Learn How Move Sports Physio & EP can help
If you’ve been feeling foggy, faint, and fatigued, you’re not alone. Many people experience similar symptoms due to a condition known as Postural Orthostatic Tachycardia Syndrome (POTS). This disorder affects your autonomic nervous system, leading to an abnormal increase in heart rate upon standing and a range of other challenging symptoms. At Move Sports Physiotherapy in Geelong, our dedicated team of Exercise Physiologists and Physiotherapists work collaboratively to guide you back to movement and enhance your quality of life.
Understanding POTS -
POTS can manifest in various ways, from lightheadedness and fatigue to palpitations and anxiety. It’s essential to address the unique triggers and symptoms of each individual. Remember the Yellow Wiggle, Greg? He’s been open about his journey with POTS, helping to shine a light on this often misunderstood condition.
Our Move Treatment Approach - Step By Step
Initial Assessment and Quick Wins: Learn More
The journey begins with a comprehensive assessment where we identify trends in your symptoms. This includes recognizing potential triggers, such as anxiety and postural changes. Here’s how we kick-start your treatment:
Symptom Tracking and Baseline Measures: We utilize tools like fatigue scales to establish a baseline and monitor your symptoms closely.
Quick Wins: Our goal is to find manageable strategies early in your treatment to boost your confidence. This might include physical counter-maneuvers such as squeezing a rubber ball, crossing your legs while tensing muscles, or squatting to help maintain blood pressure.
Key Quick Wins:
Compression Garments: Wearing compression clothing can help reduce blood pooling in your legs, supporting circulation during movement. Check out options here.
Salt and Fluid Intake: Increasing your intake of salt and fluids is crucial for boosting blood volume, which is vital for managing POTS symptoms. Make sure to follow your healthcare provider’s guidance on this.
Medications: We can collaborate with your GP for pharmacological interventions, such as:
Ivabradine: Helps reduce heart rate without impacting blood pressure.
Propranolol: A beta-blocker that manages sympathetic effects on heart rate and blood pressure.
Fludrocortisone: Increases sodium and water retention to expand plasma volume.
Midodrine and Phenylephrine: Medications that constrict blood vessels to raise blood pressure.
Acute Management: Small changes = BIG WINS
Now, let’s address those immediate symptoms:
Fatigue Management: We educate you on energy conservation and pacing techniques. Think of it as a “cup of marbles” strategy, where each activity you do uses a marble from your cup. If you run out, it's time to rest!
Symptom and Anxiety Management: We’ll help you address anxiety related to your symptoms with gentle exercise initiation, focusing on breath control and relaxation techniques. Studies show that breathing retraining can improve symptoms for POTS patients.
Increasing Movement Tolerance
To avoid overexertion, we might use digital tools like PIXELS for patient-guided pacing outside the clinic. This helps build confidence in movement gradually. See below - this helps us understand how your energy levels and the pacing is going.
Regular clinic visits (aiming for twice a week) will keep you engaged and motivated, (we work up to this)
Progressive Exercise Program: Building Endurance
Our structured program is designed to improve your load tolerance and functional capacity over 6-8 weeks:
Starting with Lying Down Exercises
We begin with supine strength and endurance exercises that emphasize breathing patterns and body awareness. You’ll learn to connect with your body, enhancing both physical and mental strength.
Endurance Training
Initial Phases: Engage in lower-intensity horizontal exercises, such as using a recumbent bike or swimming, to build cardiovascular conditioning without triggering symptoms.
Target Heart Rate Training: We’ll monitor your heart rate to ensure you’re exercising safely within your zones, gradually increasing intensity as you adapt.
Resistance Training
We focus on strengthening your lower body and core, essential for supporting your body during upright activities. Your program might include:
Lower Body Exercises: Seated leg press, leg curl, calf raises—starting with manageable sets and progressing as tolerated.
Upper Body and Core Work: Chest presses, seated rows, and core stability exercises like side planks to enhance your overall strength.
18-Week Progressive Movement Program: Building Endurance, Strength, and Confidence
The key to managing POTS long-term is consistent, gradual progression in movement. Our program spans 12-18 weeks at a minimum, with ongoing structured movement for 6-12 months depending on your individual needs.
Weeks 1-6: Supine and Seated Strength Training
In these first few weeks, we’ll focus on supine (lying down) and seated exercises to prevent any risk of dizziness or fainting while building strength and endurance.
Reformer Pilates: This is a key strategy for supine work. Reformer Pilates provides controlled, low-impact movement that strengthens the core and lower body while supporting your joints. This method is great for improving muscular endurance and stability without overloading your cardiovascular system.
Seated Resistance Exercises:
Leg press (seated)
Leg curl (seated)
Leg extension
Seated chest press
Seated row
Calf raises
These exercises will be performed in 2 sets of 10-12 reps. As your strength builds, we’ll adjust the resistance and the complexity of the exercises.
Weeks 6-12: Horizontal Endurance and Cardiovascular Conditioning
In this phase, we’ll integrate more endurance-based work with low-impact cardiovascular activities.
Swimming or water-based exercises: This is an excellent option because it alleviates strain on the body while improving overall cardiovascular fitness.
Recumbent Cycling or Rowing Machines: These are low-impact ways to increase heart rate without putting stress on your joints or increasing symptoms.
Start with 20-30 minutes, 3-4 times per week, and aim to increase your duration gradually.
Weeks 12-18: Upright Functional Movements
As you build strength and endurance, we’ll transition to more upright, weight-bearing exercises. This is crucial for improving your ability to function in everyday life without triggering symptoms.
Reformer Pilates (Upright Exercises): We’ll begin to incorporate upright movements on the reformer to simulate more functional positions, gradually increasing the intensity and duration.
Treadmill Walking: A low-impact way to begin reintroducing upright movement.
Standing Strength Exercises: These may include squats, lunges, or standing calf raises, tailored to your ability.
During this phase, the goal is to increase your total exercise time to 40-45 minutes per session, progressing from 3 days a week to daily activity. We'll emphasise breathing and hydration throughout, with ongoing adjustments to avoid overexertion.
Beyond 6 Months: Maintenance and Long-Term Progress
After the few months, we’ll move into a maintenance phase, where you’ll continue structured exercise, with progressive resistance and cardiovascular conditioning for the next 6-12 months.
We may also begin integrating more dynamic, functional exercises, including:
Pilates-based core strengthening to stabilize the spine and pelvis.
Higher-intensity walking or cycling if your tolerance allows.
The goal is to keep progressing slowly, adding more challenging exercises only when you feel confident and capable.
Key Strategies for Success
Hydration and Nutrition: Adequate fluid and salt intake are crucial for improving blood volume and minimizing symptoms.
Breathing and Relaxation: Incorporate breathwork and relaxation techniques to reduce stress and support autonomic function.
Pacing: Learning how to pace your activity is critical to avoid overexertion. Focus on gradual increases in exercise intensity and volume.
Transition to Functional Movement
As you gain strength and confidence, we’ll introduce more upright functional activities. This includes:
Structured Home Programs: Designed to integrate movement into your daily routine, like walking or mild resistance work.
Pacing Strategies: Preventing the boom-bust cycle of activity and ensuring you understand the importance of pacing to maintain consistent progress. More on pacing here
Advanced Rehabilitation: Chase Bigger LIFE Goals
Once you’ve built a solid foundation, it’s time to set your sights higher! Our advanced rehabilitation phase focuses on:
Addressing High-Level Goals: This might include preparing for running or more intense strength training.
Multidisciplinary Support: Nutrition, hydration, and possibly massage therapy or cold therapy for muscle recovery will be integral to your journey.
As your tolerance improves, we’ll transition to upright functional activities. This includes integrating more weight-bearing tasks and gradually building your home program to increase cardiovascular conditioning.
Once you’ve made significant progress, we’ll chase bigger goals! Whether it’s running, strength training, or simply enjoying daily activities, we emphasize the importance of multidisciplinary support, including nutrition and hydration strategies, to sustain performance.
WE CAN HELP YOU GET MOVING & BACK INTO TO LIFE !
At Move Sports Physiotherapy in Geelong, we’re dedicated to helping you manage POTS and reclaim your life. Our comprehensive treatment approach combines hands-on care, tailored exercise programs, and ongoing support to help you thrive. Remember, you’re not alone in this journey; we’re here to guide you every step of the way. If you’re ready to take control of your symptoms and enhance your well-being, get in touch with us today!
Useful Resources
For further reading and support, check out these links: