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What is POTS?

Postural orthostatic tachycardia syndrome (POTS Syndrome) is a condition that affects the nervous system and how the body functions.

The term “postural orthostatic” refers to how the body reacts to changes in posture among those with POTS. When moving from laying down to sitting or standing, POTS leads to a drop in blood pressure.

The heart reacts to this change in posture to immediately compensate for the drop in blood pressure by increasing heart rate (HR), an outcome referred to as “tachycardia” (HR over 100 beats per minute).

In addition to the HR changes as a result of the postural change, women who suffer from POTS will usually have smaller hearts and less blood volume compared to women without the condition. This affects cardiovascular health and fitness, as well as the ability to perform common daily tasks. POTS typically affects females of childbearing age, but men can also have the condition.

Symptoms of POTS Syndrome

There are a number of symptoms resulting from POTS. These symptoms include:

  • Sudden change in blood pressure
  • Increased heart rate
  • Nausea
  • Dizziness
  • Anxiety
  • Sweating
  • Exercise intolerance
Managing POTS Syndrome through exercise

According to the Australian POTS Foundation, there are currently no POTS-specific medications available on the Pharmaceutical Benefits Scheme that can assist with the management of POTS. Not having access to medication makes living with this chronic condition more complex. Physical activity and exercise often exacerbate POTS symptoms, making it seem counterintuitive to
use exercise to help manage POTS. However, exercise is an effective method in managing POTS symptoms when exercise is supervised by a specialised exercise professional such as an accredited
exercise physiologist. Regular exercise leads to increased physical capacity, meaning it can assist to increase the time it takes for symptoms to arise when being active. After 3 months of regular exercise, people with POTS benefit from an increase in the volume of the heart muscle and an increase in blood volume. Additionally, research has shown that regular supervised exercise can drastically improve POTS symptoms in just 3 months. The symptoms can reduce so much that a person may no longer meet the criteria for having POTS. An added bonus of exercise for the management of POTS is improvement in mental health and overall quality of life. Exercise can help make daily tasks more manageable and give those with POTS a powerful tool to manage their health.

What exercise is recommended for POTS Syndrome?

When beginning exercise for the management of POTS it is recommended to begin with aerobic and strength-based exercise that focuses on the lower body. Examples of suitable introductory aerobic exercises for the management of POTS include:

  • Recumbent exercise bike cycling
  • Rowing
  • Swimming for aerobic exercise

A strength training program should involve floor-based exercises as they are recommended for building muscle strength whilst limiting POTS symptoms. Suitable floor-based strength exercises to
begin with include:

  • Glute bridges
  • Planks
  • Clams
  • Side lying leg raises

Aerobic and strength training can be progressed through resistance bands, weights, and seated exercises as exercise tolerance increases. A clinical exercise physiologist can help design an exercise
program that progresses according to the client’s individual circumstances and goals.

 

[lightweight-accordion title=”References“]

(Australian POTS Foundation, 2021)
(Fu & Levine, 2018)
(Bruce et al., 2016)
(Fu et al., 2011)
(Shibata et al., 2012)
(Karas, Grubb, Boehm, & Kip, 2000)
(Johnson et al., 2010)

Australian POTS Foundation. (2021). What is POTS? . Retrieved from https://potsfoundation.org.au/
Bruce, B. K., Harrison, T. E., Bee, S. M., Luedtke, C. A., Porter, C.-B. J., Fischer, P. R., . . . Weiss, K. E.
(2016). Improvement in functioning and psychological distress in adolescents with postural
orthostatic tachycardia syndrome following interdisciplinary treatment. Clinical Pediatrics,
55(14), 1300-1304.
Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic
Neuroscience, 215, 20-27.

Fu, Q., VanGundy, T. B., Shibata, S., Auchus, R. J., Williams, G. H., & Levine, B. D. (2011). Exercise
training versus propranolol in the treatment of the postural orthostatic tachycardia
syndrome. Hypertension, 58(2), 167-175.

Johnson, J. N., Mack, K. J., Kuntz, N. L., Brands, C. K., Porter, C. J., & Fischer, P. R. (2010). Postural
orthostatic tachycardia syndrome: a clinical review. Pediatric neurology, 42(2), 77-85.

Karas, B., Grubb, B. P., Boehm, K., & Kip, K. (2000). The postural orthostatic tachycardia syndrome: a
potentially treatable cause of chronic fatigue, exercise intolerance, and cognitive
impairment in adolescents. Pacing and Clinical Electrophysiology, 23(3), 344-351.

Shibata, S., Fu, Q., Bivens, T. B., Hastings, J. L., Wang, W., & Levine, B. D. (2012). Short‐term exercise
training improves the cardiovascular response to exercise in the postural orthostatic
tachycardia syndrome. The Journal of physiology, 590(15), 3495-3505.

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Being active has taken on a whole new meaning and I am 100% here for it. I like to fink I’m pretty active, and I keep up de vibes during team meetings – just making sure everyone’s hands are always moving (across my butt) because I know dat any exercise is good exercise. I keep close to everyone, real close, just to keep dem on their toes when dey walk by too.
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