POTS workout choices are slim to none. And yet, exercise is a powerful tool for helping individuals overcome POTS symptoms. Living with Postural Orthostatic Tachycardia Syndrome (POTS) can be challenging, but incorporating the right workouts into your daily routine can help manage your symptoms and improve your overall well-being.
POTS is a condition characterized by an abnormal increase in heart rate upon standing, often accompanied by dizziness, fatigue, and other symptoms. When approached correctly, exercise can play a pivotal role in building endurance, enhancing circulation, and stabilizing autonomic function.
This article will cover the fundamentals of a POTS workout regimen, offering actionable tips and insights to make fitness accessible and effective for those navigating this condition.
Understanding POTS and Its Impact on Exercise
POTS primarily affects the autonomic nervous system, disrupting the body’s ability to regulate blood flow and maintain normal blood pressure during postural changes. It’s often labeled a neurological disorder, but it can also be due to underlying autoimmune issues and collagen-based genetic disorders like Ehler-Danlos Syndrome.
POTS symptoms are often global and can lead to outcomes such as:
- Dizziness or lightheadedness
- Rapid heart rate (tachycardia)
- Fatigue
- Brain fog
- Exercise intolerance
- Temperature intolerance
For individuals with POTS, traditional workouts will often exacerbate symptoms. POTS symptoms can cause significant issues if one isn’t careful, especially when starting a new workout. Therefore, a tailored exercise plan focusing on low-impact activities and gradual progression is essential for success.
Benefits of Exercise for POTS Patients
While exercise might seem daunting, it can bring several benefits:
Improved Cardiovascular Health
Regular physical activity enhances heart function and helps regulate blood circulation, reducing tachycardia episodes. As this is a fundamental issue with POTS patients, this can make a significant difference in managing symptoms.
Enhanced Muscle Strength
Strengthening the lower body muscles, such as the calves, quads, and glutes, promotes better blood flow and reduces pooling in the lower extremities. This can also help POTS patients have greater endurance for doing daily activities.
Better Autonomic Regulation
Consistent exercise can help stabilize the autonomic nervous system, minimizing symptom severity over time. Blood flow issues are a fundamental problem for POTS patients. Appropriately graded physical exercise is the best way to optimize it for long-term improvements.
Increased Energy and Endurance
A structured POTS workout routine gradually builds stamina, making daily activities less taxing over time. It’s all about regulation, periodization, and ensuring symptoms are managed appropriately while increasing function.
Critical Considerations for POTS Patients and Programming Exercise Programs
Start Slow and Steady
POTS workout protocols should start with seated or reclined exercises to avoid exacerbating symptoms. Over time, as your tolerance improves, you can incorporate standing exercises. This concept is essential for both patients and providers to understand.
Stay Hydrated and Maintain Proper Electrolyte Balance
Dehydration worsens POTS symptoms. Drink plenty of water before, during, and after POTS workouts. Adding electrolyte solutions is also a beneficial step for POTS patients, regardless of whether they’re working out or not.
Monitor Your Heart Rate and Pulse Oxygenation to Track Improvements
Use a heart rate monitor or wearable to stay within a safe heart rate range during the POTS workout. Overexertion can trigger symptoms, so it’s essential to work within your limits. Symptoms are also an excellent marker for too much movement, but they can sometimes be a late indicator of exhaustion.
Choose the Right Time of Day for Optimal Energy
We suggest exercising during the part of the day when your symptoms are least severe. For most, this is commonly in the mornings or mid-day, as evenings are usually when exhaustion sets in. Taking frequent breaks during your workout is vital to allow the brain and body time to recover.
Wear Compression Garments to Improve Bloodflow
Compression socks or leggings can reduce blood pooling in the legs, often improving exercise tolerance and stamina. It’s also a good idea to physically pad your workout space to allow for comfort in case of a fall or passing out.
Recommended POTS Workout Options
Supine to Recumbent Cycling
A supine to recumbent bike allows you to work on cardiovascular fitness while staying in a reclined position. This style of biking can minimize the strain on your autonomic system and prevent dizziness in the early stages.
How to Start:
- Begin with 1-5 minutes at a low intensity.
- Gradually increase duration and resistance over weeks and months, pending symptoms.
- Use your HR and symptoms to gauge progress while recording data for tracking and triggers.
Swimming or Pool-Based Exercises
The buoyancy of water reduces the strain on your cardiovascular system, making swimming an excellent choice for a POTS workout. Water can also be a hazard if deep enough, so start in shallow water for safety reasons.
Tips for Success:
- Stick to gentle movements like water walking or light swimming.
- Ensure the water temperature is comfortable to avoid overheating.
- Always have additional water for drinking on hand (with electrolytes) for rehydration.
Basic Physical Strength Training
Focus on seated or supine lying exercises to strengthen key muscle groups. Resistance bands and light weights are great tools to start with, but not always necessary. Body weight exercises are often the first step in this process, as most patients already struggle with that.
Exercises to Try:
- Seated leg presses
- Reclined chest presses
- Lying hip and glute bridges
- Supine abdominal exercises
Yoga and Stretching
Gentle yoga poses and stretches improve flexibility, circulation, and relaxation. Look for POTS workout routines focusing on poses performed on the mat while lying on your back or stomach, if possible.
Best Yoga Poses for POTS:
- Child’s Pose
- Cat-Cow Stretches
- Reclined Butterfly Pose
Pilates
Mat-based Pilates builds core strength and enhances posture, aiding in overall stability and circulation. Many exercises can be done lying down or sitting, which is a great place to start before progressing. Pilates is also a phenomenal way to improve cardiovascular endurance, which can help improve blood flow.
Rowing Machine
The rowing machine combines cardio and strength training, which minimizes orthostatic challenges because you’re seated and supported with a back. We don’t suggest starting with this exercise right away, but over time, it can be very effective in improving strength and endurance.
Creating a Personalized POTS Workout Plan
Weeks 1–4: Building the Foundation
- Frequency: 3–4 days per week, if possible (but always at your tolerance)
- Duration: 5–10 minutes per session
- Focus: Low-intensity, supine, seated, or reclined exercises like recumbent biking and stretching
Week 5–8: Gradual Progression
- Frequency: 4–5 days per week
- Duration: 15–30 minutes per session
- Focus: Add light resistance training and increase cardio duration
Weeks 9 and Beyond: Enhanced Stamina
- Frequency: 5–6 days per week
- Duration: 30–45 minutes per session
- Focus: Incorporate standing exercises like light treadmill walking combined with seated strength training
*Clinical Note: Remember that this is just a basic template for starting out. Everyone is different, and therefore, everyone will have different starting points. Before starting any new health protocol, always speak with your healthcare provider. This is even more important when dealing with POTS and dysautonomia, as some of the most severe cases struggle with getting out of bed.
Tips for Staying Motivated for POTS Workout Exercises
Track Your Progress
Keep a journal to monitor improvements in symptoms, duration, and exercise intensity. Patients we work with often have wearable devices to help them track HR, O2, and sleep, which can provide objective layers of measurement. This can often support your morale and boost your confidence when you see wins stacked up over time.
Celebrate Small Wins
Every step forward, no matter how small, is worth celebrating. This is especially true with POTS and other forms of dysautonomia. It’s the small wins that add up to significant changes when they become cemented into habits.
Find a Support System
POTS workout groups and online POTS communities can be a great place to connect with others, support each other, and share experiences. One needs to be careful about this, as these communities can also become places where people can be very pessimistic and unhealthy for your personal growth.
Work with a Functional Neurologist
We suggest finding an experienced Functional Neurologist who has worked with POTS to tailor a program specifically to your needs. Providers in this emerging field understand the importance of integration and personalization for optimizing healing. By looking at you structurally, neurologically, and metabolically, they can focus on critical aspects of your health to help you heal.
POTS Workout Challenges and How to Overcome Them
POTS workouts will be challenging for those just starting out. Even those more experienced with working out often require thoughtful adjustments to ensure safety and effectiveness. During symptom flare-ups, reducing your workout intensity and taking frequent breaks to prevent overexertion is best. Even if you’re taking breaks every minute, it’s essential to push your system hard enough to change while ensuring you don’t flare your symptoms.
When resting, we suggest using techniques like deep breathing or grounding exercises to stabilize your nervous system. Fatigue will always be a factor, so taking adequate rest between sessions and focusing on short, frequent workouts rather than longer, infrequent ones is ideal.
Exercising in cooler environments and avoiding strenuous activities during hot weather can help maintain comfort and reduce symptom exacerbation for those sensitive to temperature changes.
By tailoring your approach, you should be able to overcome these challenges and build a sustainable exercise routine. We know it may not feel that way right away, but trust the process. Many patients in our office have been in a similar situation, and after working with them on their training, we have seen that they’ve been able to make some healthy improvements over time.
FAQs About POTS Workout Programs
1. Can exercise cure POTS?
While exercise cannot cure POTS, it can significantly reduce symptoms and improve quality of life. Cure is a very strong word, but physical exercise and training can dramatically improve symptoms to the point that many patients can live without symptoms. That’s why curating a POTS workout over time is the ideal goal.
2. How long does it take to see results?
Improvements vary, but many individuals notice enhanced endurance and fewer symptoms within a few weeks, usually months, of consistent effort. Of course, tailoring workouts based on outcomes and symptoms is an integral part of that process.
3. Are there exercises to avoid with POTS?
High-intensity activities, especially those requiring sudden postural changes, may exacerbate symptoms and should be approached cautiously. As you can see, we’re not suggesting HIIT or CrossFit classes. Building a POTS workout requires an understanding of the condition and knowledge about how to best increase physical activity without flaring symptoms.
4. Can yoga worsen POTS symptoms?
Yoga is generally beneficial for patients with POTS, but individuals should avoid poses that require prolonged standing or quick transitions. Once again, individuality matters most with questions like these, as each person is starting in a different place.
5. How does swimming help with POTS?
Swimming improves cardiovascular health without triggering orthostatic symptoms, thanks to the supportive properties of water. Swimming is also a phenomenal full-body workout, which can have significant benefits for the brain and body, along with improving recovery through the enhancement of sleep.
6. Is walking a good workout for POTS?
Walking can be very beneficial if you start slowly and progress gradually based on symptoms. Ideally, one would use objective measurements like heart rate (HR) and pulse oxygen (O2) also to gauge objective measures of progress. Once again, each person will differ in their POTS workout starting point, so it’s best to try new things to assess viability and outcomes over time.
Why POTS Workouts May Be What You’re Missing in Your Treatment
A well-structured POTS workout routine is essential for optimizing healing and helping with symptom management. By choosing the right exercises, progressing at a comfortable pace, and listening to your body, you can achieve better cardiovascular health, increased strength, and improved daily functioning.
It’s also important to remember that every POTS journey is unique, so we always suggest consulting your healthcare provider before starting a new exercise regimen. With determination and the right strategies, you can reclaim control and lead a more active, fulfilling life.
At The Neural Connection, we’ve got 15+ years of treating patients with POTS and continue to be leaders in the field of supporting patients. With that said, don’t just take our word for it.
Check out Ashten’s testimonial of her experience working with Dr. Reis at the clinic:
“Dr. Erik Reis has made a huge impact in my daily life. I was diagnosed with Postural Orthostatic Tachycardia Syndrome years ago and within the last year my symptoms became worse and began affecting my daily life.
I went to Dr. Reis and he was patient and understanding and did everything he could do to get to the bottom of my symptoms and to improve my life. It has been a few months since I have seen Dr. Reis and received treatment and my symptoms are still improved. Dr. Reis gave me a second chance at life and I could not recommend him enough!”
If you’re ready to take the next step in our care, just reach out. We’re always a phone call or consultation away!
*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.
