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What is POTS?

Exercise is an important treatment for POTS Syndrome
How to exercise with POTS: Postural Orthostatic Tachycardia Syndrome 

Postural orthostatic tachycardia syndrome (POTS) is a complex condition that causes a rapid heart rate when transitioning from sitting or lying to standing. It can affect an individual’s cardiovascular health and quality of life if untreated. While there are no specific medications for POTS, supervised exercise guided by an accredited exercise physiologist can help improve heart and blood volume, significantly alleviate symptoms and enhance overall well-being

POTS is a condition that affects the nervous system and how the body functions

Postural orthostatic tachycardia syndrome (POTS) is a complex medical condition characterised by a rapid increase in heart rate upon transitioning from a reclined or seated position to standing. When moving from lying down to sitting or standing, POTS leads to difficulty maintaining normal blood pressure (5)

The heart reacts to this change in posture to immediately compensate for the drop in blood pressure by increasing heart rate, an outcome referred to as “tachycardia” (heart rate over 100 beats per minute) (5)

In addition to the HR changes as a result of the postural change, people who have POTS will usually have smaller hearts and less blood volume compared to people without the condition (3). This affects cardiovascular health and fitness, as well as the ability to perform common daily tasks (2). POTS typically affects females of childbearing age, but men can also have the condition.

Symptoms of POTS (2)

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 (1). 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 (4). 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 (4). Additionally, research has shown that regular supervised exercise can drastically improve POTS symptoms in just 3 months (6). 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 an improvement in mental health and overall quality of life (3). 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?

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 (3)

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.

Enlisting the expertise of an accredited exercise physiologist empowers individuals to embark on a tailored fitness journey to help manage their symptoms. With their guidance, a personalised exercise regime is carefully crafted to evolve in sync with each client’s unique circumstances and goals. This approach creates a responsive exercise experience, prioritising client safety and well-being.

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.

Meet the team

Be Physiology

At Be Physiology we focus on exercise and movement for the management and improvement of neurological and chronic conditions.

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Trent Brock | Mobile Exercise Physiologist

Trent Brock

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I have had 3 major passions throughout my life; exercise, competitive sports, and a strong will to help others. Those 3 factors made it an easy decision to pursue a career as an exercise physiologist. By encouraging and facilitating evidence-based exercise rehabilitation, I can help individuals living with various chronic conditions, particularly those living with neurological conditions.
I see exercise physiology as an extremely beneficial practice that enables clients to experience an improved quality of life. Personally, being able to provide insight into exercise and other tools that can equip clients with helpful skills and wellbeing improvements is extremely fulfilling. Being able to improve not only an individual, but their support network’s day-to-day life fills me with great joy and motivates me to continue to be better so that I can do better. I understand that everyone has a different view of exercise and there is no one-size fits all approach, so I operate with an open and adaptive mind, supported by evidence-based practices. If you or anyone that you know is looking to improve their quality of life and begin a journey to improved living, or just have any general questions, get in touch and let's have a chat!
Michelle Marais AEP

Michelle Marais

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My passion for movement, health, and helping others led me to become an Accredited Exercise Physiologist. Through this role, I facilitate exercise-based rehabilitation for individuals with various chronic conditions, with a primary interest and area of expertise in neurological conditions.
To me, exercise physiology is about equipping clients with valuable skills that make daily tasks easier and empowering them to achieve their goals while enjoying the process.I take great pride in being a part of my clients' rehabilitation journey and exploring new methods with them to find the optimal exercise approach that works best for them.If you have any questions or are interested in starting your journey to a happier, healthier lifestyle, please feel free to reach out to me.
Angus Sullivan AEP

Angus Sullivan AEP

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As an accredited exercise physiologist, I see my role as an opportunity to facilitate a safe and effective environment for my clients to explore their physical capabilities, identify areas where they would like to improve, and then prescribe meaningful and appropriate activities to achieve these improvements.
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To me, exercise physiology is not only about achieving narrow objective goals (eg. 1 Rep Max bench press), but improving an individual’s lifestyle and making activities of daily living easier (mobilising, transferring, feeding, and more).
I love what I do and enjoy learning new methods and discussing different opinions about exercise. I am always happy to chat about it so please get in contact if you have any questions or knowledge that you wish to share!
Our team of mobile exercise physiologists

Walter White

manager of good vibes
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.
Fings are always better when I am der so if you need some good vibes, I will be der for you.
Brb just going to have a snooze.
Love and licks,
Wally
Brittney Kenward

Brittney Kenward

co-founder / Operations manager
I’m NOT an exercise physiologist, but I do take my hat off to my team and get to admire the work they do each and every day. Be Physiology means that we’re able to apply our passion, and our experience, to make exercise physiology more accessible to the people who need it the most.
You might hear the team describe me as ‘the person who does everything else’, and that can be translated to ‘marketing and operations'. My background is marketing and business, which I’ve lived and breathed since 2011. I’ve worked in both the agency and corporate spaces, across many industries, with many amazing people and now with Be Physiology, I get to explore the health industry further and continue to meet the most incredible people who are the ones to define motivation.
If you’ve met Harry and Aj, you’d know that they don’t really need marketing - they’re genuine, have ridiculous amounts of charisma, knowledgeable, and extremely passionate about helping people to be a better version of themselves. But, sometimes getting an introduction is the hardest part and that’s where I come in.
If you want to chat, a coffee, a laugh, I’m always here to make one or all of them happen.

So call me and let’s keep sharing the love!
Keegan Betts AEP

Keegan Betts AEP

mobile exercise physiologist
As an Accredited Exercise Physiologist, my work is driven by my passion for movement, health, and empowering others. With my experience working with individuals of all ages who have neurological conditions such as autism, stroke, and cerebral palsy, I focus on delivering activity-based therapy to optimise their independence.
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I know the importance of creating a welcoming and safe environment particularly when improving our health and I always strive to ensure everybody feels supported by the team around them and receives the highest level of care.
Get in touch today and let's make it happen.
Kristen McCluskey

Kristen McCluskey

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If you spend as little as 10 minutes a day exercising, it will still make a huge difference to your overall physical and mental health - this is a fact and it is very often underappreciated! The benefits of exercise don’t discriminate and the rumours are true, exercise is medicine.
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I'm passionate about learning new methods and learning what my clients enjoy and how they approach exercise. I am always happy to chat about the many benefits and outcomes of exercise physiology so please get in contact if you have any questions or knowledge that you wish to share.
If you’re interested in learning more about who I am or want to ask any questions, don’t hesitate to get in touch at .
Charlotte Gill

Charlotte Gill

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My name is Charlotte, and I'm a sports enthusiast currently studying for a marketing degree. Although I am not an exercise physiologist, I have a passion for sports having a background in ski instructing and adaptive skiing. Like the team, I believe exercise is medicine and share a similar passion and values to help and motivate others I meet.
I've been fortunate enough to work globally with a background in event management, ski instructing, administrating, and climbing supervisor. However, working alongside the Be Physiology team as my dream role in marketing is a highlight. If you have had the pleasure of meeting the team, you will know their genuine, funny, knowledgeable, and passionate to help others. These are values that I also pride myself in, and I am so fortunate to be surrounded by like-minded colleagues.
Harry White AEP

Harry White AEP

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Exercise physiology combines two of my favourite things: health and helping people. As an accredited exercise physiologist with more than seven years’ clinical experience, I have treated people presenting with a wide variety of health conditions and concerns, postural issues, chronic injuries and rehabilitation needs.
My expertise is spinal cord injuries and neurological disorders and helping my clients to achieve an improved quality of life through rehabilitation and functional training. Rehabilitation for spinal cord injuries and neurological disorders can be slow but incredibly rewarding for clients when results are achieved, no matter how small. Assisting people through learning useful skills and functional training is the most important role that an EP can play to help people lead a more fulfilled life.
Working for many years with people who have suffered serious injury or live with a disability, I know that taking a proactive approach to your health changes your life. If you care for your body, it will take care of you.
I’m passionate about helping people live a long, healthy and active life, so call today.