External Compression

  • Researchers have continued to find that external compression can help counteract the effects many in our community experience secondary to venous pooling (Coleby, 2022).

  • Venous pooling is believed to contribute significantly towards the orthostatic intolerance many in our community experience (Gaw et al., 2012).

  • Adding external compression can reduce the severity of pooling and help get your blood where it needs to go; this is accomplished by applying compression to help bring blood back into your central circulation so it can get to major organs, including your brain, as stroke volume is increased (Bourne et al., 2021)!

  • Researchers have noticed that a number of individuals with POTS experience splanchnic (referring to organs within the abdomen) pooling when upright, in addition to the pooling that is more visible to us in our legs and feet, increasing tachycardia as the body compensates for a reduction in cardiac output (Stewart et al., 2006). Because of this, they are finding that abdominal compression may be most beneficial for individuals with POTS, and can include compression garments that extend from the feet/legs to the abdomen (Coleby, 2022; Fu & Levine, 2018).

  • Overall, however, some studied options for compression include the use of compression socks, full leg compression, and abdominal compression (Coleby, 2022).

  • The amount of compression used in the Bourne et al. study demonstrated benefits when applying compression that ranged from 20-40 mmHg (2021).

  • Too little compression may not be as effective, and too much may be harmful. Proper sizing is important!

  • Please make sure to ask your medical team what their recommendations are. For brand ideas, a few options are included in our Helpful Items section. We also have a post on our Instagram page specific to other brands individuals in our community love!

Sources:

Bourne, K. M., Sheldon, R. S., Hall, J., Lloyd, M., Kogut, K., Sheikh, N., Jorge, J., Ng, J., Exner, D. V., Tyberg, J. V., & Raj, S. R. (2021). Compression garment reduces orthostatic tachycardia and symptoms in patients with postural orthostatic tachycardia syndrome. Journal of the American College of Cardiology, 77(3), 285–296. https://doi.org/10.1016/j.jacc.2020.11.040

Coleby, C. (2022, October). Non-Pharmacologic Treatment Overview. POTS & Beyond. Salt Lake City; Utah.

Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of pots. Autonomic Neuroscience, 215, 20–27. https://doi.org/10.1016/j.autneu.2018.07.001

Gaw, C. E., Shields, R. W., Mayuga, K. A., Gornik, H. L., & Fouad-Tarazi, F. (2012). Pots due to excessive venous pooling in an enlarged inferior vena cava. Clinical Autonomic Research, 22(4), 197–198. https://doi.org/10.1007/s10286-012-0157-7

Stewart, J. M., Medow, M. S., Glover, J. L., & Montgomery, L. D. (2006). Persistent splanchnic hyperemia during upright tilt in postural tachycardia syndrome. American Journal of Physiology-Heart and Circulatory Physiology, 290(2). https://doi.org/10.1152/ajpheart.00784.2005