Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system which controls many of the ‘unconscious’ physiological functions of the body:
— Heart rate and blood pressure regulation
— Bladder regulation
— Gut movement and digestion
— Temperature control
— Stress responses (fight or flight)
Symptoms can appear as fatigue, headache, gut disturbance, dizziness, pain, poor concentration and light-headedness. 25% of people with POTS report having to stop work or education due to the impact of their health condition. POTS consumes three times more energy it takes to stand than the general population, making simple life tasks like showering, cooking and cleaning very exhausting. Mental health conditions such as anxiety and depression are more likely to be developed in people with POTS.
POTS can be categorised as primary or secondary.
Primary POTS can be from a disruption in the autonomic and circulatory system that can’t be explained by other conditions.
Secondary POTS is defined by those with an existing underlying health condition such as heart failure, thyroid dysfunction or another condition in which there is a loss of blood volume.
Research believes that POTS can be triggered by multiple underlying mechanisms varying from person to person.The mechanisms that are thought to be underlying risk factors include:
— Preceding health condition or event such as viral infection, concussion, surgery, pregnancy or puberty
— When blood volume is reduced or blood flow gets disrupted throughout the body
Exercise for POTS
Studies show that many people with POTS have demonstrated a lower stroke volume (amount of blood pumped out of the heart in each beat) and smaller size of the heart. Exercise can help increase stroke volume and overall heart size to normal levels.
— As always, it’s important to start small and increase slowly with physical activity.
— Experiencing a day or two of fatigue after an exercise session is normal and the body will need those extra rest periods between workouts.
— Always start with recumbent exercise like swimming, rowing, pilates and recumbent bicycle and work your way up to upright exercises.
— Aiming to increase leg and core strength will promote blood flow return from the legs to the heart and brain.
— Gradually build up to 30 minutes at least four times a week.
— Working with an exercise physiologist is highly recommended for the safety and efficiency of exercising with POTS. They will be able to monitor your progress and know when it’s time to build on more or reduce activity.