POTS Syndrome and Massage Therapy

When Your Nervous System Feels Like a Rebel

Understanding POTS and How Massage Can Help You Reclaim Balance

At Rebel Wellness, we believe healing is a sacred rebellion. When your body starts to whisper or shout that something feels off, it is not betraying you. It is trying to communicate. Postural Orthostatic Tachycardia Syndrome, also known as POTS, is one of those conditions where the body’s signals can feel confusing, unpredictable, and exhausting.

Let’s talk about what POTS actually is, how massage can support your body and nervous system, and what to look for when choosing a massage therapist who truly understands this condition.

What is POTS?

POTS stands for Postural Orthostatic Tachycardia Syndrome. It is a form of dysautonomia, which means the part of your nervous system that controls things like heart rate, blood pressure, and circulation has trouble regulating itself.

When someone with POTS stands up, their heart rate may suddenly jump by 30 beats per minute or more. That can cause dizziness, lightheadedness, fatigue, nausea, and sometimes fainting. Many people also experience brain fog, shortness of breath, and that heavy, tired feeling in the neck and shoulders often called the “coat hanger sign.”

In simple terms, the body is working overtime to do what it should be able to do automatically. This creates constant stress on the nervous system.

Common triggers include standing for long periods, dehydration, heat, and illness. Most treatments focus on lifestyle support such as hydration, increased salt intake, compression garments, and gentle physical conditioning. But there is growing evidence that massage therapy can help support the nervous system and ease the physical tension that comes with POTS.

References:

• National Institutes of Health

• Cornerstone Physio

• Standing Up to POTS

How Massage Can Support People Living with POTS

Massage can be a valuable addition to a POTS management plan when done by a therapist who understands the condition. Here is how it can help:

1. Improves CirculationMassage helps move stagnant blood and lymphatic fluid through the body. Because many people with POTS experience blood pooling in the legs, gentle techniques that promote circulation can help the heart and vessels work more efficiently.

2. Calms the Nervous SystemMassage activates the parasympathetic nervous system, also known as the “rest and digest” response. This can help counter the overactive “fight or flight” response that many people with POTS experience. Studies show that regular massage can lower stress hormones and improve heart rate variability, which is a key marker of nervous system balance.

3. Reduces Muscle Tension and PainThe body compensates when the nervous system is under strain. People with POTS often develop tightness in the shoulders, neck, and back from muscle fatigue and poor circulation. Massage helps release that tension, allowing for more mobility and less pain.

4. Encourages Body Awareness and SafetyA trauma-informed massage therapist helps you rebuild trust in your body. They create an environment where you can feel safe, grounded, and present. That is powerful for anyone living with chronic illness or nervous system dysregulation.

Important note: Massage is not a cure for POTS. It is a supportive therapy that can make life more comfortable and help you connect more deeply with your body’s needs.

References:

• Tri-Motion Rehab

• PubMed Central Study on Massage and Stress Hormones

• Elite Myotherapy Australia

What to Look for in a Massage Therapist if You Have POTS

Not every therapist is trained to work with this condition. Here is what you should look for when choosing a massage professional:

Licensing and ExperienceFind a licensed massage therapist (LMT) who has experience with chronic illness, dysautonomia, or trauma-informed care. They should be familiar with the circulatory and nervous system considerations that come with POTS.

Clear CommunicationDuring your intake, your therapist should ask about your symptoms, heart rate changes, medications, hydration, and overall triggers. They should listen without judgment and encourage you to share what feels safe and comfortable.

Proper Positioning and SafetyBecause standing up too quickly can trigger symptoms, your therapist should allow you time to rest before getting off the table. They may also keep the table slightly inclined, elevate your legs, or avoid using too much heat during the session.

Gentle and Grounded TechniquesThe best approach for POTS clients is often gentle, slow, and rhythmic. Lymphatic drainage, Swedish techniques, myofascial release, and craniosacral work can all support nervous system regulation. Deep tissue massage may not be ideal unless you know your body tolerates it well.

Aftercare SupportA professional therapist will provide self-care guidance. They may suggest breathing techniques, hydration, compression, or light movement after the session. They will also remind you to take your time before standing up and moving around.

Tips for Your Massage Day

• Drink water and have a salty snack about 30 minutes before your session.

• Avoid caffeine or alcohol beforehand since they can affect circulation.

• Wear comfortable clothes and bring water for after your massage.

• Take your time when standing up at the end of the session. Sit for a moment first, then rise slowly.

• Let your therapist know right away if you feel lightheaded or overheated.

Final Thoughts

Your body is not broken. It is communicating in the only way it knows how. Living with POTS can feel frustrating, but it is also an invitation to slow down, listen, and rebuild a partnership with your nervous system.

Massage therapy can be one way to support that healing. When you work with a therapist who understands your condition, you are not just getting bodywork. You are creating space for your body to feel safe, supported, and seen.

At Rebel Wellness, we believe that is where real healing begins.