Dysautonomia/Long Covid & ME/CFS Program
Helping You Recover Without Pushing Past Your Limits
Living with dysautonomia, postural orthostatic tachycardia syndrome (POTS), Long COVID, or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can be overwhelming. Many people are told to simply exercise more or “push through” their symptoms—only to feel worse.
Our program is different!
We provide highly specialized and individualized physical therapy for people with autonomic dysfunction and post-exertional symptom flares. Treatment is designed to help you better understand your body, reduce crashes, improve daily function, and gradually build tolerance in a way that respects your nervous system.
Dr. Alex Chan is regarded as a leading voice in dysautonomia care in NYC and is consultant for developing hospital based programs. He specializes in the management of POTS, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long-COVID, and various Complex Chronic Illnesses. He himself has ME/CFS and consults from both a clinical and personal perspective. Dr. Chan is connected to the most experienced Dysautonomia medical providers for outbound referrals and stays current with the newest published research in the field. There is no better clinician to guide you while you treat and manage your condition.
What Is Dysautonomia?
Dysautonomia is an umbrella term for conditions that affect the autonomic nervous system—the part of the body that controls heart rate, blood pressure, breathing, digestion, temperature regulation, and circulation.
Common symptoms can include:
- Dizziness or lightheadedness
- Rapid heart rate
- Palpitations
- Fainting or near-fainting
- Fatigue
- Brain fog
- Exercise intolerance
- Shortness of breath
- Difficulty tolerating standing
- Nausea or digestive symptoms
- Temperature sensitivity
Many patients with dysautonomia also have:
- POTS
- Long COVID
- ME/CFS
- Hypermobile EDS or generalized hypermobility
- Mast cell activation symptoms
- Migraine
- Vestibular symptoms
What Is ME/CFS?
ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) is a complex neurologic and metabolic illness that causes profound fatigue, reduced function, sleep disturbance, cognitive symptoms, pain, and exercise intolerance.
The hallmark feature of ME/CFS is post-exertional malaise (PEM): a worsening of symptoms after physical, mental, emotional, or sensory activity. Unlike typical fatigue, PEM may not occur immediately. Symptoms often worsen 12–48 hours after activity and can last for days or even weeks.
Common symptoms can include:
- Severe fatigue not relieved by rest
- Post-exertional malaise (PEM)
- Brain fog and concentration difficulties
- Dizziness or orthostatic intolerance
- Sleep that does not feel refreshing
- Muscle and joint pain
- Sensitivity to light, noise, or overstimulation
- Headaches
- Difficulty tolerating exercise or upright activity
Our Treatment Philosophy
Many traditional rehabilitation programs rely on graded exercise or automatic increases in activity. For people with dysautonomia and ME/CFS, that approach may worsen symptoms.
Our program follows a “start low, go slow, and stay below the crash threshold” philosophy.
We focus on:
- Identifying your personal energy limits
- Preventing post-exertional malaise
- Respecting fluctuations in symptoms
- Building stability before intensity
- Improving function without triggering setbacks
- Treating the autonomic nervous system—not just deconditioning
We work collaboratively with you to find the right balance between activity and recovery.
What Makes Our Program Different?
1. Pacing and Energy Envelope Education
We help you understand how much activity your body can tolerate and how to stay within your “energy envelope.”
This often includes:
- Tracking symptoms and triggers
- Identifying delayed crashes
- Learning when to rest before symptoms escalate
- Breaking tasks into smaller pieces
- Planning activity throughout the day or week
2. Individualized Autonomic Rehabilitation
Treatment may include:
- Breathing and nervous system regulation strategies
- Gentle mobility and circulation exercises
- Recumbent or seated strengthening when appropriate
- Gradual upright tolerance training
- Compression, hydration, and lifestyle strategies
- Vestibular and balance treatment if dizziness is present
- Education on orthostatic intolerance and pacing
Every exercise is tailored to your current level of function and adjusted based on your response.
3. Care for the Whole Person
Many people with dysautonomia and ME/CFS have additional conditions that affect recovery.
We frequently help patients who also experience:
- Long COVID
- POTS
- Hypermobile EDS
- Chronic dizziness or vestibular dysfunction
- Migraine
- Joint pain and instability
- Neck pain and headaches
- Sensory sensitivity and nervous system overload
Who This Program Is For
This program may be a good fit if you:
- Feel worse after activity, exercise, or busy days
- Have been told your symptoms are due to deconditioning, but exercise makes you crash
- Have dizziness, racing heart, fatigue, or brain fog when upright
- Struggle to tolerate standing, walking, errands, or work
- Have Long COVID, POTS, ME/CFS, or dysautonomia
- Want a physical therapist who truly specializes in autonomic dysfunction
