An article published in National Geographic recently (02/10/23) explores postural orthostatic tachycardia syndrome (POTS), a little-known condition causing lightheadedness and heart palpitations in response to standing up. It has surged with long COVID, but exercise may worsen some patients’ symptoms.
POTS puzzles doctors, as standing briefly shouldn’t affect heart rate. Some believe a malfunctioning nervous system is at fault. Exercise is normally recommended, but this can backfire for POTS patients by exacerbating fatigue and faintness. Determining optimal exercise regimens remains a challenge.
Experts like Dr. Peter Rowe note POTS must be carefully managed, as pushing through symptoms often makes them worse. He advises starting with supine exercise, like rowing or swimming. Slowly increasing to upright exercise is ideal, but difficult to tolerate for some.
POTS patient Jessica Sico experienced extreme crashes after exercise following COVID. She had been very fit and active before. She has improved via pacing her activity and targeted physical therapy exercises, though progress is slow.
Research on post-viral POTS offers hope for long COVID patients. Many youth after mononucleosis can resume normal activity in months with a gradual increase in movement. Applying those learnings to POTS after COVID is an active area of inquiry.
While exercise intolerance in POTS presents dilemmas, experts emphasize movement at the right pace helps. But listening to your body is critical, as overexertion can fuel crashes. More research into optimal regimens for post-viral POTS will enable better guidance for long COVID patients.