Doctors frequently recommend exercise as a foundational approach to managing POTS symptoms. What many people don’t realize is that not all exercise is helpful. Only after learning how to exercise properly with POTS did my symptoms start to improve.
The challenge of exercise intolerance with POTS
POTS is often characterized by exercise intolerance. Activity that used to be easy suddenly felt impossible. Before POTS, I fast-walked 30 minutes to work. After POTS, I could barely make it around the block.
When I was first diagnosed, I followed my doctor’s advice and tried a vertical climber.
Just two minutes on the climber would send my heart rate to 160. I’d be out of breath, shaking, and feeling my heart pound in my chest. It was miserable.
Discovering the Dallas CHOP Exercise Protocol
After struggling for several weeks, my doctor recommended the Dallas CHOP Exercise Protocol—a structured exercise program designed specifically for people with POTS. She warned that it could take five months to see real results. Despite my skepticism, I decided to give it a try.
The biggest difference wasn’t exercising harder. It was starting with exercise my body could actually tolerate.
Committing to the exercise protocol
I committed to following the CHOP protocol for six months. My progress and feelings can be summed up by the emoji journey below.
Exhausted after just a few minutes
Slightly more tolerable
Building strength and consistency
Stronger, more energy, fewer symptoms
Recumbent exercise: a better way to exercise with POTS
Before POTS, I’d never heard of recumbent exercise. When I thought of someone exercising, I thought of running, climbing, or lifting—all vertical, all difficult with POTS. Recumbent exercise is horizontal, which reduces blood pooling in the legs and makes movement more sustainable.
The first few months of the CHOP protocol are all horizontal exercise, like recumbent biking or rowing. After a couple of months, you graduate to upright biking, and then to standing exercise a few months later.
I chose the recumbent bike. That single change made all the difference. Where I could barely last two minutes on a vertical climber, I could complete a full 50-minute workout on the recumbent bike by month three.
Seeing results: the power of consistent exercise
As the months went by, I noticed gradual improvements. By the fifth month, my heart palpitations had lessened by roughly 80–90% depending on the day. I felt stronger and fitter than I had in years.
Consistency mattered more than intensity. Small, tolerable sessions really did add up.
Integrating exercise into POTSie
To make the protocol easier to follow, I added the exercise plan to POTSie. Now, instead of digging through PDFs, I can pull up each day’s workout directly in the app.
