POTS and Exercise: Finding Movement That Works for You

Living with Postural Orthostatic Tachycardia Syndrome (POTS) is like constantly playing a game where the rules keep changing. One day, standing up feels manageable. The next, just walking across the room leaves you dizzy, exhausted, and feeling like you just ran a marathon. So when doctors recommend exercise as part of POTS management, it can feel laughable—how can I work out when just standing feels like a workout?

I get it. I’ve been there. And honestly? The idea of exercise used to make me roll my eyes because I could barely function on bad symptom days. But over time, I’ve learned that moving my body doesn’t have to mean pushing myself to the point of a crash. There are ways to incorporate movement that actually help, rather than make things worse.

If you’re living with POTS and trying to figure out how (or if) exercise fits into your life, let’s break it down together.

What is POTS?

Before we talk about exercise, let’s quickly go over what POTS actually is. Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia, which means it affects the autonomic nervous system—aka, the part of your body that controls things you don’t consciously think about, like heart rate, blood pressure, digestion, and temperature regulation.

For people with POTS, our bodies struggle to regulate blood flow properly. When we stand up, blood pools in our lower bodies, and our hearts race to compensate. This leads to symptoms like:

• Dizziness or lightheadedness
• Rapid heart rate (tachycardia)
• Extreme fatigue
• Brain fog
• Exercise intolerance
• Temperature dysregulation

Basically, our bodies don’t handle gravity well, and even small activities—standing, walking, carrying groceries—can leave us feeling like we ran a marathon.

Why Exercise Can Be So Hard with POTS

Let’s be real—POTS and exercise don’t always get along.

• Many of us experience exercise intolerance, meaning physical activity can trigger a worsening of symptoms.
• The moment we stand, our bodies struggle to pump blood efficiently, making workouts feel way harder than they should.
• Fatigue is real. Some days, getting out of bed feels like an accomplishment, so the idea of intentionally exerting myself? Not exactly appealing.

So why do doctors keep pushing exercise? Because if done correctly, it can actually help improve circulation, strengthen the cardiovascular system, and increase overall stamina—which can make symptoms a little more manageable over time.

The key is finding the right approach—one that doesn’t leave you completely wiped out but instead helps you build strength slowly and safely.

How to Integrate Exercise Safely with POTS

If you’re ready to try adding some movement into your life, here are a few ways to make it work for you, not against you.

1. Start Low and Slow

This is not a “no pain, no gain” situation. For POTS patients, slow and steady wins the race—and I mean slow.

• Begin with recumbent exercises like stretching, light yoga, or floor-based movements before progressing. My favorite go-to for yoga is Find What Feels Good.
• If you can tolerate it, consider seated or recumbent cardio, like a recumbent bike or rowing machine.
• Some people start with just a few minutes a day and gradually increase as tolerated.

2. Prioritize Strength Training Over Cardio

Traditional cardio can be brutal on a POTS body, especially if it involves standing or sudden position changes. Instead, focus on strength training to help improve muscle tone and blood flow.

• Leg and core strength are especially important, as stronger muscles help circulation and can reduce blood pooling.
• Start with seated or lying-down exercises (think leg lifts, resistance bands, or light weights).
• Gradually incorporate standing exercises only if and when you feel ready.

3. Keep It Horizontal

If standing up triggers your symptoms, don’t stand up to exercise.

• Try reclined workouts like Pilates, stretching, or mat-based movements.
• Swimming can also be great since the water reduces gravity’s effects on your body.

4. Hydration & Salt Are Non-Negotiable

Staying hydrated is a must for anyone with POTS, but it’s even more crucial before and after exercise.

• Drink electrolyte-rich fluids (like water with added salt or electrolyte powders).
• Make sure you increase sodium intake to help retain fluids and maintain blood volume.
• Don’t forget to hydrate before, during, and after movement to avoid crashes.

5. Listen to Your Body (Seriously, Listen to It)

This is the most important part: your body knows best.

• If something makes you feel worse, stop.
• Rest when you need to. Pushing through fatigue isn’t strength—it’s self-sabotage.
• Not every day will be a good day for movement. That’s okay. Rest is just as important as exercise.

6. Consider Compression Gear

Compression socks or leggings can help improve circulation and reduce blood pooling in the lower body, which can make movement more tolerable.

• Try gradually introducing compression socks during movement sessions.
• If they feel uncomfortable, experiment with different levels of compression.

The Mental Battle: Giving Yourself Grace

One of the hardest parts of exercising with POTS isn’t just the physical struggle—it’s the mental struggle.

• It’s hard to accept that movement that once felt easy now feels impossible.
• It’s frustrating to take two steps forward and one step back.
• It’s discouraging when you see others making progress while you feel stuck.

But here’s what I remind myself: My journey is my own.

My progress won’t look like someone else’s, and that’s okay. What matters is that I’m doing what I can, when I can, in a way that supports my body rather than punishing it.

If you’re navigating this too, be gentle with yourself. Movement isn’t about pushing through pain—it’s about finding what makes you feel stronger, not sicker.

Final Thoughts: You Are Not Alone

Exercising with POTS isn’t easy, and it’s okay if it takes time to find what works for you. Some days will be better than others, and some weeks, the best thing you can do is rest.

The key is to honor where you are, celebrate small wins, and remember that progress—no matter how slow—is still progress.

You are not alone in this. And no matter what your journey with POTS and exercise looks like, you are doing an amazing job just by showing up for yourself in whatever way you can.

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Disclaimer: Hey there, friend! Just a reminder—I’m not a doctor, and this blog post isn’t medical advice (as much as I wish my Google searches made me a certified expert). Endometriosis is a complex condition, and everyone’s experience is different. If you suspect you have endo or are struggling with symptoms, please chat with a qualified healthcare provider. They have the tools, knowledge, and fancy medical degrees to give you the right guidance. This blog is all about sharing personal experiences and insights, not diagnosing or curing anything—so take what resonates, do your own research, and always prioritize your health. 💛