Tips To Manage POTS Symptoms
Feeling dizzy, lightheaded, or unsteady when you stand can be unsettling — and for people with Postural Orthostatic Tachycardia Syndrome (POTS), it can happen often and without warning. The good news is that there are simple physical strategies you can use to help your body stabilize in the moment.
These are called counter-maneuvers, and they’re a useful tool to have when symptoms start.
What Are Counter-Maneuvers?
Counter-maneuvers are brief physical actions that help increase blood return to the heart and brain. For people with POTS, blood tends to pool in the legs when upright, which can reduce blood flow to the brain and trigger symptoms.
These techniques work by activating muscles to assist circulation and temporarily support blood pressure.
When to Use Them
Use counter-maneuvers at the first sign of symptoms, such as:
Dizziness or lightheadedness
Blurry or dimming vision
Feeling weak or shaky
Nausea
A sense that you might faint
Common Counter-Maneuvers to Try
Muscle Tensing
Tighten your leg, glute, and abdominal muscles for several seconds at a time. Make sure to keep breathing! Bonus: attempt to picture a compression machine and start with your toes/feet, move to calves, then up to your quad muscles, then finally glutes and abdominal muscles. This is a strategy used by pilots experiencing G Forces!
Leg Crossing
Cross your legs firmly while standing and gently squeeze them together.
Calf Raises
Standing or sitting - lift your heels towards the ceiling to contract your calf muscles which helps move blood towards your upper body.
Squatting
If safe to do so, moving into a squat can quickly improve symptoms by increasing blood flow to the upper body.
Handgrip
Squeeze a stress ball or make a fist and hold for several seconds, then release and repeat.
Forward Bending
Bending forward at the waist can help redirect blood flow toward the brain.
Lying Down with Legs Elevated
If symptoms are strong, lying down and elevating the legs is often the most effective option.
Helpful Tips
Safety first: If you feel faint, sit or lie down immediately.
Practice ahead of time: Trying these techniques when you feel well can make them easier to use during symptoms. You also can use these techniques prior to standing up for improved tolerance of this transfer motion.
Individual response varies: Not every maneuver works the same for everyone — finding your go-to strategies takes trial and error.
A Final Note
Counter-maneuvers are a helpful short-term strategy, but they are only one piece of managing POTS. If dizziness or near-fainting is frequent, working with a medical provider and a physical therapist trained in autonomic and vestibular conditions can help address the bigger picture.
