POTS is a disorder of the autonomic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, digestion, and body temperature. In individuals with POTS, the primary characteristic is an abnormal increase in heart rate (>30bpm) when moving from lying down to a standing position. 

The symptoms of POTS can vary in severity and presentation, often fluctuating from day to day. While the hallmark symptom is an excessive heart rate increase upon standing, other common symptoms can include:  

• Dizziness or lightheadedness

• Palpitations

• Fatigue

• Brain fog

• Presyncope or syncope

• Shortness of breath

• Chest discomfort

• Nausea and gastrointestinal issues

• Headaches or migraines

• Heat intolerance

• Sleep disturbance

• Exercise intolerance

POTS often coexists with conditions such as Ehlers- Danlos Syndrome (EDS), Chronic Fatigue Syndrome (ME/CFS), and Mast Cell Activation Syndrome (MCAS).

Exercise is a crucial component of POTS management, but it must be approached with caution and a tailored plan. While people with POTS often experience significant exercise intolerance, a carefully structured and progressive exercise program can help improve symptoms, quality of life, and increase overall functional capacity. The goal is to gradually recondition the cardiovascular system and improve orthostatic tolerance.

Key principles for exercise with POTS:

• Start low, go slow: Begin with very short durations and low intensity, gradually increasing as tolerated. Pushing too hard too soon can exacerbate symptoms.

• Prioritise supine (lying down) or seated exercise: Activities that minimise the effects of gravity on blood pooling are often best for initial stages. Examples include: 

  • Recumbent cycling

  • Rowing 

  • Swimming 

  • Floor-based exercises (e.g., Mat Pilates or Reformer Pilates)

  • Arm ergometry

• Focus on lower body strength: Strengthening leg and core muscles can help improve venous return and reduce blood pooling.

• Hydration and sodium intake: Adequate fluid and electrolyte intake (under medical supervision) is essential to support blood volume during exercise.

• Compression garments: Wearing abdominal binders or compression stockings can help prevent blood pooling in the lower body during upright activities.

• Listen to your body: Pay close attention to symptoms and stop if you feel unwell. It's important to differentiate between normal exercise fatigue and POTS symptom exacerbation.

• Gradual progression to upright exercise: As tolerance improves, carefully introduce short periods of upright activities like walking, always monitoring symptoms.

• Individualised approach: There is no one-size-fits-all exercise plan for POTS. An exercise physiologist will work with you to develop a program tailored to your specific symptoms, limitations, and goals in conjunction with your medical team.

• Pacing: Learning to pace activities throughout the day, including exercise, can prevent post-exertional malaise.

Working with an accredited exercise physiologist is highly recommended for individuals with POTS. CardioCare Clinic can help you navigate the complexities of exercise, develop a safe and effective program, and support you on your journey to improved health and well-being.

1. The Australian POTS Foundation (APF)

The APF is a vital, volunteer-run, consumer-led organisation dedicated to supporting Australians affected by Postural Orthostatic Tachycardia Syndrome. 

The APF website is an excellent starting point for reliable information and to connect with the POTS community in Australia.

2. SODII Hydration

Maintaining adequate hydration and electrolyte balance is often a cornerstone of POTS management, as it can help to increase blood volume and mitigate symptoms like dizziness and fatigue. SODII is an Australian company that produces electrolyte hydration salts. Their products are designed to provide essential electrolytes (sodium, potassium, magnesium).

It's important to discuss your hydration and sodium needs with your healthcare provider to determine the appropriate intake for your specific condition.

3. Supacore Compression Garments

Compression garments, particularly medical-grade leggings that extend to the abdomen, can be highly beneficial for individuals with POTS. They work by applying pressure to the lower body and core, helping to prevent blood from pooling in the legs and abdomen. Supacore is an Australian brand that offers compression garments designed with patented Coretech® technology. Their POTS-specific range aims to improve circulation, reduce blood pooling and stabilise the pelvis and core. Supacore compression garments are registered with the Therapeutic Goods Administration (TGA) as a medical device and may be eligible for health insurance rebates. Always consult with your doctor or exercise physiologist regarding the suitability and type of compression garments for your needs.

Enquire within for 20% off discount code for CardioCare Clinic members.