By Meredith Kendrew
Living with Postural Orthostatic Tachycardia Syndrome (POTS) can make even the simplest activities feel like a marathon. Standing up too quickly might bring on heart palpitations, dizziness or nausea, and some days, fatigue hits like a wave. But while the condition can make exercise feel daunting, movement is actually one of the most powerful tools for improving symptoms, building strength, and restoring confidence.
What is POTS?
POTS stands for Postural Orthostatic Tachycardia Syndrome. It’s a condition that affects the autonomic nervous system, the part of the body responsible for regulating things like heart rate, blood pressure, and circulation.
When someone with POTS stands up, blood tends to pool below the heart, reducing circulation and causing the heart to beat faster to compensate. This rapid increase in heart rate, combined with reduced blood flow to the brain, can lead to symptoms such as:
- Forceful heartbeats or heart palpitations
- Lightheadedness, nausea or vomiting
- Severe and long-lasting fatigue
- Headaches and brain fog
- Excessive sweating
- Pale face or purple discolouration in the hands and feet
These symptoms can make exercise feel intimidating, but done safely and gradually, it can make a huge difference.
Why Exercise Matters
For people with POTS, low exercise tolerance is common. Over time, this can lead to physical deconditioning, where muscles weaken and fitness declines, making symptoms worse. Regular exercise helps to reverse that cycle.
Studies have shown that aerobic and resistance training can increase blood volume, improve heart function and boost peak oxygen uptake (a measure of cardiovascular fitness). These changes can help regulate your body’s response to standing, making daily activities easier and less exhausting.
Resistance training, in particular, strengthens muscles and stabilises joints, both essential for maintaining posture and balance. And like any form of regular physical activity, exercise supports mental health, improves energy levels, and boosts overall wellbeing.
Where to Start
If you’re living with POTS, the key is slow, steady progress. Exercise doesn’t have to mean running marathons or lifting heavy weights, in fact, it shouldn’t. The focus should be on rebuilding tolerance gradually and safely.
Here are some general guidelines:
- Begin with horizontal exercises like recumbent cycling, rowing, or swimming. These positions help reduce symptoms while allowing the body to adapt.
- As tolerance improves, include reclined or upright seated movements, and eventually progress to standing exercises.
- Start small. Just a few minutes at a time, and increase gradually as your endurance builds.
- Combine low to moderate-intensity aerobic exercise with lower-body resistance training to improve circulation and muscle strength.
- Choose activities you enjoy and feel comfortable with, that’s what keeps you consistent!
Get the Right Support
Because POTS affects everyone differently, it’s important to work with a professional who understands the condition. An Accredited Exercise Physiologist can design a personalised program that meets you where you are, monitors your progress, and helps you move safely at your own pace.
At Conveniently Active, our team specialises in exercise for chronic and complex conditions, including POTS. We’ll guide you through every step, helping you build strength, stamina and confidence through movement that’s achievable and sustainable.
Living with POTS can be challenging, but with the right support and a carefully structured approach to exercise, it’s absolutely possible to regain energy and independence. Because even small steps, or slow pedals, can lead to powerful progress.