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  • Saskia Müller

How To Stop Yourself From Fainting: PoTS Edition

Ever stand up too fast and feel like a blackout or fainting episode is imminent? As someone with PoTS, I get this all the time. Although, I consider myself lucky that I don’t always faint. But for others with PoTS, vasovagal syncope, or other forms of orthostatic intolerance, fainting happens frequently, which can be dangerous depending on where you are when it happens. So how can you stop yourself from fainting? Read on for some effective fainting counter manoeuvers to try the next time you feel faint.

Before we get into the syncope manoeuvres, I want to talk briefly about what happens physiologically when we stand to cause us to feel faint.

When we stand, as much as 70% of our blood volume moves below heart level. This means that our circulatory system has to work harder to pump blood back up to the heart while upright. Normally, our bodies initiate a response to compensate for this change so that we don’t even notice it. However, someone with an impaired response to such postural changes may experience symptoms of orthostatic intolerance, which can include presyncope and fainting. 

People with orthostatic intolerance can perform several effective counter manoeuvres to prevent fainting. According to a 2018 review, “Physical countermeasures may be effective in the management of acute clinical symptoms and prevention of orthostatic intolerance or syncope/near-syncope in patients with PoTS.”  So, performing these syncope manoeuvres when you stand up too fast or feel like fainting can help prevent you from fully blacking out. 

Sounds pretty great, right?

So let’s get right to learning how to stop yourself from fainting!

1. Whole-Body Muscle Tensing

The first fainting counter manoeuvre in this roundup post is whole-body muscle tensing. This one is pretty straightforward, so don’t overthink it. Literally, just tense all the muscles in your body (legs, butt, stomach muscles, etc.) as much as you can. It also helps if you grip a ball or clasp your hands together and squeeze them while tensing the rest of your body. This syncope manoeuvre can be helpful for those prone to vasovagal syncope because it increases mean arterial pressure.  

2. Leg Crossing

An effective PoTS counter manoeuver, leg crossing can be effective to stop yourself from fainting. For maximum effectiveness, tense your thighs and squeeze your legs together when crossed. This syncope manoeuvre helps to increase cardiac output and decrease blood pooling while sitting upright. If it’s not comfortable for you to sit with your legs crossed, try performing this move right before you stand up! You can also do this move while standing; simply cross one leg in front of the other and squeeze them together.

3. Muscle Pumping

I don’t know about you, but I probably do this one the most while upright to counter blood pooling from PoTS. But this can also work to stop you from fainting. Walking around on your tip-toes and performing calf raises activates the natural pumping mechanism in your calf muscles, which pumps more blood back up to your heart. You can also do butt kicks, march in place, or walk on your heels, but I find the first two options to be a bit more subtle if I’m out in public. Pro tip: I’ll also perform seated calf raises if I’m travelling or sitting for a long time! 

4. Squatting

Drop it low! For this fainting counter manoeuvre, I’m not talking about the traditional squat you perform to work your booty. This type of squatting involves lowering yourself to the floor in a squatted position and pressing your calves up against your butt and hamstrings. Squatting is an effective syncope manoeuvre because it combines sitting, bending, and muscle tensing and promotes venous return to the heart. So, the next time you stand up too fast, try squatting low to stop yourself from fainting. 

I do this to counter fainting with PoTS all the time at home because it’s the most effective for me. While I don't always lose consciousness, the first time I fainted was because I didn’t immediately squat to the floor and lean forward.

5. Building Negative Pressure

You may read this one and immediately think, huh? Yeah, me too. But as it turns out, this fainting counter manoeuver is not all that complicated. All you have to do is plug your nose, purse your lips, and (try to) inhale. Voila! You’ve built negative pressure in your body. Pretty simple, right? While in studies participants used this method with something called an impedance threshold device, you can still achieve similar results by performing the plug-your-nose method at home–or wherever!    

6. Bending Forward

This is another straight-forward counter manoeuvre that you can use in a variety of situations. Simply bend forward at the waist to align your head with your heart level. Similarly, you can bend forward and rest your elbows on your knees. You can even perform this while sitting down by leaning forward and sticking your head between your knees. This is actually called the “crash position.” Bending forward works by increasing abdominal compression and raising blood pressure. 

7. Forceful Coughing

Here’s an interesting one! Did you know that if you forcefully cough it can serve as a fainting counter maneuver? Studies show that forceful coughing can help maintain consciousness by acutely raising blood pressure and encouraging blood circulation through the heart. Coughing has even been found to keep people temporarily conscious when experiencing cardiac arrest! That’s how powerful this trick is! Try forcefully coughing every one to three seconds when you start to feel lightheaded and dizzy.


8. Laying Down With Legs Vertical

A favourite position for PoTS patients to counter fainting, laying with your legs vertically against a wall or other stable surface helps redistribute blood through the body. Not only does this PoTS counter manuever lessen gravitational stress but it also increases central blood volume. As a result, this combination brings relief to many with PoTS and orthostatic intolerance. You can often catch me hanging out in this position after I exercise or go on a long walk, or while I’m reading or scrolling social media. It just feels so good (until my feet fall asleep!). Anyone else?! 

9. Sit In a Knees-to-Chest Position

This counter manoeuvre to stop yourself from fainting works similarly to squatting and bending forward. Although, this is a great move you can do if you have been sitting for a long time and need to get up, such as when travelling or working. As the name suggests, draw your knees into your chest and give yourself a big hug. Tense your muscles for an added benefit! 

10. Lift One Leg Onto A Surface

This is a helpful syncope manoeuvre if you’re already standing. To perform this one, lift a leg, place your foot onto a stable surface, like a chair or a step, and lean into your raised leg. Like many of the other syncope manoeuvres, this one increases abdominal compression and raises blood pressure. 

11. Whole-Body Skin Cooling

Similar to forceful coughing, whole-body skin cooling is another fainting counter manoeuvre that doesn’t necessarily involve moving your body. But this method is also unique in that it can be most helpful for PoTS patients in hot environments–a POTS trigger for many. Cooling the face, neck, chest, arms, and legs with a cool compress can be effective in increasing central blood volume. You can also fill a spray bottle with water and chill it before spritzing yourself. Or, take a cool shower or bath, or soak your feet in cold water (one of my personal favourites for surviving the summer heat!). 

Physical counter maneuvers can be used to help manage orthostatic intolerance and other clinical symptoms of PoTS and stop yourself from fainting. I experience presyncope after standing up more times than not. So it became really important for me to learn fainting counter maneuvers that I can perform to protect myself. And I want to protect you from hurting yourself while fainting too, so try out these syncope maneuvers and see if any prove helpful to you!  

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