Feeling dizzy, exhausted, or lightheaded when standing up isn’t something teens and young adults should have to “push through.” If these symptoms are interfering with school, sports, work, or daily activities, they may be related to Postural Orthostatic Tachycardia Syndrome (POTS).
POTS is increasingly recognized in adolescents and young adults, particularly during periods of growth, recovery from illness or injury, or increased physical and academic demands.
What Is POTS?
POTS is a condition that affects the autonomic nervous system, which controls automatic body functions such as heart rate, blood pressure, digestion, temperature regulation, sleep, and mood.
Normally, when you move from lying down or sitting to standing, your autonomic nervous system smoothly adjusts heart rate and blood flow to keep you stable. With POTS, this regulation does not occur efficiently. As contribute, heart rate increases more than normal during postural changes, often leading to uncomfortable or limiting symptoms.
A key diagnostic feature of POTS is an excessive or abnormal increase in heart rate when moving into an upright position, especially during standing.
Why the Autonomic Nervous System Matters
The autonomic nervous system helps the body stay balanced in response to everyday demands — physical, emotional, and environmental. It regulates:
- Heart rate and blood pressure
- “Fight or flight” and “rest and digest” responses
- Digestion and energy regulation
- Temperature control
- Sleep and mood
When this system is dysregulated, multiple body systems can be affected at the same time, which is why symptoms of POTS can feel widespread, frustrating, and unpredictable.
What Causes POTS?
The exact cause of POTS is not fully understood and likely varies from person to person. Common triggers and contributing factors may include:
- Significant illness or viral infection
- Concussion or other physical trauma
- Surgery
- Periods of rapid growth or hormonal change
POTS is most commonly diagnosed in adolescents and young women and is frequently seen alongside hypermobility conditions, such as Ehlers-Danlos Syndrome (EDS).
Common Symptoms of POTS
Symptoms can vary in severity and may fluctuate from day to day. Teens and young adults with POTS may experience:
- Dizziness or lightheadedness when standing
- Fainting or near-fainting episodes
- Fatigue that limits school, work, or sports participation
- Difficulty concentrating or “brain fog”
- Heart palpitations or a racing heart
- Shakiness, sweating, or feeling anxious
- Shortness of breath or chest discomfort
- Headaches or migraines
- Nausea, bloating, or poor digestion
- Changes in skin color, including pale skin or purplish discoloration of the hands and feet when below heart level
- Mood changes related to physical stress and fatigue
When Symptoms Tend to Worsen
Many individuals notice increased symptoms in certain situations, including:
- Hot environments or warm weather
- Hot showers or baths
- Prolonged standing (school hallways, assemblies, waiting in line, shopping)
- Strenuous or poorly graded exercise
- Illness or infection
- Menstruation
How Physical Therapy Can Help
Physical therapy is an important part of managing POTS, especially for teens and young adults who want to return to school, sports, exercise, and independent daily activities safely.
At Skills on the Hill, physical therapy focuses on:
- Identifying exercise and movement strategies that support symptoms rather than worsen them
- Modifying activities to improve tolerance and reduce flare-ups
- Helping you understand how to safely start, pace, and progress physical activity
- Teaching strategies to manage upright tolerance, endurance, and recovery
- Supporting confidence and independence in managing symptoms
Therapy also includes the development of a personalized home exercise program, so skills learned in therapy can be applied at school, work, the gym, or home.
We’re Here to Help
If symptoms of dizziness, fatigue, or exercise intolerance are limiting participation in daily life, a physical therapy evaluation may help clarify next steps.
Skills on the Hill provides physical therapy services in Washington, DC and Arlington, VA for older children, adolescents, and young adults.
Call today to schedule an evaluation and learn how physical therapy can support you in managing POTS and returning to the activities that matter most.
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