Core Strengthening

[green]

I've heard that core training is part of Dr. Levine's exercise protocol for POTS.

It was something that I've heard people talk about for sometime.

But I can't find any basic research on the relationship between the core muscles and blood pressure regulation

I searched on pubmed for:

core muscles AND POTS

core muscles AND autonomic

core muscles AND blood

core muscles AND blood pressure

skeletal muscle and autonomic regulation

None of these search terms turned up anything.

Does anyone have any information on how we know that core strengthening helps the body cope with autonomic dysfunction? Thanks.

[Godsgal]

Not sure if it will answer any questions but reading the actual study by Dr. Levine is pretty interesting and explains how exercise helps. It's at potsrecovery.com on the top right for the link.

[HopeSprings]

Just guessing -- could it be the same premise as strengthening the leg muscles to help bloodflow to go upward. Maybe it has something to do with countering "sphlanic pooling." Here's something kinda sorta related. And if not, still interesting.

http://www.fitnesstipsforlife.com/stretching-in-the-morning.html

[firewatcher]

I think the emphasis on "core strengthening" comes from the need for postural stability, not blood flow. That being said, core muscles are all along the pelvic floor, spine and abdomen, so toned core muscles work more efficiently to squeeze the blood back into the tissues and bloodstream. Since most of us have orthostatic/postural issues, I'm guessing that stronger cores would allow us to be less accident prone and less prone to injury if we faint or grey-out.

I could not find any particular emphasis on core training and POTS, but definitely did for athletes and manual labor and injuries.

[Guest tearose]

Just my 2 cents...

I purchased a core strengthening book years ago. I was on the treadmill and doing the core program. I was trying to strengthen. Instead, I wound up tearing up my inner core! I needed total pelvic reconstruction, including mesh to help reattach muscles to the anterior wall of my pelvis.

I think I did not benefit but did damage. I wish I had simply kept on the treadmill and walking.

I do get splanchnic pooling and now have tons of scar tissue and looser muscles because of surgery. I want NOT to wear torso compression but it often helps relieve pain from the permanent damage and changes. I believe that as we age, gravity plus the lack of adequate blood supply to the muscles makes these cookie cutter exercise programs dangerous. We really do need to personalize our exercise plans to match our ability and challenges so as not to do harm.

[green]

Jeez! That's pretty awful! What kind of exercises were you doing?

My idea of "core strengthening" is to do planks, situps on an ab ball, pelvic thrusts, etc. I can't imagine tearing something up that way.

A sobering ancedote.

[ramakentesh]

LOL that is because it doesnt.

Increasing muscle mass in areas where there is low blood flow - such as the calf muscle in low flow POTS would improve the function of the skeletal muscle pump, but in other forms of POTS it isnt faulty and in other forms of POTS muscle mass has very little to do with blood flow regulation.

On the other hand, exercise may re-regulate the autonomic nervous system to some degree and potentially improve some of the underlying causes (theories) of POTS.

I find it amusing that at the same time that Levine and Co are suggesting that 'exercise cures POTS' research consensus from Vandy, Toledo and the NY Centre for Hypotension is demonstrating the underlying endothelial and biochemical abnormalities behind POTS that one can exercise away about as much as one can treat hypertension with a high onion diet.

[green]

>LOL that is because it doesnt.

I had previously believed that a stronger core would reduce blood pooling in the abdomen. Then I wondered if there were any published research substantiating that belief. Now I think there isn't anything to support it.

But, Ramakentesh, you seem to bring up the larger issue of whether there is adequate evidence to support any kind of exercise as a treatment for POTS.

I have posted on this forum, that I have been feeling better since using testosterone supplementation and exercising. But, it is also true that when I started testosterone, I left off of doing intensive cardio to focus on lifting weights exclusively. After 3 months of that, I added back low-intensity cardio X 3 weekly, >55 minutes.

I wonder now, if the gains I've made these past few months are due to a REDUCTION in cardio load rather than any kind of conditioning. I always crash for at least a day after I workout hard. But as long as I've had POTS, I've exercised regularly anyway. Maybe I was keeping myself in a permenant crash!

[yogini]

I haven't done my best with cardio. Other forms of exercise sitting or lying down have been much better for me. I don't think of cardio/treadmill, etc as a strenghthening exercise - cardio is to burn fat and weight bearing/resistance exercises are for strength.

I find myself squeezing my abs unconsiously - I do think it helps somewhat with my POTS symptoms. More importantly, I think it helps my circulation, energy and endurance.

I have been doing yoga for a few years and it has really helped my POTS. Exercise definitely helps some of us, though it might not help all of us. We each have to do do what works for us. The most important thing is to be very gentle.

[ramakentesh]

Dont get me wrong. Exercise helps me, but it isnt a magical cure or anything for me. I run 3-5kms three times a week, yet some days out of the blue I nearly faint, and sitting at my chair ar work and Im POTSie at the same time every day. It just means for me I dont get a rebound if I push myself like today chopping up some logs.

I think cardio exercise rather than strenghening exercises help.

[Noreen]

Yogini-

What type of yoga do you do? I tried to take a yoga class and the bending and stretching caused my HR to go into 140s. The teacher was basically freaking as I tried to explain why I was modifying some poses. It was depressing as I used to love yoga back in college.

[abetterjulie]

LOL that is because it doesnt.

Increasing muscle mass in areas where there is low blood flow - such as the calf muscle in low flow POTS would improve the function of the skeletal muscle pump, but in other forms of POTS it isnt faulty and in other forms of POTS muscle mass has very little to do with blood flow regulation.

On the other hand, exercise may re-regulate the autonomic nervous system to some degree and potentially improve some of the underlying causes (theories) of POTS.

I find it amusing that at the same time that Levine and Co are suggesting that 'exercise cures POTS' research consensus from Vandy, Toledo and the NY Centre for Hypotension is demonstrating the underlying endothelial and biochemical abnormalities behind POTS that one can exercise away about as much as one can treat hypertension with a high onion diet.

I get knots in my muscles and have a painful zone in my calves that can't be massaged because it is excruciating. I wonder if this is due to low blood flow to those muscles? I also get cramping of my legs and back with exercise, including just sitting for extended periods.

[yogini]

I do hatha/vinyasa. I started really slowly and now go to classes almost every day. If you can't swing a class, you can try doing a yoga DVD at home and skip through the hard parts. A yoga stretching DVD would be even more gentle - all sitting or lying down and no bending. The stretching part is the best part for POTS, I think!