Postural Orthostatic Tachycardia Syndrome (POTS) Support in Perth (Malaga & Noranda)

Individualised rehabilitation for dizziness, fatigue and reduced upright tolerance

Postural Orthostatic Tachycardia Syndrome (POTS) can cause dizziness, rapid heart rate, fatigue, “brain fog,” and reduced tolerance to standing. Symptoms can fluctuate and often impact work, school, and everyday life. At Palms Physiotherapy & Allied Health, we provide evidence-informed, symptom-aware rehabilitation to support function, build physical tolerance safely, and improve day-to-day participation—working alongside your GP/specialist team.

What is POTS?

POTS is a form of dysautonomia (autonomic nervous system dysfunction). It is commonly characterised by an excessive increase in heart rate on standing (or during upright posture) along with symptoms of orthostatic intolerance (feeling unwell when upright). POTS can affect teenagers and adults and may occur on its own or alongside other health conditions.

Important: Diagnosis and medical management of POTS should be overseen by your GP and/or specialist team. Allied health support focuses on functional rehabilitation, symptom-aware exercise, pacing, and daily living strategies.

Common symptoms of POTS

POTS can present differently between individuals. Symptoms may include:

• Rapid heart rate on standing

• Dizziness, light-headedness or feeling faint

• Fatigue and reduced stamina

• “Brain fog” or difficulty concentrating

• Exercise intolerance or symptom flare after exertion

• Shortness of breath, nausea, shakiness, or chest discomfort (in some people)

• Temperature sensitivity and sweating changes (in some people)

If you have chest pain, fainting, severe shortness of breath, or rapidly worsening symptoms, seek prompt medical review.

How Palms can help

POTS management often requires a careful balance: building physical capacity without triggering symptom flare-ups. Our approach is:

• Symptom-aware (we work within your tolerance)

• Graded (small steps, consistent progress)

• Function-focused (what you need for real life)

• Collaborative (with your medical team where appropriate and with consent)

We do not promise a cure. Our goal is to support improved function and quality of life.

Physiotherapy for POTS (upright tolerance and movement confidence)

Physiotherapy may help by targeting:

• Postural control and movement efficiency

• Gentle reconditioning and mobility where appropriate

• Symptom-aware progression of standing and functional tasks

• Education on pacing, recovery, and flare planning

For some people, therapy may begin with low-symptom positions (e.g., seated or supported activities) and progress gradually as tolerance improves.

Exercise Physiology for POTS (structured, graded reconditioning)

Exercise physiology is often central to POTS rehabilitation because it supports:

• Carefully graded cardiovascular and strength training

• Building tolerance without “boom–bust” cycles

• Structured progression and monitoring over time

What an EP program may include

• Starting with recumbent or low-upright exercises where needed (e.g., bike/rower-style positions when available)

• Strength training focused on large muscle groups (especially lower body) to support circulation and function

• Gradual progression of volume and intensity based on symptom response

• Education on recovery, hydration routines, and safe exercise pacing

Exercise programming is always tailored to your symptoms, medical advice, and current capacity.

Occupational Therapy for POTS (daily living and energy management)

Occupational therapy can help people manage the day-to-day impacts of POTS, including fatigue, cognitive load, and routines.

OT may support:

• Energy conservation and pacing for home, work and school tasks

• Activity planning to reduce symptom flares (prioritising, task chunking, rest breaks)

• Routines and strategies for mornings, showering, meal prep, and community access

• Environmental modifications or equipment suggestions where clinically indicated

• Communication and planning strategies for study/work demands

Lifestyle strategies (medical guidance required)

Many people with POTS are advised by their medical team about strategies such as hydration, salt intake and compression garments. We can reinforce practical implementation strategies in line with your GP/specialist guidance, but we do not prescribe medical nutrition changes or medications.

Always follow your doctor’s advice for:

• Salt/fluid targets

• Compression garment use

• Medication management

Psychological wellbeing and support pathways

Living with POTS can be stressful and isolating. While Palms is an allied health clinic (not a psychology service), we can:

• Support practical coping strategies around pacing, routines, and uncertainty

• Recommend referral pathways (psychology/counselling) if anxiety or low mood is significantly impacting wellbeing

• Encourage coordinated care with your GP/specialist team

Family support and education

Family and carers often play a key role in supporting pacing and daily routines. We can provide:

• Education around symptom variability and why “pushing through” can backfire

• Practical routine strategies to reduce crashes

• Communication tools to support safe independence and participation

When to seek urgent medical review

Seek urgent medical attention if you experience:

• Chest pain, fainting, severe shortness of breath

• New severe or worsening neurological symptoms

• Persistent vomiting, inability to keep fluids down, or signs of dehydration

• Rapid unexplained deterioration

Our Mobile Therapy Services

Please visit these other websites for further information:

POTS Australia – An organisation dedicated to raising awareness and providing resources for individuals with POTS.

• https://www.potsaustralia.org

Dysautonomia Australia – Offers information and support for individuals with dysautonomia, including POTS.

• https://www.dysautonomia.org.au

The Australian Heart Foundation – Provides resources on heart health and conditions related to dysautonomia.

• https://www.heartfoundation.org.au

Chronic Fatigue Syndrome and Dysautonomia Support – Offers resources for managing chronic fatigue and related conditions.

• https://www.cfs.org.au

The Royal Australian College of General Practitioners – Information on diagnosing and managing POTS.

• https://www.racgp.org.au

Healthdirect Australia – General information about POTS and its symptoms.

• https://www.healthdirect.gov.au

The Butterfly Foundation – Mental health resources for individuals dealing with chronic conditions.

• https://butterfly.org.au

Exercise and Sports Science Australia (ESSA) – Provides guidelines and resources for exercise interventions for various health conditions.

• https://www.essa.org.au

Rare Voices Australia – Advocates for people living with rare diseases, including POTS and related conditions.

• https://www.rarevoices.org.au

Australian Psychological Society (APS) – Offers information on mental health support for individuals with chronic health conditions.

• https://www.psychology.org.au

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.