If you’re using the Levine Protocol to improve exercise tolerance and build cardiovascular fitness with POTS, then you’ll need to know how to calculate your target heart rates for each training pace in the program. Sound daunting? That’s why I’m here! In this post, I’ll take you through all the math in a step-by-step process to show you exactly how to calculate your Levine Protocol training paces tailored to your age and fitness level. All you need is a pencil, paper, and a calculator.
Disclaimer: I am not a medical doctor or a certified personal trainer. All advice I give in this blog is based on my personal experience with the Levine Protocol and research. Consult your doctor before starting this or any new exercise program.
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Before I begin, as per the Levine Protocol guidelines, if you are on a beta-blocker for your POTS, then you will NOT be able to follow these calculated heart rate ranges. Ask your doctor how you should gauge exercise intensity on these medications.
I detail the different training paces in my post about the Levine Protocol and the CHOP Modified Protocol. In summary, there are five different training paces that you’ll need to calculate heart rate ranges for. They include recovery pace, base pace, mid-maximal steady state (MSS) pace, race pace, and interval pace. By following the step-by-step process below, you’ll be able to calculate your personal heart rate ranges for each Levine Protocol training pace.
If you are new to the Levine Protocol, have just been diagnosed with POTS, or your doctor has recommended the Levine Protocol, I would suggest going to either a cardiac rehab program or an exercise physiologist first. They’ll help you calculate your target heart rates to get started with the program and monitor your progress through the initial stages.
I went to cardiac rehab for several weeks after my POTS diagnosis for guidance on starting to exercise with this condition. Plus, I also saw an exercise physiologist at Cleveland Clinic whose knowledge from just one appointment has been invaluable throughout my exercise journey.
Once you’re ready to exercise on your own, either at home or at a gym, it’s important to calculate and recalculate your training paces as your fitness level improves. Your supine (or laying) resting heart rate is a simple way to gauge your fitness level. A lower resting heart rate generally indicates better cardiovascular fitness. Since resting heart rate is a factor in determining the values for your training paces, any drastic change in it will consequently change your target heart rates for each pace. Make sense so far?
So, as you get in better shape and become more fit, you’ll need to recalculate your training paces. On the opposite end of the spectrum, if you take too long of a break from exercise and become less fit, you’ll also have to recalculate these values. That’s why monitoring your resting heart rate is so valuable!
You should find your supine resting heart rate first thing in the morning before getting out of bed. You can do this manually by placing two fingers on the carotid artery in your neck or the radial artery on your wrist. Count your heartbeats for 30 seconds and multiply that number by 2. Or, if you have a smartwatch (like the Fitbit Sense), just check there! Easy! Do this for a few days and take the average as your resting heart rate.
Now, you may be asking, how often should I recalculate my heart rate ranges for the Levine Protocol? To this, I will say there is no definitive answer I can give you, as everyone responds to exercise differently. My rule of thumb? I’ll recalculate my values when I turn a year older, or if my supine resting heart rate has consistently changed by 3 or more bpm for at least a week. Of course, you can recalculate your values whenever you want, but your ranges probably won’t change too much with a change in resting heart rate of only 1-2 bpm.
How to Calculate Your Levine Protocol Training Paces in 9 Easy Steps:
Now that you know why you should calculate (and recalculate!) your Levine Protocol heart rate paces, let’s get down to business calculating them! I’ve taken these steps directly from the Levine Protocol guidelines. You can view the instructions yourself and refer to my example below as a guide. Reminder: The following example is based on my data, so make sure to fill in your own!
*The order of each pace in ascending order of intensity is: recovery pace, base pace, MSS pace, race pace, and interval pace.
Step 1: Find your Max Heart Rate (MaxHR): 220 – your age
Example: MaxHR = 220 – 25 = 195 bpm
Step 2: Find Heart Rate Reserve (HRR): MaxHR – supine resting HR
Example: HRR = 195 bpm – 65 bpm = 130 bpm
Step 3: Multiple HRR by .75 (75% of HRR)
Example: 130 bpm x .75 = 97.5 bpm (round up to 98 bpm)
Step 4: Find Mid-Maximal Steady State (MSS) HR: 75% of HRR + Resting HR
Example: 98 bpm + 65 bpm = 163 bpm
Step 5: Find MSS pace: 5 bpm +/- MSS HR
Example: 163 bpm +/- 5 = 158-168 bpm
*So, my MSS pace is between 158-168 bpm.
Step 6: Find base pace: Subtract 20 bpm from low end of MSS pace range
Example: 158 bpm – 20 bpm = 138 bpm
*So, my base pace is between 138-157 bpm.
Step 7: Find recovery pace: Less than your lowest base pace HR
Example: 138 – 157 bpm is my base pace range
*So, my recovery pace is < 138 bpm.
Step 8: Find race pace: Multiply .95 by MaxHR
Example: .95 x 195 bpm = 185.25 (round down to 185 bpm); 168 is upper limit of MSS pace
*So, my race pace is between 169-185 bpm.
Step 9: Find Interval Pace: Anything higher than your greatest race pace value (but not more than your MaxHR!).
Example: My greatest race pace value is 185 bpm; my max HR is 195 bpm
*So, my interval pace is 186 bpm – 195 bpm.
Summary of My Levine Protocol Training Paces:
Recovery Pace = less than 138 bpm
Base pace = 138 – 157 bpm
MSS pace = 158 – 168 bpm
Race pace = 169 – 185 bpm
Interval pace = 186 – 195 bpm
There you have it! Now you know how to calculate your five Levine Protocol training paces! At this point, I’ll usually write up a nice summary of my heart rate ranges for each training pace (like above) and take a picture of it on my phone. This way, I’ll have a reminder with me when I’m exercising so I know: 1. How hard to work, 2. What kind of exercise session to do, and 3. Where to keep my heart rate during exercise.
This may seem like a no-brainer now, but wearing a heart rate monitor is a necessity when exercising with POTS. If you went to cardiac rehab, they’d strap you up to monitors so they can tell if you’re pushing yourself too hard, or not enough. The same logic applies to exercise at home or at a gym. You need to have some way to monitor your heart rate during exercise on the Levine Protocol! It’s crucial to not over- or under-train, which can contribute to rebound symptoms or lack of progress, respectively.
I’ve used Fitbit products for years, not just for exercise, but also for everyday monitoring. I recently got a new Fitbit Sense smartwatch and love all the new features, like stress management and exercise readiness scores.
For running and higher intensity training, I now also use a Polar H10 Heart Rate Sensor as chest straps are known for their precision accuracy. High-intensity exercise is when I can easily over-do it, so this was completely worth the investment for me.
I depend on both of these products, and while having two monitors is a personal choice, I highly recommend having at least one. I’ve never gone wrong with Fitbit or Polar products!
The Levine Protocol has changed my life with POTS and has been instrumental in helping my body heal. I know I would not be at the point I am today without using this detailed, step-by-step program. Calculating my heart rates for each training pace has been another detail that’s made all the difference, especially in the beginning months when my supine resting heart rate decreased more.
Exercising with POTS is hard, but stick with it! The first three months of the Levine Protocol were the most difficult, but it began to get a lot easier after that. Be patient with yourself, listen to what your body needs, and keep pushing forward! Your body will adapt to the demands of exercise and grow stronger and more conditioned. It just takes time, consistency, and perseverance. But don’t worry–you got this!
If you have any questions about any of the above steps or need clarification, let me know! If you are unsure about your calculated training paces or how you should gauge exercise intensity with your own POTS case, please ask your doctor for assistance!
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