Compassionate, evidence-informed care for complex conditions
We support people living with POTS/dysautonomia, endometriosis, MCAS, hypermobility/EDS, Long COVID, fibromyalgia and complex pain. Our Exercise Physiologists blend joint variability, strength, breathwork and pacing — tailored to symptoms, energy and recovery.
POTS / Dysautonomia
Recumbent starts, tolerance ladders, breath pacing and cooling/hydration planning.
Endometriosis
Variability + breath-led strength to reduce inflammatory load, flares and fatigue.
MCAS
Trigger-aware programming, dose control and down-regulation strategies.
Hypermobility / EDS
Movement literacy, assistive-aware strength, thermoregulation & pacing.
Long COVID
Symptom-paced activity, PEM-aware dosing, breath & nervous system support.
Fibromyalgia / Complex Pain
Education, graded exposure, variability and nervous-system down-regulation.
From recumbent capacity to upright tolerance
Snapshot
POTS requires careful autonomic loading. We build capacity with recumbent/semi-recumbent work, then progress upright using tolerance ladders, breath pacing, and symptom-aware monitoring.
How we help
- Recumbent starts (bike/row/reformer) with short, repeatable bouts
- Compression + fluids/salt education where appropriate
- Breath-paced strength, controlled tempo
- Graded progression to upright (sit-to-stand → marching → walking → carries)
Generally helpful
- 1–3 min intervals with full/longer recovery
- Lower-body strength to aid venous return
- Cooling breaks & environment control
Modify / avoid
- Sudden jumps to upright/long static standing
- Breath-holding/bracing under load
- Heat spikes without hydration plan
FAQs
Is cardio safe with POTS?
Yes, when dosed well. We start recumbent and progress volume/intensity by tolerance.
What if I crash after sessions?
We adjust bout length, rest, temperature and fluids/salt; we’ll use stricter pacing and symptom logs.
Build capacity safely. Start recumbent, progress to upright — with an EP guiding each step.
Exercise & Endometriosis — what helps, what hurts
Snapshot
Movement supports circulation, pain modulation, hormones and confidence. With endometriosis, baseline inflammation and fatigue can be higher — success relies on joint variability, smart dosing and down-regulation.
How we help
- Joint variability (rotation, side-bend, varied angles)
- Strength with breath (manage pressure, avoid bracing)
- Gentle mobility for pelvis/hips/lumbar
- Pacing: frequent, shorter sessions beat boom-and-bust
Generally helpful
- Low–moderate strength (reformer, bands, bodyweight)
- Breath-led tempo & down-regulation
- Rotation & asymmetry when tolerated
Modify / avoid during flares
- High-intensity/impact blocks without build-up
- Excess abdominal compression
- Rigid, repetitive routines in one plane only
FAQs
Does exercise increase inflammation?
Exercise creates a small adaptive signal. We dose carefully and prioritise recovery.
Why am I so fatigued after exercise?
Fatigue and inflammation are linked — our pacing and variability reduce load and improve recovery.
Ready for personalised support? Book a 1:1 EP consult or 1:3 Clinical Pilates.
Trigger-aware exercise with calm recovery
Snapshot
Programming respects triggers and recovery. We use symptom-aware dosing, environment control, and nervous-system down-regulation.
How we help
- Progressive strength with careful dose
- Breathwork & down-reg between sets
- Environment, temperature & timing adjustments
Support without overwhelm. Build capacity around your triggers.
Learn how to move — not avoid movement
Core principle
Avoiding movement isn’t the answer. For many, movement has meant injuries. Success comes from understanding compensation patterns, building joint variability, and dosing strength you can recover from.
Snapshot
Hypermobility/EDS often co-exists with POTS, MCAS, thermoregulation issues, GI symptoms, complex pain and fatigue. We use systems thinking and movement literacy — not just “more stretching”.
How we help
- Compensation mapping → safer alternatives
- Closed-chain strength, proprioception, tempo control
- Assistive device integration (braces, crutches, compression)
- Thermoregulation & autonomic awareness
- Complex pain: education, pacing, down-regulation
Generally helpful
- Slow, controlled resistance with feedback
- Breath-led tempo & pressure management
- Reformer variability with thoughtful springing
Modify / avoid
- Over-stretching already lax joints
- Early high-velocity impact/plyometrics
- Ignoring fatigue/autonomic red flags
FAQs
Do you work with braces, crutches and compression?
Yes. We clarify each aid’s role, program with it, and plan progression if/when appropriate.
Is it safe to load “unstable” joints?
With coaching and dose control, controlled loading is protective and improves confidence.
We see the whole picture. Map compensations, build variability, and load safely for real-world resilience.
PEM-aware activity and nervous-system support
Snapshot
We respect post-exertional malaise (PEM). Programming uses symptom-paced activity, strict energy budgeting, and calm recovery to reduce crashes.
How we help
- PEM-aware pacing & activity diaries
- Breathwork, down-regulation, isometrics
- Very gradual tolerance ladders
Move within your window. We’ll build capacity without tipping into crashes.
Education, graded exposure, variability
Snapshot
We work with central sensitisation using education, graded exposure and movement variability to reduce threat and restore confidence.
How we help
- Low-threat movement options & variability
- Breath-paced strength and mobility
- Pacing, flare plans and recovery rituals
FAQs
What if movement increases pain?
We adjust the stimulus, not just the volume. Safer options reduce threat while still building capacity.
How fast will this progress?
Consistency over intensity — micro-wins compound. We measure function and flare frequency, not just “PRs.”
Make movement feel possible again. Start with a 1:1 EP consult or 1:3 Clinical.
