effect
This takes a toll on motivation. Many end up in a negative spiral:
Low movement → stiffer joints → poorer circulation → weaker muscles → more inflammation → more pain → even higher threshold for trying again.
This is where Ingrid believes pilates can play a role for many:
A safe re-entry into movement where the goal is not to push harder, but to build up — gently, consistently, and with respect for the body’s limits.
The nervous system, stress, and why slow movement works
Ingrid speaks often about the connection between stress and pain. She frequently recommends the Norwegian book “Vagusnerven” (The Vagus Nerve) by Annette Løno for those who want to understand why the body reacts the way it does.
Her explanation is simple and clear:
A stressed body lives in fight-or-flight mode for long periods.
In that state, the body does not prioritise healing, inflammation control, or digestion.
Long-term pain sensitises the nervous system — the “danger alarm” goes off more easily.
She uses a metaphor with her participants:
When the body has experienced pain for a long time, it builds tall defensive walls. Even small sensations trigger the alarm. Through cautious, controlled movement, you slowly take down the wall brick by brick. The body learns:
“This movement was safe. Nothing bad happened.”
Slow tempo, calm breathing, and movements that are meant to feel good — not threatening — are reasons she sees pilates as “gold” for a stressed nervous system. It activates the rest-and-digest system, where the vagus nerve is active, and over time this can reduce pain and lower baseline stress.
Lymphatic flow and slow exercise
When Ingrid trained as a lymphedema therapist, more pieces fell into place.
The lymphatic system moves slowly and depends on muscle activity to flow. The controlled, soft full-body movements in pilates make it especially useful for people with:
lymphatic issues
lipedema with fluid components
swelling that worsens with inactivity
The adaptability of pilates also makes it accessible to women with pain, unstable joints, or poor experiences with exercise. For Ingrid, the goal is not that everyone does everything — but that everyone experiences something that feels better afterward.
“Less is more” — and the value of a strong foundation
Many of Ingrid’s participants come in with a belief that “real exercise” must be sweaty, heavy, and last at least an hour.
She disagrees.
Instead, she focuses on:
shorter sessions
lower thresholds
gentle progression
consistency over intensity
She often says:
“You can’t build a house on toothpicks.”
The foundation needs to be solid before loading and complexity increase — strength, control, understanding of how your own body moves.
This is why she offers courses rather than drop-in classes. She knows it often takes 6–7 sessions before participants say:
“Now the lightbulbs are turning on.”
What participants notice in everyday life
Feedback from long-term participants often includes:
fewer aches and tensions
easier movement
more flexibility
a sense of calm and mental clarity
renewed curiosity about their own body
One woman summed it up:
“Pilates made me aware of what works and doesn’t work for me. Knowing your own body is worth gold.”
Advice for women with lipedema, pain, or “exercise trauma”
Ingrid knows many women with lipedema have been hurt by exercise — physically, mentally, or both. Her recommendations are:
Find an instructor with genuine knowledge — ideally a physiotherapist or someone with solid training in pain and/or lymphatics.
Start smaller than you think you “should.” The goal is to feel better, not worse.
Give your body time. The nervous system often needs weeks to interpret new movement as safe.
Try a one-to-one session or a video first if you’re unsure.
Pilates isn’t for everyone — but there is a form of movement for everyone, she says, if you help people find the right entry point.
Advice for instructors and therapists who work with women with lipedema
Her message to other professionals is:
get to know the person, not just their diagnosis
explore their past experiences — good and bad
help them find movements that feel good, and don’t be afraid to scale down
remember that “every little bit counts” — small changes can be life-changing over time
And above all:
Movement is just one piece of the puzzle. Health is holistic. Seek advice from others when needed — we grow stronger together.
What we can learn from Ingrid’s experience
1. Safety and adaptation are the foundation for long-term movement.
When exercises can be adjusted and the pace is slow, women with lipedema and pain histories can finally train without fear of making things worse.
2. The nervous system needs training too.
Slow, controlled movement with calm breathing helps the body shift out of constant stress mode. Over time, this can reduce pain and improve inflammation control.
3. Small steps build strong bodies.
You don’t need long or intense sessions to get results. Consistency and gentle progression create softer joints, better circulation, more energy, and a stronger sense of control.
