The Little Things
November 19, 2013

This is another post in my series on Postural Orthostatic Tachycardia Syndrome.

Working out with POTS is interesting, and is completely different than exercising without it. Exercise is a critical component of the treatment of POTS, but while we’re asked to exercise, it’s pretty much the last thing that our bodies actually want to do. People with POTS are often labeled as “exercise intolerant”, as it’s difficult for the body to handle the stress that occurs when the body exercises. Exercise is helpful as it strengthens the leg muscles, a crucial aspect of treating pots. However, exercise also exacerbates symptoms afterwards, at least for a day or two.

So, you can see the problem. With POTS, it’s the best thing for you and the thing that is the most difficult to do. I wrote an entire post on “how POTS changed my exercise“, and that will give you some information about what changed for me. Picture someone with a resting heart rate of 120, dizzy regularly throughout the day, loses vision almost every time she stands up being told she needs to start working out. Crazy, right?

Starting to work out was a LONG and SLOW process for me, and one that I would never embark without talking to a physician. Here are some of the steps that I took in working out with pots:

  1. TALK TO YOUR DOCTOR. Never start an exercise regimen without talking to your doctor first if you have POTS. With POTS there are so many variables that we have to do with, and it’s important to have a doctor be a part of your journey.
  2. I got on a Beta Blocker. With my resting heart rate at 120, I could hardly start to move much without getting dizzy, with my heart pounding, and being very short of breath. Getting on a beta blocker allowed my resting heart rate to go down to about 80 beats a minute, which gave me a wider gap in which to workout in. However, a beta blocker also means that it’s not safe for me to run much faster than a 10:00 minute mile, so it comes with some constraints.
  3. Start to walk… slowly. Over the course of about 4 months I started to walk more frequently and with more intensity. I picked up my pace through more days until I was walking around 20 miles a week (and felt good through most of them). This took some patience, lots of hours with friends laughing and talking, and a nutrition plan.
  4. With POTS you need more salt and water than the average person, and it took a bit of time for me to figure out how that looked for me personally. I realized what I needed to do not only the day that I worked out, but also the day before I worked out.
  5. I went on my first run, and collapsed in a yard close to passing out at mile 0.75. You can read all about that run here. It would’ve been really easy to quit here, but I was determined.
  6. I came up with a new running plan, and started to do a “run/walk” pattern, slowly increasing my amount of run time and decreasing the amount of walk time. I started running for abut 20 seconds at a time, and then increased to 30-40 seconds, and kept increasing from there. You can read all about that progress here.
  7. I found ways to cross train that would strengthen other leg muscles. Biking, swimming, and pilates were all part of this strategy.
  8. There are things that I avoid. Running in the heat almost never turns out well, and if I do it, I very much limit my time/miles. Also- STAY AWAY FROM HOT YOGA. Or, as my doctor said “RUN AS FAR AWAY FROM HOT YOGA AS YOU CAN. IT’S TOO DANGEROUS FOR YOU.” Since heat further exacerbates symptoms of POTS, hot yoga can become too dangerous far too quickly for someone with POTS. If you do yoga, stick to normal temperatures.
  9. I came up with a permanent walk run strategy by using the Galloway Method. Because I consistently walk for 1 minute after running for 3 minutes, I had a chance to regularly bring my heart rate down. This become highly important as I started racing, particularly during my half marathons.
  10. BE PATIENT! Some days POTS symptoms are overwhelming, some days they are more manageable. Some days might be ideal schedule or weather wise to work out, but your body might just not be ale to do it that day; that’s ok- be patient. Build your strength slowly, and don’t try to push too hard or too fast. Building up a good base without POTS can be tough, but building it up with POTS takes far more work. Be patient with yourself.

Like I said above, this is just what I did. Everyone’s journey to working out while managing POTS looks different. The best you can do is avoid comparison, be patient with yourself, and move slowly as you start gradually exercising. Be smart, be wise, and enjoy what you can do!

Disclaimer: I am not a doctor, and this post shouldn’t be taken as advice on what you should do. I am simply sharing what I personally did as I started to work out after my POTS diagnosis. Always consult a doctor before beginning a workout regime. 

7 responses to “How I Started Working Out with POTS”

  1. Kasey says:

    I never knew POTS was an actual “thing,” which is just stupid because my whole life, I have battled wicked low blood pressure, dizziness upon standing that often includes a short loss of vision, weird heart beats, etc. I’ve been told in the past by doctors just to eat more salt and stand slowly. I’m kind of annoyed that not one of them ever mentioned this as a real issue! For 29 years, I’ve just been dealing with it. I’ll have to bring it up the next time I see a doctor.
    I’m guessing there are differing levels of severity? I do ok running as long as my blood sugar stays stable (I do know I have hypoglycemia like a boss. I’m that girl who carries practically a full lunch with me at all times). But, it interferes with teaching my yoga class- what my students don’t all know is that any time we seem to slow down or do extra deep breaths in mountain pose, there’s a high likelihood i’ve lost my vision and am trying not to collapse!
    Thank you for sharing!

    • Caroline says:

      Thanks for leaving a comment! There are many doctors that have no idea about POTS (I was lucky enough to live in a place where a lot of research is done and doctors are aware of it). Where I’m currently living none of the doctors or nurses I’ve ever seen have heard about it, so I bring information on it with me to each doctors appointment. If you’d like to talk more separately about it, just let me know. There are differing levels of severity, and different levels of stability and management. It sounds like you’ve managed to find some good management strategies!

  2. Lindsay says:

    great post! exercising with POTS has been a huge challenge for me, but i do think it helps with some of my symptoms, so i’m determined to continue. your suggestions are very helpful!

  3. Jenny says:

    Thanks for sharing!!! I have read like 10 of your posts in a row tonight. I have POTS and am also a runner trying to train through the every day! I’d love to know more details about your POTS specific training… like do you run 3 walk 1 in a race? What kind of diet are you on, since runners need carbs but POTSies don’t? Any suggestions on using gels more frequently? I have done several halfs, a full and am trainibg for my next full in October. It is amazing how some days runs can seem so much harder than others. Your story is amazing and I’m totally impressed! Thanks for sharing!

    • littlethingscaroline@gmail.com says:

      Hey Jenny- It’s nice to meet you! In regards to races, I do either 3:1 walk run or 2:1 when it gets hotter out. I walk through water stops so that can change it a tiny bit, but I train and race this way. I actually don’t have a difficult time with carbs so I guess I’m lucky that way. I don’t eat a crazy amount of them (this summer has been a different story and I’ve noticed my stomach hurting more because of it). I eat A LOT of quinoa with chicken and veggies in it, with difference spices. I have a few of those recipes under my recipe tab. I take shot bloks every 3-4 miles during a race, and I especially love the margarita flavor since they have extra sodium. I also take a salt packet before half marathons, and in my last half marathon I took another salt packet at mile 7 since it was so hot and I was sweating quite a bit. That’s the thing with POTS- every day is different and you never know what you’re going to wake up to. It gets frustrating, doesn’t it? I’m impressed that you’re able to run fulls! I’m not sure if my body could handle that. Thanks for stopping by and saying hi. If you have more questions, please feel free to email me! I’d love to keep chatting.

  4. Joanne says:

    Hi, I’ve just come accross your blog as I follow another fellow potsie – Linds. I was diagnosed with pots last year after my 4th bout of shingles. I suspect I had symptoms for a while before hand though.
    I just wanted to know what beta blocker you take? I am also on a beta blocker but did not know there where dangers to running certain speeds in certain times. Not that I run but I’ve had no guidance on getting reconditioned except to do exercise from my neurologist.
    Do you take any other pots medications such as florinef or do you find the extra salt helps enough for your blood pressure?
    I hope you can answer my questions.
    Thankyou
    Joanne

    • littlethingscaroline@gmail.com says:

      Hi Joanne,
      Welcome to my blog, and thanks for commenting! I take Atenolol (beta blocker) and have found that that helps quite a bit! I take A LOT of salt (I have a container of salt packets at work and in my purse… and bring them with me while racing). If you have other questions or want to continue talking about POTS, you can always shoot me an email! It’s littlethingscaroline [at] gmail [dot] com!