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Moving with Confidence – Pilates for Chronic Health Conditions: Postural Orthostatic Tachycardia Syndrome (POTS)


At Mobilates we embrace everyone's individuality and provide a person-centred approach to exercise activities. Below you will find details about Postural Orthostatic Tachycardia Syndrome (POTS) - a condition that some of our members live with. You’ll find some information about the condition alongside some top tips on exercising whilst staying safe and supported.


Definition: What is POTS?


Postural Orthostatic Tachycardia Syndrome (POTS) is a condition where your heart rate rises very quickly when you move from lying down or sitting to standing.


Symptoms can vary day to day and may include:


There’s currently no cure, but POTS can be managed with lifestyle adjustments, pacing, and sometimes medication.


Common symptoms include:


  • Dizziness or lightheadedness when standing

  • Noticeable heartbeats (palpitations)

  • Chest discomfort or shortness of breath

  • Shaking or sweating

  • Fainting or nearly fainting


Other symptoms may include:


  • Stomach or digestive issues such as nausea, bloating, diarrhoea, constipation, or tummy pain

  • Headaches or visual disturbances such as blurred or tunnel vision

  • Hands or feet looking purple (may be harder to see on darker skin)

  • Weakness and extreme fatigue, difficulty exercising, and poor sleep

  • Cognitive difficulties such as brain fog, poor memory, or trouble concentrating


What Causes POTS?


The exact cause of POTS isn’t fully understood. It can develop suddenly or gradually and may involve a combination of factors:


  • Changes in blood volume or circulation

  • Nervous system dysregulation

  • Co-existing conditions such as EDS/HSD

  • Genetics or family history

  • Physical or hormonal triggers


You may be more likely to experience POTS if you have conditions such as long COVID, ME/CFS, or joint hypermobility/EDS.


Certain factors can also make symptoms worse or trigger flare-ups, including:


  • Hot environments

  • Standing or sitting upright for long periods

  • Not drinking enough fluids

  • Alcohol consumption

  • Eating refined carbohydrates

  • Menstruation

  • Resting too much or overexerting

  • Stress


Symptoms are real and can vary from day to day, which is why pacing, listening to your body, and adapting movement is so important.


Focus


For people living with POTS, Pilates and gentle exercise can support circulation, stability, and nervous system regulation. The aim is control, awareness, and adaptability rather than intensity.


Key areas of focus:


  • Supporting circulation: Gentle, rhythmic muscle activation helps blood return to the heart.

  • Building stability and control: Strengthen the core, glutes, and legs to provide a safe movement base.

  • Regulating the nervous system: Slow movements, controlled breathing, and relaxation reduce “fight or flight” responses.

  • Pacing: Short, consistent sessions suit fluctuating energy levels and exercise tolerance.

  • Closed-chain movements: Hands or feet in contact with a stable surface provide stability, support circulation, and give the nervous system clear feedback.


Focusing on these areas helps people with POTS gradually build strength, confidence, and movement control, while respecting their body’s limits.


Exercise Tips


At Mobilates we aim to help you become more aware of your body and what feels safe. Every teacher provides adaptations so you can get the most from each class.


Tips for POTS-friendly Pilates:


  • Start lying down, semi-reclined, or seated: Ground-based, seated, and recumbent positions reduce the impact of gravity on circulation.

  • Move slowly and mindfully: Focus on control rather than speed or range.

  • Arm positioning: Keep arms lower when possible; raising them overhead can increase heart rate.

  • Roll downs / forward bends: Breathe at the bottom, gently squeeze legs, and rise slowly to keep blood in your head. Avoiding rapid head movements.

  • Use props: Cushions, blocks, straps, or balls for extra support.

  • Short sessions: 5–10 minutes is enough to start; build gradually as tolerated.

  • Small-range movements: Improve proprioception and control safely.

  • Listen to your body: Rest is part of the process; pacing is key.

  • Pre-hydrate with water or electrolytes and sip slowly throughout your exercise routine.

  • Consider wearing compression tights or socks, it just helps keep the blood flow where it needs to be.


Exercises to Try


Supine Heel Presses

Support circulation and gently activate the legs.

  • Lie on your back with knees bent and feet on the floor.

  • Press one heel into the floor, then relax.

  • Repeat with the other leg.


Supported Bridge

Strengthen glutes, core, and legs while lying down.

  • Lie on your back with knees bent, feet hip-width apart.

  • Lift hips slowly, squeezing glutes, then lower slowly.


Leg Slides / Heel & Toe Taps

Improve hip and knee mobility while supporting circulation.

  • Lie on your back with knees bent.

  • Slide one foot along the floor, then return. Alternate legs.


Side-Lying Leg Lifts

Strengthen glutes and hips safely.

  • Lie on your side with legs stacked.

  • Lift the top leg slowly, then lower.


Cat-Cow (Spine Mobility)

Mobilise the spine and improve core awareness.

  • On hands and knees, round the spine (Cat), then arch slightly (Cow).

  • Move slowly with your breath.


Modified Forward Stretch / Hip Hinge

Improve spine and hip mobility safely.

  • Sit or stand with a neutral spine.

  • Hinge from the hips, keeping the back straight, and reach forward slowly.

  • Return gently.


Side Stretches

Relieve tightness and improve mobility.

  • Lie in a star shape (arms and legs open).

  • Reach one hand across your body, allowing your shoulder and hip to lift.


Final Thought


Living with POTS can make exercise feel challenging, but adapted, mindful movement can be safe, empowering, and enjoyable.


Pilates helps support circulation, stability, and nervous system regulation while respecting your body’s limits. Key points to remember:


  • Pace yourself: Short, frequent sessions are often more effective than longer ones.

  • Listen to your body: Rest is part of the process.

  • Adapt positions: Lying, seated, or standing variations can all be used safely.

  • Celebrate small gains: Even gentle movement is progress.


With the right guidance, pacing, and adaptations, Pilates can help people with POTS feel stronger, more confident, and in control of their movement.


Member Comment


"When I first started exercising with POTS, I was worried about feeling dizzy or getting too tired. The gentle, supported approach in Mobilates classes has helped me build confidence and move safely. Even small, mindful exercises make a difference, and I feel stronger and more in control of my body."


Further Information and Guidance



Not yet a member? Then you can book your free online Mobilates trial here.


For more Information visit:


These organisations have factsheets and resources about POTS, including movement symptoms, coping strategies, and recovery stories.



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Mobilates CIC provides inclusive, adapted exercise for people living with long term health conditions, chronic pain, fatigue and disability.

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