Overview
Postural orthostatic tachycardia syndrome (POTS) is commonly accompanied by unrelenting heaviness and pain in the legs. Exercise plays an important role in alleviating the common symptoms of POTS. In some people, a lack of general movement and exercise can exacerbate the symptoms of POTS. Exercising helps restore the body’s normal stroke volume and overall heart size. In this article, we will further discuss what POTS is and what exercises you can do to better manage the symptoms of POTS.
What is Postural Orthostatic Tachycardia Syndrome (POTS)?
POTS is a condition that affects blood circulation and involves both the autonomic and sympathetic nervous systems. It is a type of orthostatic intolerance in which symptoms appear when standing up from a reclining position and can be relieved by sitting or lying back down.
Who Can Get POTS?
Most patients who suffer from POTS are women aged between 13 to 50 years old. Approximately 1 to 3 million people in the United States suffer from POTS.
What are the Symptoms Of POTS?
- Abdominal pain and bloating nausea.
- Blurred vision.
- Chest pain.
- Discoloration of feet and hands.
- Dizziness, especially in standing up, prolonged standing in one position, or on long walks.
- Exercise intolerance.
How is POTS Diagnosed?
POTS can be hard to diagnose because the majority of its symptoms are very common and may be attributed to other diseases. A tilt table is the most popular test used to diagnose POTS. It usually measures your heart rate and blood pressure as you change posture and position. Other tests include:
- Echocardiogram.
- Skin nerve biopsy.
- TST (tuberculin skin test).
Management and Living With POTS
The best way to manage POTS is to exercise. Here are some simple exercises you can do to help manage POTS.
- Begin with a simple walking program.
Count the number of steps you can take without experiencing any symptoms. You must train 3 to 4 weekly for 25 to 30 minutes per session using rowing, swimming, or a recumbent bike. This recumbent or semi-recumbent training helps to avoid eliciting POTS symptoms. As you become increasingly fit, the base pace training can be prolonged. Subsequently, sessions of increased intensity (i.e., maximal steady state) can be added. At first, add once per two weeks and then once per week with recovery sessions.
- Isometric exercises:
These require you to contract your muscles without moving your body. Isometrics contract the muscle and force blood back toward the heart. They are simple to perform and can be performed while lying in bed or sitting in a comfortable chair.
Combine strength and aerobic exercise:
Strength training for the legs and core should be done twice a week. Exercises that can be done on the floor or in a chair, such as a seated leg press, leg curl, leg extension, calf raise, chest press, and seated row, should be prioritized. Abdominal crunches, back extensions, and side planks are examples of core exercises to do.
Any Pilates exercises and yoga on a mat would be ideal. Consider purchasing resistance bands and a physioball to do this at home.
- Do exercises in a sitting position for aerobic exercises.
Consider purchasing a rowing machine or a stationary recumbent bike.
- Swimming is also a fantastic exercise.
- Simple yoga with a strong focus on breathing can also help reduce POTS symptoms.
Physical deconditioning makes exercises all the more important for those with POTS
POTS patients have poor exercise tolerance as well as difficulty staying upright. They also have lower peak oxygen uptake during exercise. This is a strong indicator of physical deconditioning. Physical therapists use various levels of exercise for people with POTS.
Level one exercises would be reserved for the most severely disabled individuals, such as those who are bedridden. These exercises include squeezing a pillow between the legs or arms, writing the alphabet in the air with the toes, leg lifts laying on the side or back, and stretching. Many of these exercises will be difficult, but doing a little daily will help.
Level two exercises include rowing, recumbent biking, swimming, and weight and strength training. Again, some of these may be difficult but will become more comfortable when done regularly.
At level three, people who are physically fit and have POTS should exercise for at least 45 minutes weekly. Leg and core strength, as well as cardiovascular exercise, should be prioritized during these workouts. Exercises including the treadmill, elliptical, bike, stair stepper, jump rope, and arm bike can be done.
Level two and three exercises should always be preceded by a five to ten-minute stretch or yoga warm-up.
Best Practices to Get the Most Out of Your POTS Exercises:
Adhere to the POTS Exercise Protocol
Educating yourself before beginning to exercise is critical to maximizing your chances of success. You can begin with a cardiac rehab program or with an exercise physiologist familiar with POTS. They will design exercise plans for you, track your progress, and educate you on exercise and nutrition principles that can help you improve your overall health.
Also familiarize yourself with the POTS exercise protocols, such as the Levine Protocol or the Dallas/CHOP Protocol which assist patients in overcoming exercise intolerance and treating symptoms.
Purchase a Heart Rate Monitor
Having a smartwatch that monitors your heart rate is important. If you follow an exercise protocol, a heart rate monitor can help you stay in your POTS exercise heart rate zones for maximum workout effectiveness.
Wear compression
Wearing compression help reduce pain and other POTS symptoms when standing or exercising as it promotes blood circulation. This prevents blood from pooling and reduces pain in the lower extremities, lightheadedness, and tachycardia.
For POTS Exercise, Try Floor Workouts
Pilates workouts and any other workouts which can be performed on a yoga mat are always the best.
Takeaway
Exercising with POTS is still one of the best natural ways to treat the syndrome. Cardio and resistance training will condition and strengthen your cardiovascular system and helps you better manage your symptoms. It may not cure POTS, but it helps make it more manageable.
