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Experts’ Guide: How to Safely Exercise with POTS



For many individuals with Postural Orthostatic Tachycardia Syndrome (POTS), staying active can be a challenging task. However, it is possible to build strength and fitness gradually, starting with exercises like upright cycling, treadmill walking, elliptical, and then moving on to running. Using an AlterG anti-gravity treadmill can also be beneficial for getting back into running. Dr. Spirlock recommends starting with seated or close-to-the-ground strength training exercises and gradually progressing to more advanced movements as your body adapts. It’s important to listen to your body and start with what is most comfortable for you, whether it be strength training or cardio.

Staying hydrated and supplementing with sodium are also important factors to consider for individuals with POTS. Drinking plenty of water and incorporating salt into your diet can help boost blood pressure and blood volume, as well as offset the effects of norepinephrine on heart rate. Dr. Spirlock suggests consuming between 3,000 and 10,000 milligrams of sodium daily to help manage symptoms. Additionally, a proper warm-up and cooldown routine can help prepare your body for exercise and promote relaxation afterwards. Dynamic movements and breathing exercises can be beneficial for increasing circulation and calming the nervous system.

Considering the conditions in which you exercise is also crucial for individuals with POTS. Many people with this condition experience worsened symptoms in hot environments, so working out indoors in air conditioning or modifying your routine to adjust to the conditions can be helpful. Adding in more rest breaks and making them longer can also prevent overexertion and crashes. Dr. Bauer recommends using pacing techniques to manage energy levels and track how different types and durations of rest and exertion affect you, helping to prevent burnout and optimize your workout routine.

Ultimately, finding a balance between pushing yourself to improve and listening to your body’s needs is key for individuals with POTS when it comes to exercise. It’s important to start slowly and gradually increase the intensity and duration of your workouts as your body adapts. By incorporating strength training, cardiovascular exercise, hydration, sodium supplementation, proper warm-up and cooldown techniques, and adjusting your routine to the conditions, individuals with POTS can work towards building fitness and improving overall well-being. Remember to consult with a healthcare provider before starting any new exercise regimen, especially if you have a medical condition like POTS.

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