12/06/2026
Exercise is often one of the first things recommended for POTS — but it’s rarely explained why it helps, or how to actually start.
Here’s the short version.
POTS involves a dysregulation of the autonomic nervous system — the system that controls heart rate, blood pressure, and blood flow when you change position. One of the key issues is low circulating blood volume, which makes it harder for your body to maintain stable blood flow when you’re upright.
Regular, progressive exercise helps in a few important ways:
It increases blood volume, so there’s more circulating volume for your heart to work with. It strengthens the muscle pump in your legs, which actively helps push blood back up toward your heart — and as those muscles get stronger, everyday tasks become easier too. It also improves stroke volume — the amount of blood your heart pumps with each beat.
In POTS, stroke volume is often reduced, which is part of why the heart rate climbs so high to compensate. Building it back up means your heart works more efficiently, and that compensatory rate rise becomes less severe over time. And over time, it helps calm an overactive sympathetic nervous system — the “fight or flight” response that’s often running too high in POTS.
Progress takes time — but with the right starting point and a gradual approach, the evidence is strong. This is why an individualised approach matters so much.
Exercise doesn’t cure POTS. But for many people, it’s one of the most meaningful things they can do to improve how they feel day to day.
If you’ve been told to exercise but had no idea where to begin — that’s exactly what we help with.
