Why the Warriors have had a hard time talking about Kristaps Porzingis

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Golden State Warriors center Kristaps Porziņģis gestures after making a 3-point basket during the first half of an NBA basketball game against the Boston Celtics in San Francisco, Thursday, Feb. 19, 2026. (Jeff Chiu/AP)


After apologizing for the "stupid mistake" where he called Kristaps Porziņģis' diagnosis of postural orthostatic tachycardia syndrome (POTS) "misinformation," Warriors head coach Steve Kerr used another word to describe the forward's condition that made one medical professional cringe: "mysterious."

The term came up when Kerr spoke with reporters on Monday and told them the organization wasn't exactly clear on what Porziņģis is dealing with.

"It's a little mysterious," the coach said, per The Athletic. "We're obviously working with him, and he can get some clarity, and he can kind of break through, and he can get to a point where he's consistently healthy, but that's something that the medical staff is working hard on with him. I'm not going to posit any medical theories anymore."

Dr. Svetlana Blitshteyn is the director of Dysautonomia Clinic, and a clinical associate professor of neurology at the University at Buffalo Jacobs School of Medicine. She sees the word "mysterious" come up a lot when discussing POTS and isn't too fond of the term.

"I think the more we say the word, the more it delegitimizes this disorder," Blitshteyn told SFGATE in a phone interview Thursday. "It's not mysterious. It's complex. It's underdiagnosed. We know a lot about pathophysiology, symptoms, and we have treatments for POTS. It's only a mystery to people who've never heard of it, and doctors who don't know anything about POTS. For the rest of us in this field, it's absolutely not a mystery."

Of course, the complexity is perhaps why Kerr used that term in the first place. Not only is there a spectrum of how people with POTS respond to it, the syndrome is itself in a spectrum of dysautonomia, a nervous system disorder that disrupts involuntary body processes like blood pressure, heart rate and blood flow to the heart and other vital organs. Even its causes are a spectrum, a key reason why it's a syndrome and not an illness, according to Dr. Italo Biaggioni, director of the Vanderbilt Autonomic Dysfunction Center.

"For a disease, you know the cause, and they're all homogeneous and we have a precise mechanism of disease," Biaggioni told SFGATE on Thursday. "A syndrome is mostly a description of similar symptoms that can be due to several different causes, and that's where we are. It's a syndrome that we understand much better than ever, but still, we don't have a clear cause, there might be more than one."

In the wake of Jonathan Kuminga's immediate success with the Atlanta Hawks, all eyes have shifted to Porziņģis, the player Golden State received in exchange for the seventh-overall pick in the 2021 NBA Draft, and his lack of playing time on the Dubs. The Latvian international revealed his POTS diagnosis in October, which followed a season in which he missed a stretch of games due to a non-COVID-19 viral illness. POTS is a chronic disorder that causes dizziness, fatigue, exercise intolerance, headaches and mental fog from activities as simple as standing up. But that alone isn't what's kept him out of the lineup. He's also been sick with other unspecified illnesses, which is part of what seems to have caused some public confusion with Kerr.

The truth is that POTS creates a vicious cycle of sickness where one problem can exacerbate another. Blitshteyn estimates that about half of all POTS cases start with a viral infection - such as COVID-19 or mononucleosis - but other sources include concussions, pregnancy, a surgical procedure or even sustained heavy drug use. Even if someone is able to make progress toward managing their POTS or dissipating their symptoms entirely, something as simple as the common cold could set them back in their progress, triggering their symptoms once again. Generally speaking, the setback can create tougher problems for high-level athletes.

"When you have to go to the office, you may go in and you may feel very tired, but you can still sit for eight hours and work potentially," Blitshteyn said. "But if you have to run a marathon or, you know, play a big game, then the next virus can set you back."

Neither Blitshteyn or Biaggioni can directly comment on Porziņģis' exact situation as he's not their patient, and they both noted that POTS cases can vary from person to person. That being said, POTS has pretty stringent diagnosis criteria. First is that a person's heart rate goes up at least 30 beats per minute - or 40 beats in teenagers - when they go from horizontal to standing. Next is that their blood pressure does not drop, which would make it orthostatic hypotension. Third is that consistent symptoms when standing, like the aforementioned fatigue, occur for a length of three months.

Biaggioni noted that while there are other conditions that have symptoms which could overlap with POTS, it doesn't rule out the syndrome. He described it as a Venn diagram situation where the patient could have both POTS and, for example, chronic fatigue syndrome. Another key element of the evaluation process is ruling out other issues that could explain the increased heart rate, but, "if you have a good physician doing a good history and a regular workup, you should be able to detect those diseases."

Another way being a professional athlete complicates things is that even when the diagnosis has been established, guidance on recovery for someone in that field can be tricky. Blitshteyn researches long COVID, which can be intertwined with POTS, and said that for long COVID there were at one point guidelines on when a high-level athlete could return to competition. Since there are way fewer elite athletes with POTS, a condition that doesn't even have a direct FDA-approved method of treatment - there are approved methods of treating the symptoms - it's not as cut-and-dried.

For the fans who might feel uneasy about the breadth of complexity that their big acquisition is dealing with, there's some good news: Porziņģis has begun workouts that make Kerr sound "optimistic." Whenever the big man makes his way back to the floor, he'll have at least one more sympathetic fan.

"We're all rooting for him, because these disorders are hard," Blitshteyn said. "They can be disabling, and there's always a struggle. ‘Oh, my God, I need to do this. Oh, but my body is not keeping up with my mind,' and the desire to do things, it's quite hard. Patients struggle to push through the symptoms."

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This article originally published at Why the Warriors have had a hard time talking about Kristaps Porzingis.

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