how this works
Start Where You Are. Build Slowly. Stay Upright Longer.
Start Lying Down
Begin below the problem.​
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Being upright is the hard part. Programmes usually start supine or recumbent - floor work, a recumbent bike, rowing - where the heart is not also fighting gravity, and build toward upright from there.
Guided by Heart Rate
Let the numbers set the ceiling.
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Sessions are paced by what your heart rate is actually doing, not by what a session is supposed to look like. That is what keeps the work productive instead of triggering the crash that follows overshooting.
Progress on Response
Advance when your body says so.​
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Each step forward is earned by how you recovered from the last one. Some weeks that means moving up. Some weeks it means holding where you are, and holding is progress too.
what we work on
Tolerance, Strength, Recovery & Daily Life.
Exercise Intolerance
Not a willpower problem.
Being told to exercise more, when standing up already sets your heart racing, is not useful advice. The work starts from where your body actually is and builds tolerance in small, repeatable steps.
Leg & Trunk Strength
Support the work of being upright.
Strength through the legs and trunk supports circulation when you are upright. It is slow and specific, and at the start it is usuall done lying down or seated rather than standing.
Pacing & Energy
Spend it where it matters.
Planning a week so the things that matter are still possible, and so a good day does not cost you the three that follow. Pacing is a skill, and it can be taught.
Everyday Upright Time
Showering, cooking, shopping.
The goal is not a number in a gym. It is more minutes upright doing ordinary things - a shower, a meal, a trip to the shop - without paying for them for days afterwards.
diagnosis & your care team
Where Physical Therapy Fits
POTS is diagnosed medically, not by a physical therapist. If you have not been evaluated yet, that is the right first step. If you have, we work alongside whoever is managing it - cardiology, neurology, or your primary care physician.​
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Fluids, salt, compression and medication are your physician's to manage, and we build around what they have set rather than second-guessing it. Tell us what you take and what you have been advised, so the plan fits the rest of your care.​
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Reconditioning for POTS is well established, and it is measured in months rather than weeks. Progress is rarely a straight line. Flares happen, and a plan that does not expect them is a plan that gets abandoned. Yours will expect them.
