Zebras | Postural Orthostatic Tachycardia Syndrome Treatment | Melbourne2019-06-16T03:20:41+00:00

Project Description



Postural Orthostatic Tachycardia Syndrome (POTS), hyperadrenergic POTS, Orthostatic Intolerance (OI), postural tachycardia, vasovagal syncope, neurocardiogenic syncope, pre-syncope, initial orthostatic hypotension

The variety of conditions listed above possess one common debilitating feature: an inability to tolerate upright positions. In the case of POTS, a significant increase in heart rate will occur (>30bpm) along with lightheadedness, weakness and blurred vision. In initial orthostatic hypotension, a significant drop in blood pressure will be observed and in vasovagal syncope, a transient loss of consciousness will present.

These are the acute symptoms which are seen when the body is placed under stress such as being placed upright for a prolonged period of time (this may be a few minutes of sitting up in some severe cases), being in a hot, humid environment or changing postures from supine or sitting to standing.


  • Excessive sympathetic drive

  • Dizziness

  • Physical and mental fatigue

  • Difficulty concentrating

  • Gut disturbances and food intolerances

  • Tachycardia / palpitations

  • Exercise intolerance

  • High thirst and salt cravings

  • Sleep disturbances

  • Lower limb oedema and pain

  • Sensitized pain response

  • Coat hanger pain

  • Allergies, asthma

  • Headaches and migraines

  • Nausea

The onset of symptoms may vary from one case to another ranging from sudden onsets following infections, vaccination, puberty, stress or trauma or gradual onsets. It is common for patients to report mild, manageable symptoms which were “normalised” prior to experiencing a trigger which exacerbated the symptoms to a debilitating level.

Recent research has suggested numerous possible causes for these symptoms such as:

  • Dysautonomia

  • Mast Cell Activation Syndrome (MCAS)

  • Ehlers-Danlos Syndrome (EDS)

  • Central sensitivity

  • Genetics

  • Deconditionning


Our belief is that treatment must focus on managing the symptoms and address the underlying physiology which lead to these symptoms. Whilst these conditions are not fully understood, an increased sympathetic drive is identified in these conditions suggesting that treatment based on lifestyle interventions which reduce physical and emotional stress whilst preserving maximal engagement can permit significant improvements.


One-on-one therapeutic neuroscience education sessions will cover the following topics dependent on the patients’ needs assessed during the initial assessment and continuously monitored and discussed between the patient and therapist:

  • Postural symptoms physiology

  • Pacing

  • Home based movement prescription

  • Postural symptom management

  • Relaxation Techniques

  • Goal Setting / Gradual Exposure Planning

  • Trigger identification & Prevention

  • Setback Management

  • Sleep Physiology / Hygiene

  • The Stress Response

  • Dietary Advice


  • Gradual Return to Work & School

  • Travel Planning

  • Graded Motor Imagery


We know the importance of a holistic program in the recovery from POTS/OI. Movement sessions will be introduced after an initial musculoskeletal assessment and movement screening has been conducted. Movement sessions are carefully constructed and monitored (during and after the completion of the session) to ensure that PEM is NOT triggered by the movement session. These sessions may consist of: one on one or small group Exercise Physiology sessions, Pilates, Physiotherapy, anti-gravity treadmill or yoga and will focus on:

  • Personalised Movement Prescription

  • Address Musculoskeletal Injuries

  • Supervised & Home Based Programs

  • Mindful Movement

  • Physical Load Monitoring

  • Postural Education

  • Breathing Through Movement 

  • Mindfulness

  • Breathing Focus

  • Re-conditioning / improve blood flow


Psychology sessions involve education and psychological approaches to manage chronic health issues. These sessions also target any psychological challenges which may have developed due the chronic condition (eg. anxiety, depression) or unrelated factors which may affect mood and stress levels which are likely to impact on symptoms.

  • Emotional Awareness

  • The Impact of Fatigue

  • Neuropsych Education

  • Acceptance Commitment Therapy (ACT)

  • Addressing Barriers to Change

  • Cognitive Behavioural Therapy (CBT)


The goal of these sessions is to have an enjoyable, relaxing experience and to stimulate the parasympathetic (rest & relax) side of your autonomic nervous system to reduce sympathetic overload. These techniques will be implemented within the Zebras facility at also at the patients home.

  • Mindfullness

  • Breathing Focus

  • Restorative Yoga and Pranayama

  • Massage

Start your road to recovery with Australia’s most collaborative and holistic postural orthostatic tachycardia syndrome program.