Living with Postural Orthostatic Tachycardia Syndrome (POTS) can feel like navigating a puzzle where every piece—heart rate, blood flow, fatigue, dizziness—impacts the others. One piece many people don’t talk about enough? Sore muscles. Whether it’s after light activity, standing too long, or seemingly out of nowhere, muscle soreness with POTS is real, frustrating, and often misunderstood.
So what’s the deal?
Why Are My Muscles Always Sore with POTS?
- Poor Circulation: One of the main issues in POTS is dysregulated blood flow. When blood pools in the lower body and doesn’t return to the heart and brain efficiently, your muscles can be left starved of oxygen and nutrients. That can lead to cramping, burning, and soreness—especially after standing or walking.
- Deconditioning: Many people with POTS go through periods of inactivity (either before diagnosis or during flares), and unfortunately, muscle strength and endurance decline fast. When you try to resume activity—even gentle stretches or short walks—your muscles may feel like you just ran a marathon.
- Lactic Acid Build-Up: Poor blood return means that waste products like lactic acid aren’t cleared as quickly, which can cause that deep, aching burn even after mild exertion.
- Hypermobile Joints & EDS: Many people with POTS also have Ehlers-Danlos Syndrome (EDS) or other hypermobility conditions. These can cause instability in joints, making muscles overcompensate to keep everything in place, leading to fatigue and pain.
What Helps?
While sore muscles can feel defeating, the good news is: you’re not powerless. Make sure to always talk with your doctor before adding anything new to your routine! Here are a few tips that many people with POTS find helpful:
- Compression Gear: Wearing compression leggings or socks can help support circulation, reduce pooling, and ease muscle fatigue—especially during or after activity.
- Hydration & Salt: Don’t underestimate the power of fluids and electrolytes. Staying well-hydrated helps support blood volume and circulation, which can directly reduce soreness.
- Gentle Movement (Not Full Rest): It’s tempting to rest completely when you’re sore—but gentle, consistent movement** (think: stretching, slow walking, recumbent biking) can actually improve circulation and reduce soreness over time.
- Magnesium & Epsom Salt Baths: Magnesium supports muscle relaxation and recovery. Topical magnesium or Epsom salt baths are great tools to ease tightness and soreness.
- Physical Therapy: If possible, working with a PT familiar with POTS can make a huge difference. They can help you build muscle without pushing into a crash.
Living with POTS often means your “limits” can change daily. Some days your body can handle more, and some days even standing up feels like too much. Sore muscles don’t always mean you’re doing something wrong—but they are a signal to slow down, hydrate, and give your body extra care.
Sore muscles might seem minor to outsiders, but in the world of POTS, they can be another layer of a tough, invisible battle. Be kind to yourself. Honor your limits. And remember, building strength and stability takes time—but every small effort matters.
