How Can Physiotherapy Help with POTS, Dysautonomia and PSWT?

If you've been diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome), dysautonomia, or PSWT (Postural Symptoms Without Tachycardia), you've probably experienced symptoms that can significantly impact your daily life.

Dizziness, fatigue, brain fog, exercise intolerance, palpitations, nausea, temperature regulation difficulties, and feeling unwell when upright can make even simple activities feel challenging.

Many people are surprised to learn that physiotherapy can play an important role in managing these conditions and improving quality of life.

How Physiotherapy Can Help

Education and Understanding

One of the most important roles of physiotherapy is helping people understand what is happening in their body.

Understanding your condition can help reduce uncertainty and anxiety while providing practical strategies for symptom management.

We often discuss:

  • Why symptoms occur

  • Common triggers

  • The role of blood flow and circulation

  • Nervous system regulation

  • Recovery strategies

  • Flare-up management

Knowledge can be a powerful tool when living with a chronic condition.

Exercise Rehabilitation

Exercise is considered one of the key management strategies for many people with POTS and dysautonomia.

However, traditional exercise advice is not always appropriate.

Many people find that upright exercise significantly worsens symptoms, particularly in the early stages of rehabilitation.

Physiotherapy can help identify an appropriate starting point based on your current symptoms and functional capacity.

This may include:

  • Supine exercises

  • Recumbent cycling

  • Swimming or hydrotherapy

  • Seated strengthening exercises

  • Gradual cardiovascular training

  • Progressive resistance training

Programs are tailored to the individual and adjusted over time as tolerance improves.

Building Orthostatic Tolerance

Orthostatic tolerance refers to the body's ability to tolerate being upright.

Physiotherapy can help improve orthostatic tolerance through:

  • Graded exposure to upright activity

  • Muscle pump activation strategies

  • Lower limb strengthening

  • Functional movement training

  • Activity progression planning

These strategies can help improve circulation and reduce symptom severity over time.

Strength Training

Research increasingly supports the role of strength training in managing POTS and related conditions.

Improving muscle strength, particularly in the legs and core, can assist with venous return and support blood flow back to the heart.

Strength training may also improve:

  • Physical function

  • Fatigue management

  • Confidence with movement

  • Activity tolerance

Pacing and Energy Management

Many people with POTS and dysautonomia experience a cycle of doing too much on good days and then experiencing significant symptom flares afterwards.

This is often referred to as the "boom and bust" cycle.

Physiotherapy can help identify sustainable activity levels and develop pacing strategies that support long-term progress.

Learning how to balance activity and recovery is often a key part of successful management.

Symptom Management Strategies

Physiotherapy may also include education regarding:

  • Fluid intake

  • Salt intake (where appropriate)

  • Compression garments

  • Counter-manoeuvres

  • Heat management

  • Sleep habits

  • Activity modification

These strategies can help individuals better manage symptoms throughout the day.

Every Person Is Different

POTS, dysautonomia and PSWT can affect people in different ways.

Some individuals are able to remain active with minimal modifications, while others experience significant limitations in daily activities.

Because of this, management should always be individualised.

There is no one-size-fits-all approach.

Our Approach at My Community Physio

At My Community Physio, we understand that living with POTS, dysautonomia or PSWT can be challenging.

Our approach focuses on:

  • Meeting your body where it is at

  • Building confidence with movement

  • Developing sustainable exercise habits

  • Supporting nervous system health

  • Improving function and quality of life

  • Working collaboratively towards meaningful goals

We recognise that progress is rarely linear and that recovery looks different for everyone.

Looking for Support?

If you are living with POTS, dysautonomia or PSWT and would like support from a physiotherapist with a special interest in these conditions, we'd love to help.

We offer home visits, clinic appointments and telehealth consultations across Adelaide.

Contact My Community Physio to learn more or book an appointment.