POTS, Orthostatic Intolerance and Exercise With Hypermobility
Standing exercise can be difficult when dizziness, a racing heart or faintness are part of the picture. Here is how rehabilitation can be adapted.
Why upright exercise may be harder
Orthostatic intolerance means that being upright itself can create symptoms such as dizziness, racing heart, greying vision or faintness. When that is happening, the starting position of an exercise can matter just as much as the exercise itself.
Supported and seated exercise can still be real training
Seated, lying or recumbent exercise can reduce the orthostatic demand while allowing useful strength and conditioning work. These options can be particularly helpful while symptoms are being assessed or while a person is building tolerance to more upright activity.
Change positions slowly
Moving quickly from lying to standing can provoke symptoms. Allow time between positions, keep support available if balance is affected and stop to sit or lie down if marked faintness or visual greying develops.
Do not use exercise to self-diagnose POTS
Dizziness, tachycardia and fainting can have several causes. Exercise adaptations can make activity more manageable, but diagnosis and medical management should sit alongside appropriate clinical assessment.
A more detailed physiotherapy resource
For a more complete physiotherapy resource, see the Complete Hypermobility Spectrum Disorder & Hypermobile Ehlers-Danlos Syndrome Physiotherapy, Rehabilitation & Self-Management Guide. It brings symptom management, practical self-management and 39 adaptable exercises across four pathways together in one 227-page digital guide.
Related reading
This article provides general physiotherapy education and does not replace individual assessment, diagnosis or treatment. New, severe or rapidly changing symptoms should be assessed by an appropriate healthcare professional.
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