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Physical Therapy Effecting Pots

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A few months ago, my dr had me start physical therapy for the shoulder and neck pain i've been having (which she thinks that's from fibromyaglia). My Pt gave me simple stretches to do, like turning my neck to side to side...other things like that. Well to make a long story short, i can't do any of them without being extremely dizzy to the point that i feel like i'm going to pass out. So i told my Pt that and we tried to do the exercises laying down....but i still get dizzy. So we have stopped most of the excerises. there are still a few that i can do without being dizzy.

So at my last appointment with my cardiologist, i mentioned all this to him. And he wanted me to get a carotid ultrasound done...which i had done and that came back ok. He said that the physical therapy shouldn't be having that kind of effect on me. He's not sure why my Pots symptoms have been worse, and is still concerned. So i don't know where we're going to go from here.

Has anyone else had problems with physical therapy cause of their POTS??

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When I was in rehab I was fainting every day after 5 minutes of PT. The doctor and therapist were frustrated with me because I was suppose to get 30 minutes of PT but after syncope I needed 3 hours to recuperate so I was off for the day.

So for them my progress were slow but for me it was worth it. They could never know when I would faint. Once I fainted after 15 second of PT so there were really really upset.

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Hi Becca,

I, personally, think that PT is great. I'm feeling super guilty that I haven't kept up my exercises this summer, but they're easy to forget! Some days I went in and could do almost nothing, and those were the days for a massage, TENS, or compresses. If that's not an option, doing what you can while laying down might be all you can do. Obviously you don't want to pass out, but if you can push yourself a little without actually passing out, I think that the effort in exercise might be good in the long run.

Exercise intolerance is pretty common with POTS, so I don't really see why your cardio was so surprised by this. Just out of curiosity, have you tried swimming? A lot of us, myself included, feel relatively great in the water (you know- practically gravity-free!), and if there are exercises you can do in the water that might be a good bet.

I know it's frustrating, but I hope it works out for you!!

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What you are experiencing is EXACTLY what happened to me with PT. When you had your PT evaluation did the movements of turning your neck cause dizziness or lightheadedness? After my exam I felt as if I had just had a TTT done again, and regardless of how carefully we did the PT (and we tried doing simple manual therapy--no stretches on my own--a thing called neural tensions) I would become so sick we could not continue after three months of no progress.

I have rambled on and on about this topic probably already, so if you do a search for DancingLight and neural tensions or manual therapy or cervical stenosis you will find my ramblings.

Basically, movement restrictions (did you demonstrate these in your PT eval?) can be a result of the nerves being tight/not sliding easily in the spinal column and can actually cause or complicate POTS symptoms. Using manual PT in the form of neural tensions, myofascial release, and craniosacral therapy can potentially help allow the nerves to slide and move again and reduce POTS symptoms.

You may want to have an MRI of your cervical spine to see if you have compression or a narrow spinal column that could be causing you to have less 'give' in your neck than a 'normal' person.

My comments are based on findings by a well-respected ANS specialist in the country.



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hi becca,

i stopped doing pt as it actually made me worse. i've been trying for about 2 years as i was VERY determined to get well again, but at some point my pt wanted me to stop (which i had been wanting long before) because i could do less and less instead of slowly more and it was unsafe for me to go home afterwards (as it was too much for me to go there driving my scooter)

whenever i feel up to it i do very light exercises while in bed, but only one thing at a time. i feel i have to do that. my pt told me that my daily moving around the house (although limited) is enough for me at this moment (for about 2 years now i think).

corina :lol:

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What do you mean by "dizziness"? Is it a sensation of "things spinning around you"? Do you feel like you are are "sea-sick" or like you are on an "amusement park ride"? Or is it a sensation of lightheadedness, like you're going to pass out?

Do you easily get car-sick? Do you have migraines? Do you sometimes get "dizzy" when you turn in bed?

Lots of questions, I know, but what you describe may in fact be caused by Benign Positional Vertigo (BPPV), which incudes feeling vertigo precipiated by various positions of the head. Even if you don't have BPPV, you may have a dysfunction of the vesitubular system, which is quite common in patients with autonomic disorders. Ask your doctor to refer you to ENT - they can check you for BPPV and other vestibular conditions.

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thanks for all the responses....

doctorguest... the dizziness that i've been having has been like the kind i get when i'm having a syncope episode. I get really light headed and start seeing those sparkly things ( aka stars). It's not like motion sickness and the room doesn't feel like it's spinning. I do have chronic migraines, and actually have had one everyone day so far this week. I'll probably be seeing my cardiologist again within the next few weeks.

emily.... i've already had one of those mri's and it came back normal.

I had therapy yesterday and will have it again tomorrow. All we've been able to do is the heat ultrasound to loosen my muscles up, and then she gives me a deep tissue massage, and then she puts a heat pack on my shoulder/neck. On the days that i not dizzy, which are few, she helps me do a simple stretch. So for the most part we've haven't been able to do much, and have had to take it really slow. I do think that it will eventually help in the end, and will be worth it, but right now it's pretty frustrating.

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Does anyone have therapy in your home?I am not able to go to PT.I am going to ask my Dr.to give me an Rx for home PT.I don't know if he will or that I can even do it, but I would should like to try. Good luck to everyone on getting what you need. Pat

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