We first stumbled upon POTS (Postural Orthostatic Tachycardia Syndrome) while exhibiting at the Combined Sections Meeting (CSM) Physical Therapy tradeshow in 2019. Ever since, we’ve done everything we can to show how cycling on Excy as a recumbent exercise bike for POTS can be a wonderful way to slowly introduce regular exercise and then gradually increase efforts over time. Our success in helping people exercise with POTS hasn’t just been about the recumbent bike position, but also pedaling lying down in a supine position on the floor or in bed.

Pedaling Excy in supine position with POTS to exercise lying down

A Link Between COVID-19 and POTS?  

Over the last two years, we’ve seen a dramatic uptick in the number of people coming to us for help to exercise with POTS. Especially young women. Most of whom are reporting that they got POTS after having COVID-19. Some researchers believe some COVID-19 “long-haulers” may actually be dealing with POTS, which affects involuntary nervous system functions, such as heart rate and blood pressure, usually upon standing from a reclining position. 

Tae Chung, M.D., a neuromuscular specialist and rehabilitation physician, and director of the Johns Hopkins POTS Program, does a great job here explaining what we know about post-COVID POTS and how to go about getting a diagnosis. 

Regular Exercise is the Cornerstone of Treatment for POTS 

One of the first things people who get a POTS diagnosis will be prescribed is exercise. This can almost feel like a sick joke. Sometimes the systems created by POTS can worsen with exercise, especially in the beginning. But research shows that exercise is a critical component to the treatment plan for POTS.  

Over the last few years, we’ve learned that everyone has a different starting point and there is no cookie cutter approach with POTS. Some people are bedridden. Others are unable to walk. Others can perform daily tasks. There are also different levels of exercise intolerance from minor to severe. A consistent theme across the board is to start slowly with a plan to make incremental progress over many weeks and months. Children’s Hospital of Philadelphia has great instructions for starting a POTS exercise program that is also great for adults.  

The POTS Exercise Prescription 

Using a recumbent exercise bike for POTS at the beginning of getting the diagnosis is a known critical strategy, allowing patients to exercise in a horizontal position while avoiding the upright posture that elicits their POTS symptoms.  

Recumbent exercise bike for POTS chair cycling

What we’ve heard from our customers is that in addition to pedaling Excy as a recumbent exercise bike for POTS, most prefer to start with our most horizontal mode of training which is to exercise while lying down. Then, they move to the recumbent bike position and alter as needed.

And while everyone is naturally allowed to do whatever exercise works for them, we wanted to share a few of the top tips we’ve learned from years of having our customers use Excy as recumbent exercise bike for POTS on a near daily basis, but also how to do more with Excy as a horizontal exercise machine. 

Take the following tips to heart to make the most of your ability to use Excy to exercise with POTS. Always talk to your doctor about how to get started (duration, frequency, and intensity).  

Supine leg pedal exercises for POTS

Calf Pumps: Press into the pedal as far as you are able by pointing and flexing toes to pump the calf muscle.

Excy Lying Down Exercises for Leg Lymphedema calf pump as alternative to recumbent exercise bike for POTS

Ankle Pumps: Leave one foot on the pedal. Pull your free foot up toward the ceiling as far as possible. Point and flex your ankle as if pushing down or letting up on a gas pedal in a car.

Excy Lying Down Exercises for Leg Lymphedema Ankle Pumps

Ankle Circles: Leave one foot on the pedal. Move your free ankle clockwise, making as large of a circle as possible. Repeat in counterclockwise direction.

Excy Lying Down Exercises for Leg Lymphedema Ankle Circles

Pedal March: Remove one foot from pedal and pull to chest (one leg off the pedal). Bring your knee up toward your chest as far as possible, then back down.

Excy Lying Down Exercises for Leg Lymphedema Pedal March

Bridge Reps with Legs on Pedals: Raise your pelvis off the floor while engaging your core with your feet on the pedals. Your back should be straight, and your knees should be in line with your shoulders.

Excy Lying Down Exercises for Leg Lymphedema Bridge Exercise

Hip abduction holds. Leave one foot on the pedal. Lying on your back, slide your leg out to the side, then back in. Keep your knee straight and toes pointing straight up.

Excy Lying Down Exercises for Leg Lymphedema Hip Abduction Holds

Back and Forth Leg Press: From the horizontal supine position, press legs back and forth with light resistance that can be increased over time. Increase resistance over time for strength training.

Excy Lying Down Exercises for Leg Lymphedema back and forth press

Cycling Forwards: Pedal legs forwards with light resistance. Gradually increase duration and resistance over time.

Excy Lying Down Exercises for Leg Lymphedema pedal forwards

Cycling Backwards: Pedal legs backwards with light resistance. Gradually increase duration over time.

Excy Lying Down Exercises for Leg Lymphedema Pedal Backwards

Recumbent exercise bike for POTS

Stationary Recumbent Chair Cycling Lie Back to Get More Horizontal

Semi-Recumbent Bike for POTS from a Comfortable Chair

Sitting Upright Cycling in Bed and Watch TV

Hand Cycling and Rowing Exercise Machine for POTS

Hand Ergometer While Sitting in Bed or on the Floor

Rowing Exercise with Excy Upper Body Ergometer

Don’t forget, you can use our mobile coaching app to keep track of results and for coaching.

Excy Mobile Coach HIIT Application for interval training and physical therapy

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