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Physical therapist and strength coachSusie Spirlock, DPT, played sports and exercised her whole life.
Delmaine Donson/Getty Images
But after she gotCOVIDin 2020, symptoms likefatigue, brain fog, and shortness of breath lingered.
And when she tried to work out, she felt dizzy, faint, and nauseous.
At first, Dr. Spirlock was afraid shed never be able to exercise again.
POTS can make exercise tricky, but that doesnt mean you should skip it.
With POTS, the nerves in your lower body dont respond properly.
Your heart keeps beating faster and faster, even as blood pools in your legs and feet.
The less blood that reaches your brain, the more severe your symptoms.
People with mild POTS might feel a bit tired, then like they cant focus or concentrate.
It can escalate to includedizziness, lightheadedness, seeing black spots or tunnel vision, and possibly passing out.
In fact, an inability to tolerate exercise is one of the hallmark signs of POTS.
Aerobic exercise boosts circulation at the moment and leads your body tocreate more bloodover time, stabilizing blood pressure.
Your heart and muscles will also grow stronger, which is whystrength trainingis also beneficial.
And if youre like Dr. Spirlock, getting back to exercise can simply help you feel more like yourself.
The road isnt always easy, she says, but these tips can help.
This is the first thing Dr. Bauer recommends when she starts working with a new patient with POTS.
It allows you to start to see patterns and correlations, Dr. Bauer says.
People may not realize that what they did yesterday is impacting how they feel today.
Start somewhere and you begin to add to that.
Consider a recumbent bike, rower, or seated elliptical like aNuStep.
A similar progression works for strength training.
As your body adaptsbecause the body is widely adaptableyou can start incorporating other things, she says.
As symptoms started to decrease, then I would lower that box, she says.
Now Im back to full-depth squats.
Also, some people find strength training causes fewer symptoms than cardio (or vice versa).
She also recommends a boost of 500 milligrams about an hour before you work out to ensure youre prepared.
(Just avoid salt tablets, Dr. Levine saystheyre so concentrated that they can be dehydrating.)
Agood warm-uphelps everyone, but its critical for folks with POTS, Dr. Spirlock says.
If youre doing cardio, ease in with five to 10 minutes of lower-intensity workthink easy biking.
Cooling down afterward can help your body relax into a more parasympathetic state.
Most people with POTS feelworse in the heat.
you’ve got the option to also try cooling towels or spritzing yourself with cold water.
Thats another big way you’re able to track progress over the long term, she says.
Keep in mind, this will likely change as your body acclimates to exercise again.
So she switched to using the talk test to gauge her intensity.
(Talk with your doctor about whats right for you, of course.)
For strength sessions, she monitors intensity using reps in reserve (RIR).
This attitude is a huge part of exercising with POTS and other chronic conditions, Dr. Spirlock says.
That way, youre not beating yourself up at the end of the workout if you cant quite finish.
In fact, if you have post-exertional malaise, ignoring symptoms can backfire, Dr. Bauer says.
Many people with POTS struggle to find medical providers who take them seriously and understand how to treat them.
If you have a medical team you trust, talk with them about your exercise program.
Discuss what symptoms you might expect and report anything new or unusual.
People arent alone, Dr. Spirlock says.
Four years later, shes back to the same level of strength training as before getting sick.
It was foreign to me; there were lots of tears, she says.
