What We Treat

POTS treatment in North Liberty.

Standing up sets your heart racing. A shower costs you the afternoon. You have been told your labs look fine. POTS is real, it is manageable, and our POTS Management Program starts by finding your actual limits instead of guessing at them.

Racing heart on standing Post-exertion crashes Brain fog Book My Free Consult

Sound Familiar?

Does this sound like you?

  • Your heart pounds or races within minutes of standing up
  • Lightheadedness, greying vision or near-fainting when you get upright
  • A crash the day after you did something completely ordinary
  • Showers, heat and standing in line are harder than exercise used to be
  • Brain fog, flattening fatigue, and a body temperature that never settles
  • Being told your labs are fine and it’s probably anxiety

Two or more? Keep reading.

Why It Happens

This is your autonomic nervous system, not your effort.

Your autonomic nervous system runs everything that is supposed to happen automatically: heart rate, blood pressure, digestion, temperature, breathing. In POTS, that system handles the switch to standing badly. Your heart rate climbs to compensate, and everything else pays for it. Deconditioning, low blood volume, hypermobile connective tissue and mast cell activity can all be part of the picture. None of it means you are not trying hard enough.

POTS also travels in company. Ehlers-Danlos syndrome and mast cell activation syndrome show up alongside it often enough that we look for the pattern, and we treat all three here. The usual advice cuts both ways too: push through it and you trigger crashes, rest completely and your tolerance shrinks further. That is the trap this program is built to get you out of.

You have already read the research, tried the salt and the compression, and been handed a generic exercise sheet that put you in bed for two days. That is exactly the kind of patient who does well here. Natalie Johnston, MPT, is a Fellow in Pain Sciences and leads the complex and chronic side of this clinic, which is why POTS sits here rather than in a general exercise class. POTS is a chronic condition, and we are not going to tell you it disappears. What changes is how much upright time you can tolerate, how often you crash, and how well you can read your own limits before you blow past them. It starts with a cause-first evaluation, one-on-one with a licensed physical therapist, and a graded plan you can actually follow.

A teenager and a younger child stretching together on a mat

The Honest Truth

Waiting doesn’t make it wait on you.

If you keep waiting

  • The rest of your body starts compensating, and the compensations start hurting too
  • Flare-ups get closer together, and take longer to settle each time
  • You move less to avoid the pain, which weakens the exact things that were protecting you

If you start this week

  • Visit one is a cause-first evaluation, and you leave knowing what we found
  • Hands-on treatment starts the same day, not after a second appointment
  • You get a plan with an endpoint: a real one, not an open tab of visits

Nobody regrets starting too early. Plenty of people tell us they wish they had come in sooner.

How We Manage It

The same four phases. Paced by your tolerance.

This is management, not a countdown. Each phase opens when the one below it is holding.

Phase 1

Pain

Stop the crash cycle.

We map your triggers and set a floor you can hold on a bad day, so the week stops being all boom and bust. Symptom relief and pacing start your very first visit.

Phase 2

Prime

Start where gravity isn’t the enemy.

Recumbent and horizontal work first: rowing, recumbent biking, swimming and strength work, plus breath and leg pump strategies you can use standing in a line.

Phase 3

Perform

Earn your upright time.

Upright cardio and leg strength get added in graded steps, elliptical and treadmill work included, and only once the level below it is holding steady.

Phase 4

Prevent

Run your own program.

You leave able to read your own signals, dose your own week, and get back on track after a flare instead of losing a season to it. That’s the endpoint of the program.

Natalie and the team at Motion Matters provide a unique person focused care that integrates not only traditional physical therapy treatments but care for the whole body. You need to check this place out!!

T Sachse · on the clinic’s approach · Google review

Phase one: stop the boom and bust weeks

Phase four: upright time you can plan around, and a flare plan you run yourself

POTS Management Program Pain to Prevent

Related Conditions

POTS usually brings company.

These three overlap often enough that we look for the pattern. We treat all of them here.

1

Ehlers-Danlos Syndrome

Joints that move too far, and a body that never feels stable.

Learn More 2

Mast Cell Activation Syndrome

Reactions to foods, heat and stress that keep moving the goalposts.

Learn More 3

Chronic Pain

Pain that has outlasted every explanation you have been given.

Learn More

Questions, Answered

What people ask before booking for POTS.

It can, if the dose is wrong, which is often what happened the last time somebody handed you a generic exercise sheet. That is why this program starts recumbent and horizontal: rowing, recumbent biking, swimming and strength work, where gravity is not fighting you. Upright work gets added only once the level below it is holding. The point is to find the dose your system accepts and build from there, not to push you through a crash.

No, and we are not going to pretend otherwise. POTS is a chronic condition, which is why this is a management program. What a graded plan changes is how much upright time you can tolerate, how often you crash, and how well you can read your own limits before you hit them. The plan still runs through the same four phases, Pain, Prime, Perform, and Prevent, and Prevent is the phase where you take it over and run your own week.

Yes, and it should. Hypermobile joints change which exercises are safe and how much end-range load your tissue tolerates. Mast cell activity changes how heat, effort and certain triggers land. We treat Ehlers-Danlos syndrome and mast cell activation syndrome here as well, so the plan gets built around all of it instead of one label at a time. Natalie Johnston, MPT, is a Fellow in Pain Sciences, and overlapping conditions like these are the work she does.

Book Your Visit

Ready when you are.

Request a time and a real person calls you back. No phone tree. No ‘someone will reach out.’ Just a plan.

  • Hours Mon-Fri: 8:00 am - 5:00 pm
  • (319) 382-2743 Prefer to talk now? Call us.
  • No referral needed in Iowa

4.9 · 79 Google reviews

Typical response: under 2 business hours

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So we know who to look for when you walk in.

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Motion Matters Physical Therapy and Wellness

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