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I have Postural Orthostatic Tachycardia Syndrome (POTS). Symptoms started for me in September 2012. Throughout the past three and half years I have discovered my limitations and triumphs with exercise and POTS. Exercise can be my ally or adversary, finding the recipe for POTS symptom management success can be tricky. There is no one size fits all and this blog post is not intended to say “exercise cures POTS” as it most certainly does not. However, activity with POTS questions are something I see a lot, which prompted me to write my opinion on the topic. It is just that, an opinion. I am not a doctor nor personal trainer nor certified in anything. If you’re willing to take to take opinions from a panda, then keep reading.

  • How do you exercise and what exercises can you do with POTS? 
  • Does it reduce your symptoms? 
  • Do you use a heart rate monitor device? 
  • How high does your heart rate go when exercising? 
  • Where can I begin?

Let’s tackle the first bullet above. How?

Dress in workout attire. The visual of the workout look is enough for me to believe in myself that exercise is possible. However, I sometimes just go back to bed in them. At times a workout isn’t meant to be and that is okay. I can always try again tomorrow.

 

A year ago my doctor advised me to stop all workouts due to my symptoms flaring. In the end, all my tests came out normal. I was sedentary for about a month. This year, I am performing moderate to intense activity 4-5 days a week.  Plans always changing. 


What exercises can you do? 

I have a symptom scale. A scale from 1-10 on how much I am flaring on any given day. My scale is my own, as in my 10 is probably different than yours. The success comes from me respecting this scale and the acceptance that my exercise goal for that day, week, month, may change from what I had planned. Once I determine where I am on scale, a sample of the workouts I complete are as follows:

  • Barre based group fitness
  • Spin/Cycle
  • 30 minute gym circuit – combo of strength and cardio
  • Water Aerobics

  
Trampoline group fitness class. One of my more difficult workouts. 

An overall goal of mine is a balance of strength and cardio. I started, however, on the recumbent bike. My first workout with POTS totaled 15 minutes. Even now my workouts can total 15 minutes or they can be two hours. Relapse and remission are very common in the life of a person with a chronic illness.

Dysautonomia International is a great resource as well for exercise tips.  

Does it reduce your symptoms? 

Yes. BUT it can also increase my symptoms if I don’t respect the scale I mentioned above. 

Do you use a heart rate monitor device?

Polar M400.


This watch is a 24/7 activity tracker, similar to many other wearable fitness trackers. It measures all sorts of goodies but most importantly, when paired with a Bluetooth Heart Rate Monitor (HRM) chest strap, it measures your heart rate.

I have only used Polar HRM so I have no personal experience with any other brand. I have used them before POTS too. 

How high does your heart rate go when exercising? 

Apples to oranges, my heart rate data is useless to you. According to the CDC ,”For moderate-intensity physical activity, a person’s target heart rate should be 50 to 70% of his or her maximum heart rate. This maximum rate is based on the person’s age”. In my instance, my maximum heart rate would be in the 190’s range, and I prefer to not go there if I can help it. I rely on my Polar M400 a lot during workouts.

Where can I begin?

I am just a panda with an opinion, but first and foremost, get with your health care provider. Find out their exercise recommendations based on your limitations. I started with advice from my cardiologist and built from there even though I was very active prior to POTS developing. My current routine is not under medical supervision but I have and will see my doctor of symptoms increase to a point of unmanageable. 

I hope this post gives my readers some insight on how I manage my chronic illness, POTS, with activity. A greater understanding why I cancelled that workout due to a flare or energy to workout now means me staying in bed later. Exercise doesn’t cure POTS but being deconditioned can make smyptoms worse. Exercise is just one tool in my toolbox for POTS symptom management. 

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2 thoughts on “Being Active with a Chronic Illness

  1. How did they determine it was POTS and not just a drop in blood pressure? I occasionally get lightheaded while exercising, especially around TOM. The DR just said to drink salt water or a sports drink but both are gross to me.

    1. Hi Cassi,

      I have had a test called a “Tilt Table Test” which is performed by a cardiologist. People with POTS will fail the test, pass out. I also encounter many other symptoms besides feeling dizzy due to POTS.

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