When an individual receives a diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS), doctors often recommend physical activity as one of the first lines of treatment. However, even people who used to be extremely active often find exercising overwhelming difficult. Exercises, such as weight lifting, strength training, running, or even walking can exacerbate symptoms and send an individual's heart rate skyrocketing. I once thought I was going to vomit in the middle of the gym just because I paused in the middle of my cardio workout.
The CHOP Exercise Protocol: A POTS Exercise Program
The CHOP Exercise Protocol, designed by the Children’s Hospital of Philadelphia, is specifically designed to help individuals with POTS gradually build up their exercise tolerance. The protocol starts with simpler, less strenuous exercises, gradually increasing in difficulty and intensity. This helps mitigate the risk of triggering severe symptoms early on.
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Months 1-3 - Supine cycling
- Recumbent bike
- Swiming laps with a kickboard
- Rowing
- Seated stepper
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Month 4 - Recumbent bike
- Swimming
- Rowing
- Upright biking
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Month 5 - Upright biking
- Treadmill walking (flat grade)
- Elliptical (stationary arms)
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Month 6 and Beyond - Progress to more difficult exercises as can be tolerated
In addition to ramping up the type of exercise, the duration of exercises also increases over the months. The first month begins with 28 minutes of exercise. By the last month, individuals are exercising for 1 hour and 5 minutes.
Exploring the CHOP with a Healthcare Provider
It’s important to remember that every individual's experience with POTS is unique. Consulting with a healthcare provider before starting any new exercise program is essential to ensure it aligns with your specific health needs. Even as I progressed through the CHOP for 5 months, I would routinely check in with my healthcare provider and physical therapist to ensure I was medically on track.
Personal Experience with the CHOP Protocol
From a personal standpoint, following the CHOP exercise protocol for five months markedly improved my ability to manage my symptoms. It’s one of the tools that I’ve been using consistently to manage my symptoms. For more information on my experience with the CHOP, check out Exercising with POTS: Improving my Symptoms with a POTS Workout Plan.
Using POTSie to Track Your CHOP Protocol Progress
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If you're interested in testing out the CHOP exercise program, the POTSie app contains a CHOP exercise tracker. It includes daily breakdowns of exercises, tailored to the specifics of the CHOP protocol, helping you stay on track with your regimen.