The Best Exercises for POTS (That Won’t Wipe You Out)

Living with Postural Orthostatic Tachycardia Syndrome (POTS) often means walking a tightrope between wanting to feel stronger—and worrying that any movement might leave you flat on the couch. As a provider and a person living with POTS, I get it. Exercise can feel intimidating, frustrating, and downright exhausting. But when done strategically, movement can actually improve your symptoms, increase blood volume, and help you feel more in control of your body.

In this post, I’ll walk you through the best types of exercise for people with POTS—based on clinical evidence, real-world experience, and patient feedback.

Why Exercise Helps (and Hurts) in POTS

Exercise is a double-edged sword for POTS patients. On one hand, it strengthens the heart, supports vascular tone, and helps counteract deconditioning (a known factor in worsening orthostatic intolerance). On the other hand, upright activity can trigger dizziness, tachycardia, fatigue, and brain fog.

The key? Start slowly, stay horizontal at first, and build gradually.

Best Types of Exercise for POTS

1. Recumbent Cardio

These exercises avoid the upright position and help build endurance without triggering symptoms.

• Recumbent bike

• Rowing machine

• Swimming or water aerobics

• Rowing ergometers (at low resistance)

Start with 5–10 minutes a day, 3–4 days a week, and work up from there.

Pro tip: Swimming is uniquely helpful because hydrostatic pressure mimics compression garments and helps venous return.

2. Seated Strength Training

Muscle tone helps regulate blood flow and stabilize blood pressure. Use light weights or resistance bands for:

• Seated leg lifts

• Ankle pumps

• Arm curls

• Core engagement exercises

Focus on large muscle groups (legs and core) since they’re key to blood volume regulation.

3. Floor-Based Yoga or Pilates

Gentle movement and breathwork can improve autonomic balance and reduce stress:

• Supine or seated poses (avoid prolonged standing)

• Use props or do routines on a mat

• Poses like legs-up-the-wall, child’s pose, and bridge pose are especially helpful

Avoid fast transitions and monitor your symptoms as you move.

4. Walking (Eventually!)

Many POTS patients eventually tolerate upright exercise—but only after building a strong base. Walking can be introduced gradually:

• Start with short indoor walks (hallways, treadmill)

• Use compression garments

• Hydrate beforehand, and try cool environments

Start with 5-minute walks and build tolerance as symptoms improve.

How Often Should You Exercise?

A great goal is 3–5 sessions per week, alternating cardio and strength. But in a flare, it’s okay to scale back. Listen to your body.

Final Thoughts: Progress, Not Perfection

The goal isn’t to run a marathon—it’s to help your nervous system regulate itself better over time. For many with POTS, consistency matters more than intensity. Some days you’ll move, and some days you’ll rest. Both are part of healing.

At Galene Health, we offer individualized exercise plans and holistic POTS care for patients across Washington state via in-person and telehealth visits. Whether you’re just getting started or hitting a plateau, we’re here to support you with evidence-based, heart-centered care.