Treadmill Versus Exercise Bike

[Lethargic Smiles]

So, the conventional POTS wisdom I've always heard from specialists (and other patients) is to start out on a recumbent bike and work up to upright exercise, the reason being is the more supine the patient is, the less symptomatic s/he will become during exercise and the less stress on the body. I'd like your thoughts on this suggestion I've been given...

I recently saw an EDS specialist. He makes no claims to be a POTS specialist, however he does encounter lots of POTS patients, was up in the latest research, and sees many patients who have various issues with exercise.

I was surprised when he suggested (in addition to physical therapy for EDS issues) perhaps the bike is too difficult right now and I should start with walking. Upon his request for me to elaborate when I said that was different than what I had been told before, I explained the conventional wisdom of the recumbent bike. I wasn't challenging him, I just wanted to understand his recommendation, He still stood by his original recommendation saying 5 minutes of walking is easier on the body than 5 minutes of recumbent biking. He stated the body will pump blood back up if it is moving, although not like it should at first. He also talked about counter maneuvers and such, so I know he understands blood pooling.

I have thought about this quite a bit. On a really good day, I can walk around a store (sort of leaning on the cart) for about ten minutes, usually with spells of dizziness throughout, before I need to squat, sit, or lay. If on a similar sort of day, instead of going to a store, I decided to do my bike, I'd struggle to do 6 minutes on resistance level 1 out of 8. I think the bike is probably less stressful overall in my body and may build more muscle than walking which is important for blood pooling. Still, what's a more natural exercise than walking?

It has been drilled into my head to exercise with my body as parallel to the floor as possible. The thought that walking may be a better option because I can get in more exercise time and recumbent biking is more difficult than walking is new to me. I thought I'd just see what everyone here thinks about this and/or has experienced.

[MightyMouse]

I was told that a recumbent bike was a better choice for me by my ep cardiologist (not a POTS specialist). His reasoning was that in the seated position, my body is "more compact" and that it's not as hard for my bp and hr to stay in an appropriate range. The second reason was that if I did happen to pass out, I'd be seated, and already close to the floor, limiting my chances of a serious injury

[lynnie22]

I've been told to start on the recumbent bike and work myself up to 30 minutes of aerobic walking! Right now after several weeks, I'm up to 12 minutes on the bike alternating between level 2-3. I also try to walk 5-10 minutes which I find very trying because I get dizzy and my HR can go up a lot. Still I started out at 5 minutes on the bike at level 2, and walking, very difficult.

My own personal experience is that the walking, simply by being upright, is very tiring, unless, as you say, I am leaning on something. However, walking is preferable to standing, but I think the bike is a better beginning, at least it doesn't create as much of a problem, although later in the day my bp does go down somewhat and my HR up for the day.

My doctor also told me to do resistance exercises for my legs to build up the muscle. This I can only do a little of, only because it causes real muscle fatigue.

[Chaos]

I was told by my POTS specialist (neuro) that walking was a good exercise. My cardiologist (somewhat aware of POTS) recommends the recumbent bike etc. for the reasons that Might Mouse stated and because that's what most of the research says.

Playing "devil's advocate" however, if you want to train the body for a functional skill, you need to do the activity you want the body to do. What you do in one position doesn't automatically transfer that ability to another position, e.g. doing exercises for a back injury in a lying down position doesn't teach you how to protect your back from injury when you are standing up at work. Using that same theory then, exercising in a compact position close to the floor doesn't necessarily mean that your increased cardiovascular tone will transfer over to being helpful in an upright position. That would be the theory at least when a normal autonomic nervous system is in play.

If you have a risk of fainting, I'd definitely stay close to the ground. I have never fainted and a recumbent bike hurt my knees so I chose to do a treadmill along with other upright activities when I did a cardiac rehab program.

[corina]

I find walking easier than biking as my hr shoots up while biking (exercise bike). I'm currently just back to work with my PT on what I call training. It means that I'm on a regular exercise bike for 10 minutes then we do a few ground exercizes and then I'm on the treadmill. I need about an hour and a quarter to finish this program. I've found that the treadmill def helps with muscle building in my legs, they already feel stronger. My hr is lower while walking which for me is more comfortable. We are all so different, which makes me think that you need to do what seems best for you! Good luck!!!

[yogini]

I don't believe the suggested protocols fit everyone. Any exercise with POTS can be challenging. I pushed myself to do a bike for many months several years back and try it every now and then. The bike does help, but it was not a miraculous cure for me. It is better for losing weight, but I've found the side effects and flare ups really painful. My main exercise has been yoga for the past several years, which is a much better fit for me.

[gjensen]

I want to do both.

I want to be able to walk the property to do this and that. It is a quarter mile across it and back. With the in between, I can get a half mile. I want to do a routine in the morning and evening.

I have not purchased one yet, but I intend to get the bike. I want to do it every couple days. I have lost muscle, and I want to get some back. I am figuring the resistance on the bike would help me there.

First, I want to get the first routine I mentioned accomplished.

I had gotten down to 158 and 6'2". I intended to put some weight back on, before I pushed anything, and I have. I am back to 173. New goal is 180, then 185. I was 190, but 185 would be close enough. I fluctuated according to the season anyways.

A summary is that the walking (feeding and watering my birds and orchard/gardens ) would be a partial return to some activity. That would give me a mile per day. Then the bike would help me get some muscle back, which I think that I need more than anything.

If I am so fortunate to get that far, I want to be able to do some mild weight lifting. I am thinking that I can get where I can handle most of these things if I am smart about it. I am sure that I will have setbacks, but I have to have a picture in my head.

[khaarina]

I just bought a recumbant exersize bike a few weeks ago and I am dissappointed to find that walking and using the bike are equally difficult for me. I really thought the bike would be easier but my hr shoots up within a minute of riding and I am out of breath and unable to continue after about 3 or 4. And this is on the easiest setting, pedaling slowly. I think I still prefer the bike to walking though because I feel that it is a slightly better workout for my legs in the amount of time I can walk, which is only a few minutes as well. Unfotunately I can't tell you what my docs think because they always blow me off when I bring up exersize. My primary says to ask my cardio and my cardio says to just do what I can. I think they are afraid they will be liable if I push too hard and something bad happens. I am only 32 and was fairly active 3 years ago, before I got sick, so being unable to workout for more than a couple of minutes a day is incredibly frustrating. I am going to keep at it though, for the sake of strengthening my legs, or as my cardio calls them, my second hearbeat.

[Confusedguy]

I'm at the gym 6 days a week. I switch each day and rotate my cardio between the bike, elliptical and treadmill. I do not notice any difference in my symptoms between them. The treadmill wears me out the most but most likely because I try to go too fast.

[Lethargic Smiles]

Thanks for your input everyone. It's been a year and a half of making progress with the bike, having a setback, starting all over again.. maybe I will give walking a shot.

[IceLizard]

My TerraTrike recumbent trike is my main mode of transportation since I am not safe to drive. Even if I am wobbly when upright and walking, I can lay back and pedal easily. If I don't push myself too hard I usually feel much better after riding.