Please click on the link above to watch a video about pacing.
Run time: 3:06 minutes
Please click the link above to watch a video describing how to use pacing.
Run time: 6:27 minutes
Managing your physical activity is an important part of managing your pain. Exercise is good for:
- maintaining overall health
- limiting pain intensity
- limiting the impact of pain
- helping to reduce fatigue
- improving mood
However, it’s important that you do not "overdo it," and pace yourself to conserve energy. In short, you should be active, but not "too active."
Finding your personal plan for energy management
- Every person has their own relationship between activity and their symptoms.
- Consider whether being too inactive ("sedentary") causes you pain.
- It is possible that extreme "peaks and valleys" in your activity levels cause pain.
- You can make changes to your activities based on your needs once you have a better understanding of how different patterns of physical activity affect how you feel.
- You can use PainGuide's activity monitoring and worksheet [JT1] (#_msocom_1) [BM2] (#_msocom_2) in this module to track how your activities relate to how you feel.
- This will help you figure out how best to use the strategies that are presented in this module.
- You can use the Activity and Exercise (https://alleviate-c.com/self-care/exercise/) and Relaxation (https://alleviate-c.com/self-care/relaxation/) modules to manage your energy.
Managing your energy by planning your day
- It is often helpful for people to think about managing their energy on a daily basis.
- To do the activities that you must do or would like to do, think about how to manage your activity and your energy across the day.
- oYou may already know if you tend to feel worse or have more pain at certain times.
- It is normal to experience some ups-and-downs in your energy, pain, and mood throughout the day.
- Managing your activity and energy by planning your day can help you avoid extreme peaks in your symptoms and help you to keep engaged in your activities throughout the whole day.
- One strategy for avoiding peaks in your symptoms is to pace activities that tire you out or increase your pain.
- As you plan your day, think about how each activity- whether it is something you have to do or something you want to do--uses energy.
- You might expect some things to be especially tiring and other things to be energizing.
Balancing activities that take energy with activities that give energy will also help you to avoid peaks in your symptoms.
Energizing activities
- Meditating or practicing a relaxation technique (https://alleviate-c.com/self-care/relaxation/).
- Exercising (yoga, a short walk, gentle stretching).
- Resting by sitting quietly, lying down for a bit, or taking a "power nap."
- oResting for a set amount of time can help restore your energy.
- oResting can help your muscles feel stronger and prepare you to take on bigger activities when needed.
Tips for incorporating rest throughout your day
- Rest before you feel tired.
- You will need less recovery time if you don’t push too far.
- This helps to prevent severe fatigue or pain.
- Take short but frequent rests.
- Experiment with how long you do things, how long you rest, and how often you rest.
Tips for saving energy
- Set your priorities -- figure out what is really important to you and which things are low priority.
- Things that are not important to you can either be put off to a later time or dropped altogether.
- Delegate tasks -- figure out which things you can ask someone else to help with or take over for you.
- Eliminate tasks -- see if you can find ways to do things that eliminate tasks that drain your energy.
- For example: remove the clothes from the dryer right away so that you don't have to iron (or buy wrinkle-resistant clothes!).
- Let your dishes drip-dry.
- Eat a frozen meal from time to time or get take-out.
- Consider doing most of your shopping online and have it delivered to your home.
Pacing your activity
You may have had a time when you did too much because you felt well and then "paid for it'' later.
It can be easy to get into a cycle where you overdo it and then feel worse or are not able to do what you had planned.
- Doing too much can cause a flare-up.
- Flare-up: increase in symptoms like pain, feeling tired or weak, emotional or mental exhaustion, thinking less clearly, or having trouble sleeping.
When you get caught up in this cycle, you may:
- Feel well and do too much.
- Have a flare-up.
- Fall behind on tasks or miss out on things you enjoy because it takes more time to rest and recover.
- Repeat the cycle when you feel well again.
Learning how to pace yourself can help you break this cycle. You can teach yourself how to alternate between periods of activity and rest. This may allow you to do more without the high risk of flare-ups.
Pacing may help you:
- Be able to continue doing many of the activities you enjoy doing
- Increase your productivity in the long run, rather than reduce it.
- Avoid extremes in pain, fatigue, tension, stress, or anxious or depressed mood.
- Maintain a more stable level of activity.
- Experience fewer and shorter symptom "flare-ups."
How to pace yourself
Finishing a big task first and then resting is often thought of as a natural way to get things done.
- For example, you might need to wash dishes.
- It might feel natural to clean the entire kitchen and then take a break.
- But you may risk having a flare-up when you do more than your body can handle at one time without resting.
Here are two better strategies, using pacing principles:
Time-based pacing. A schedule - or time-based system of activity and rest, where task completion occurs based on the following 3 steps:
- Do the task for a set amount of time that you believe will be safe, even though you may not have symptoms.
- Rest for a set amount of time, even if you are not tired or finished with the task.
- Repeat steps 1 and 2 until the task is done.
An example:
- You would start by washing dishes for a set amount of time (for instance, 10 minutes) and rest when that time has passed, even if you were not tired or you did not finish the dishes.
- After your rest period, start again.
- As you continue to use time-based pacing, you can change the amount of time you allocate to activity and rest according to what you are able to do.
- Note that you will be resting after a pre-planned, safe amount of work- not a flare up.
- Time-based pacing allows you to be active for a set amount of time, which could be minutes or hours, depending on your personal needs.
- Certain tasks may take more effort and take longer to do than others.
Goal-based pacing
- Identify an activity that you want to do or a goal that you want to achieve.
- Then, figure out how to break the activity up into reasonable steps; once you complete each step in the task, regardless of how long it takes, take a break to rest.
- After the break, begin the next step toward achieving the goal.
Both types of pacing
- Keeping a diary can help you track your current activity pattern and help you figure out what is realistic for you. This can give you a sense of where to start.
- You may also get feedback from a trusted friend, family member, or health care provider about what may be realistic for you to do.
- Then, work at improving your endurance bit by bit until you can do more between rest breaks.
Only you can determine which is the best pace for each task you do.
To create a personal pacing plan, try following the following 6 steps discussed below:
- Choose a task
You can use time-based pacing for any task, such as household chores, yard work, personal care, shopping, and pleasant activities.
- To start, pick something you want or need to do.
- Start with a simple task, such as vacuuming one room, before trying something harder, such as cleaning the whole house.
2. Find your pacing rhythm
You can find your pacing rhythm for a task in just 2 steps.
First, estimate how long you can do the task safely before risking a flare-up.
Then figure out how long your body needs to rest after this period of activity.
- Remember, during your rest period, you are not recovering from a flare-up.
- You are recovering from a safe amount of activity.
- Everyone is different, but you may need only a brief rest period to allow your body enough time to restore itself before you continue the activity.
- Your rhythm for each task will depend on how hard the task is and how much you are able to do right now.
- It may take you a little while to figure out the right rhythm, so don’t be discouraged if you don’t get it right the first time.
- Keep these ideas in mind:
- Pick simple goals that you can meet on good and bad days.
- For example, if you can get out of bed for only 10 minutes at a time, you might want to try a 5-minute activity and then rest for 15 minutes.
- Divide your activity and rest segments into small, manageable portions spread across the day.
- For example, do three 5-minute walks a day 3 times a week rather than one 45-minute walk once a week.
- Ask your healthcare provider or use the Pacing Yourself Work Sheet to help you figure out realistic pacing rhythm goals.
3. Share your pacing plan
Discuss your pacing plan with your healthcare provider so he or she can better understand your symptoms, your symptom management, and how he or she can help you.
- Your healthcare provider may be able to offer additional support and ways to adjust your plan, so you find the rhythm for each activity that’s right for you.
- For tips on speaking with your healthcare provider, see the Communication Skills section.
4. Try your pacing plan
Try your pacing plan for 3 to 4 days. This should give you enough time to find out how well it works for you.
- For example, for a period of 3 to 4 days, you could:
- Shop for 15 minutes and stop. Rest for a set amount of time.
- Repeat the cycle until you’re done.
- Stop and rest even if you are not tired or not done shopping.
- Rest in a pharmacy area chair, the furniture department, in a dressing room, or at the front of a grocery store.
- Here’s another example:
- Work on your computer for 20 minutes and stop.
- Rest for a set amount of time.
- Repeat the cycle until you’re done.
- Stop and rest even if you are not tired or not done with your work.
- Get up and walk, stretch, or use one of the relaxation techniques discussed in the Relaxation module during your rest time.
5. Review and revise your plan
After you have tried your pacing plan for 3 to 4 days, review how you are doing.
- If you can do your task and still feel okay that day and the next day, consider revising your plan and adding time to your activity. To revise your plan:
- Slightly increase the time you are active, and gradually reduce your rest time.
- Be sure to talk with your healthcare provider any time you are planning to increase your activity.
- Try this new plan for another 3 to 4 days to give your body time to adjust.
- Use the Pacing Yourself Work Sheet to track your progress.
- While practicing and reviewing your plan, you may start to feel worse or you may experience a flare-up.
- Remember, flare-ups may still happen from time to time, no matter what you do.
- Don’t let this discourage you, and don’t stop your activity.
- Instead, reduce your activity intensity, but continue for the same amount of time so you can keep the fitness gains you have already made.
- For example, if you have been walking at a moderately fast pace for 15 minutes, slow down and walk at a slower pace for 15 minutes.
- Then very slowly work back to your first goal so your body has time to adjust.
6. Continue to revise and practice your plan
Keep practicing and revising your pacing plan until it works for you.
- To start, you may want to just try doing pacing plans for 2 tasks a day.
- With patience, time, and practice, you may be able to find pacing plans that help you avoid the cycle of overdoing it.
Days when you feel good.
- Good days occur when you are feeling good, and your pain is less severe.
- Be careful that you don't turn a good day into a bad day by overdoing physical activities.
When doing physical activities that you enjoy.
- Enjoyable physical activities are wonderful ways to focus your attention on something other than your pain.
- Unfortunately, they can also divert your attention from using good pacing techniques.
- Be careful that you don't become so engrossed in an enjoyable activity that you forget to pace yourself.
When competing with other people.
- Competition is a great motivator, but it can also get you into trouble.
- Don't let competition trick you into exceeding your physical limitations.
When trying to please other people.
- It is nice to please others, but don't let this lead to neglecting your need to stay within your limits.
When feeling rushed, pressured, or emotionally upset.
- These are times when you can become careless and forget to use good judgment while doing physical activities.
You can help the person you care for manage their energy through pacing.
- The person you care about may not be able to do as much as they used to do because of their pain.
- That is why it is so important for him or her to break large tasks into small steps and rest in between steps.
- This may have an impact on you as well.
- It may mean that the things you do together may also take more time to do.
To help someone who is living with pain get used to this new way of doing things:
- Stay positive and encourage the person to follow his or her pacing plans.
- Try not to finish a task for him or her while he or she is resting, unless asked.
- Ask if he or she needs help figuring out pacing plans.
- Acknowledge what the person can do.
- Suggest that the person speak with a healthcare provider if the person has asked you a health question that you cannot answer.
It is also important that you allow and encourage the person you care about to continue to do the things that they can do.
- Do not be too quick to step in and do things for them when they can take care of it themselves.
- Completing certain tasks on their own may help boost self-esteem and improve mood.
- You may want to practice pacing and/or use the energy management tips yourself.