Fitness Training

So, you've started working on some light calisthenics and you feel ready to tackle something more "meaty." Great! Here's some ideas to get you moving...

The big rule of exercise for POTS sufferers is CARDIO! Cardio will enlarge and strengthen the heart, helping you to pump blood more efficiently and short-cutting the cascade that leads to tachycardia. However, cardio on it's own is only worth so much. It's great, don't get me wrong, but if you add resistance training to your routine, you'll be able to create more endurance and exercise tolerance than if you just do cardio and nothing else. Also, if weight management is on your radar then resistance training will help there, too. Building muscle mass will increase your resting metabolic rate, turning up your fat burning capacity overall. Win-win, right?

But how to get started if you have POTS? You can't just get out and run a marathon... and that's important to remember. You MUST respect your limits. If this means using the bike for a measley 5 minutes at first, then that's what it means. Don't let the gym or fitness center intimidate you or make you feel like you have to do more than you are capable of. Pushing too hard will not help. It will set you back. Take it easy, don't compare yourself with the person on the next bike.

Disclosure: this is the plan I came up with for myself. My doctor at the Mayo Clinic signed off on it. I then proceeded to ramp up faster because I found I could tolerate more than I thought. So did I follow this? No, not exactly. But I think for people who have severe exercise intolerance, this plan could be a good guide. And remember, always listen to your body. If your body says "Don't increase cardio this week" then don't. if your body says "Bring it on, I can take it!" then ramp up faster.

You should be exercising daily. Is it a pain? Yep, some days it sure is. But if you alternate daily cardio and resistance training, you will feel better sooner. If you are having a terrible, horrible, can't get out of bed day then go back to floor calisthenics and see if that maybe perks you up a bit. And if you get down and do your calisthenics and find that you now have the energy for your scheduled workout, go for it! There is no reason not to do both if you are able to tolerate it.

Now, some specifics...

Cardio

Recumbent! Here's two great reasons to start off recumbent. Number 1 - by taking some of the strain of gravity off your circulatory system, you enable it to provide the blood flow for your exercise. Number 2 - if you pass out on a recumbent bike you won't get hurt as bad as if you pass out on an upright bike or, worse, the treadmill. Upright exercise will put more of a strain on your system, and more of a risk on your poor noggin.

That means the recumbent bike and the rowing machine are your two new best buds. If you find that your relationship with the rowing machine is more "frenemy", don't feel too bad. Everyone is love-hate with that machine. Here is a great link about proper rowing form and technique. It will make your rowing workout more efficient, effective and enjoyable if you master form right off the bat, and rowing is a great exercise for building your overall cardio strength and stamina!

Resistance

Resistance training can seem intimidating at first, because when you head to the weight rack you'll see these giant dumbbells the size of a Buick and some musclebound dudes sizing each other up. Ignore them both. Grab the lightest weight you can and focus on your reps and form. Remember, a "rep" is a repetition, or one complete movement of the weight. A "set" is a pre-determined number of reps you want to complete in a row before resting. Your rest between sets should be brief - maybe a minute. If you can't complete all your reps, you can start lower and build up or you can take mini-breaks until you knock all the reps out. Pausing in a set is ok! The gym police will not come for you if you breathe for 10-20 seconds before continuing.

So which exercises should you use? I would recommend a full-body workout, preferably with several routines that you can alternate into your overall program. I particularly like this one, from Muscle and Strength. It says it's for women, but I think anyone can do it (that's a dude in the demo videos, right?) and the thing I like about it is that it uses dumbbells instead of barbells. With barbells I'm always worried about not having a spotter, but with dumbbells you can skip the spotter without worrying about a bar falling on your head or chest. That said, you can also surf over to www.muscleandstrength.com and peruse their whole lineup of beginner routines. Make sure to watch the videos before you try the exercise, and when you perform the exercise please do so in front of a mirror so you can check your form. Form is important! Also, feel free to ignore their prescribed sets and reps and substitute with the numbers from my table above.

A word on weight... start light so you can work on form. After you feel comfortable with your form, you can pick a heavier weight based on your strength and tolerance. At the right weight, you will be able to complete the full set but the last few reps will be more difficult. If you are breezing through all your reps without feeling any strain, it's time to move up a little bit. If you can only complete half the set before your form falls apart and you are unable to complete any more reps, bring the weight back down. Again, the gym police won't come looking for you if you reduce your weight!

I hope this all helps you. It has definitely helped me a ton.