What to Expect with Your Functional Capacity Evaluation
If you have lipedema and you’re scheduled for an FCE, this post will help you understand what to expect.
It’s been a little while since I’ve sat down to write here. Life, lipedema, and everything in between can sometimes pull us away. But today, I’m back — and this post isn’t about me. It’s about you.
Whether you’re newly diagnosed, deep into your lipedema journey, or just trying to figure things out one step at a time, I want to support you in something that can feel big, unfamiliar, and honestly a little scary: your Functional Capacity Evaluation (FCE).
Take a deep breath — you’re not alone. As someone who has lived with lipedema, I understand how stressful it can be to have your body assessed by someone who may or may not fully understand your condition. That’s exactly why I’m sharing this guide — to help you walk into your FCE feeling informed, empowered, and ready to advocate for yourself.
What Is a Functional Capacity Evaluation?
A Functional Capacity Evaluation (FCE) is a comprehensive, standardized test that measures your physical abilities and limitations. It’s typically conducted by a physical therapist or occupational therapist and may last between 2 to 6 hours, depending on how detailed the exam is.
The FCE is designed to assess things like:
How long you can sit, stand, or walk
How much you can lift, push, or pull
Your balance and coordination
Your endurance and ability to complete tasks over time
How pain or fatigue affects your ability to function
For people with lipedema, this kind of evaluation can help document how your symptoms — such as pain, swelling, heaviness, fatigue, and reduced mobility — impact your day-to-day life and physical capabilities.
How Does Lipedema Affect Functional Capacity?
Lipedema is a chronic fat disorder that mostly affects women. It causes disproportionate fat accumulation — usually in the legs, hips, and arms and is often painful, especially when touched or compressed. But its effects go far beyond appearance.
Here’s how lipedema symptoms can impact your functional ability:
Pain and sensitivity: Even light pressure can trigger deep, aching pain, which may limit movement or ability to stand/sit for long periods.
Fatigue: The added weight and inflammation can lead to extreme tiredness, especially with exertion.
Mobility challenges: Walking, climbing stairs, bending, and getting up from a seated position can become difficult.
Joint strain: Many patients develop joint pain or secondary issues in the knees, hips, or lower back.
Swelling: Especially in later stages, swelling (sometimes confused with lymphedema) may limit range of motion and balance.
An FCE can help measure and document these issues in a way that’s specific and functional — not just theoretical.
What Happens During an FCE?
The structure can vary slightly depending on the facility, but most FCEs follow a similar format. Here’s what to expect:
1. Initial Interview
The evaluator (often a physical or occupational therapist) will start by asking questions about your:
Medical history
Lipedema diagnosis and current stage
Symptoms and daily limitations
Work status (if relevant)
Personal goals (e.g., improved mobility, better pain management)
This is your time to speak honestly about what your body feels like on a daily basis.
2. Physical Measurements
They may take your:
Blood pressure and heart rate
Height and weight
Range of motion (how far you can move certain joints)
Grip strength
Pain level (usually on a 1–10 scale)
3. Functional Testing
Here’s where the hands-on testing begins. Depending on your condition and purpose of the FCE, tasks might include:
Walking tests: You may be asked to walk a certain distance or pace.
Standing/sitting tolerance: How long can you sit or stand comfortably?
Reaching or lifting: You might lift lightweight objects or reach overhead.
Pushing/pulling: Pushing a cart or weighted sled might be included.
Stair navigation: If you’re able, you may be asked to go up and down steps.
Postural tasks: Squatting, bending, kneeling—if you’re able—may be tested.
Important note: You are not expected to push past pain. FCEs are designed to capture your real limits—not how much discomfort you can tolerate. Speak up if something feels wrong.
Tips for Lipedema Patients Before the FCE
Getting ready for your Functional Capacity Evaluation can feel a little overwhelming. But a few small steps can make a big difference.
Start by keeping a simple symptom journal for two or three days before your appointment. Write down what kind of pain you’re feeling, how long it lasts, what tasks are hard, and how tired you get. If you’re taking medication, note how it affects your energy or pain. Bring this journal with you. It will help during your intake interview, especially if you forget anything when you're nervous or tired.
Wear comfortable, loose-fitting clothes. Soft leggings, a roomy top, or anything that doesn’t press into your legs or arms is ideal. Avoid anything tight or compressive. Your body already works hard — don’t add extra discomfort.
Be ready to talk about your symptoms in a way that feels real and honest. For example, say things like, “I can’t stand longer than 10 minutes without pain,” or “My legs feel like they weigh 100 pounds when I walk.” Don’t worry about sounding dramatic. You are simply telling the truth.
And please — don’t push yourself to “do well.” This is not a performance. You’re not being judged. If something hurts, say so. If you’re tired, say so. If you need to stop, say that too. The goal is to show what your body can really handle — not what it can force its way through just once.
After the FCE, you might feel sore or drained. That’s normal, especially if you haven’t been very active lately. But you shouldn’t feel injured. If you can, plan ahead to rest that day. Have a comfy place to sit or lie down. Prepare food or drinks in advance. Be kind to your body — you did a lot.
Just Me, Checking In
Living with lipedema is already hard enough. Going through an evaluation like this can feel like just one more thing to manage. But remember, this is just a snapshot. It doesn’t define you.
You are not being tested on your strength. You’re being seen for your reality.
It’s okay to speak up. It’s okay to have limits. You don’t need to push through or prove anything.
If you’re preparing for your FCE, I hope this helped you feel more ready. If you’ve already done it and want to share your experience, I’d love to hear it. And if you’re somewhere in the middle, just know: you’re not alone in this.
We’re walking this path together. 💜
Take care,
Michelle