When you live with chronic illness it seems that everywhere you turn you are told to pace yourself and your activities. But, rarely do they explain what it means or how to do it.
Pacing is a concept that gets thrown around a lot in support groups and blogs related to chronic illness. You may have even read posts from me on the importance of pacing, but…
What is pacing?
The idea of pacing comes down to simply limiting your activity so that you don’t wear yourself out.
Instead of trying to clean your whole house in a few short hours, you pace yourself, slowing down the activity, and taking breaks. It may mean you take longer to finish a job, but you are more likely to finish the job without wearing yourself out.
The concept of pacing relates back to athletics. Think of a marathon runner vs a sprinter. A sprinter is using up a lot of energy in a really short amount of time. A sprinter doesn’t need their energy to last, they just need to get the job done quickly. A marathon runner knows they have to last longer if they want to win. They can’t use up all their energy in the first half mile, so they slow their pace in an effort to conserve energy.
When we live with chronic illness we are constantly working to try to make our energy last. We can sprint through a task and use it all up, or we can set a slower pace and last through the whole marathon (or at least most of it).
Pacing with chronic illness is all about managing energy. We have to slow down and approach tasks with a measured approach so that we can make it to the end of the day rather than burning all our limited energy out with a single task.
Sometimes pacing means that a single task takes several days. When you live with a chronic illness like fibromyalgia or CFS/ME doing too much in one day can mean doing nothing for several days after.
Learning how to pace can often require a lot of trial and error. The key is learning to listen to your body so that you are stopping BEFORE you need to, resting often, and re-evaluating your needs on a regular basis.
Four steps for pacing with chronic illness
1 . Create a to-do list that has the tasks you want to complete.
Once you’ve written down all the tasks you want to do, assess whether those tasks really have to be completed by you, or can you delegate them?
If you decide that you must do the task, consider how you can break that task into smaller parts. For instance, if the task is to clean your office you could divide that into a number of smaller tasks including clean off your desk, clean the floor, and clean the windows.
2 . Limit your todo list to a single item each day and limit your work time to 15 minute intervals.
Limit your to-do list to one item per day, then set a timer so that you do not work more than the 15 minutes. When the timer goes off rest for 15 minutes. After your rest period spend a moment and really consider how you feel.
If you feel that you still have energy, continue to work on your task (if you’ve not completed it). If you assess your body and find that you are feeling fatigued. It’s time to stop for the day. If you continue working, do so in 15 minute intervals until you find that your body is telling you it is time to rest.
3 . Increase your time intervals gradually.
Over time you will be able to increase your work intervals, but do this slowly, adding only five minutes at a time, and remember to take breaks for rest that are equal in time to the time you work. Use those breaks to assess your body and how you feel.
4 . Celebrate the small accomplishments.
We don’t give ourselves credit for the many small tasks each day that take our energy. We don’t stop to think about the fact that we loaded the dishwasher as we walked through the kitchen, or that we put away a load of clothes.
If you are exercising for even five minutes a day that is an accomplishment. Celebrate these accomplishments by adding them to your to-do list after you’ve done them (and don’t forget to mark them off). You’ll be amazed at just how much you really are doing each day.
The Perils of Pacing with Chronic Illness
Be careful as you begin incorporating pacing into your life. It’s easy to think about pacing when you aren’t feeling well. It’s more difficult to use pacing as a tool when you do feel well. Yet, that’s when pacing is the most important.
When you don’t feel well, you likely aren’t going to do too much. But, when you feel well, you want to do all the things and, if you’re like me, will push yourself until you just can’t do any more. Then, you pay for it the next day (or the next week).
When I feel well, I want to catch up on all I’ve missed and do all the things. And, as I get busy I get distracted so it’s easier to tune out the pain and fatigue. I keep going and going instead of stopping and resting. And, when I finally do stop I’m wiped out and often unable to do anything for days.
Yet, if I’d just stopped and taken regular breaks to check in with my body. I would have still gotten just as much done. It just would have taken me longer.
Instead of spending one day working and two days recovering, I would have been able to spend three days working and likely accomplished more in the long-run, by working smarter.
As you learn more about your illness and how your body copes with your symptoms and varied energy, you’ll likely find new ways to help you pace. Here’s a few tips that I’ve found helpful.
Ways to Pace with Chronic Illness
1 . Use an activity tracker. Several years ago I purchased a Fitbit, but not for the reason that most people use one. I don’t care about hitting my minimum step goal. I was curious what it would tell me about my sleep patterns. But, primarily I bought a Fitbit to keep me from doing too much.
I knew that rather than having a minimum amount of activity I wanted to hit each day, that I needed to avoid doing too much. After using it for a while, I found that 5,000 steps is my limit for a day. If I hit that too early in the day and keep going, I will be worthless the next day. I set my Fitbit to alert me when I hit 5,000 steps and when that alarm goes off I know it’s time to slow down for the rest of the day.
2 . Set a timer. When I get really involved in a task it’s easy for me to lose track of time. A plan to do one quick thing can easily turn into a whole chain of tasks. And, if I’m not careful I will pay for it later.
One of the better ways for me to avoid getting caught up in an activity is to set a timer. I try to work in 15-20 minute chunks and then take a break. The small chunks of work time are enough to get a small task done, and the break gives me a chance to evaluate if I should keep going.Set a timer (and heed it) when working on tasks. When the timer goes off, stop and take a break to avoid over-doing it. #pacing Click To Tweet
3. Work – Rest – Listen. Following along with setting a timer, I find it helpful to plan my day in 15-15-5 minute blocks.
For 15 (or 20) minutes I’ll work on a task. Again, this gives me enough time to get some good headway or to finish a short task. I’ll follow that with a 15 minute break. During this time I try to get up and walk around if I’ve been sitting at my computer. Or, if I’ve been working on a physical task, I’ll take this time to sit and rest.
What I often find when doing physical activities is that as long as I keep going, I can keep going. But, once I stop and sit that’s when I realize how tired I am. That’s also why these breaks are important.
The last 5 minutes is for meditation (aka listening to my body). This is a really good time to do a 5-minute body scan meditation and to just check in and ask my body if I really should keep going, or if it’s time to just stop. Sometimes, the answer is that I just need a longer break. Sometimes, I can jump right back up and keep going. Sometimes, I realize I’m done and have to stop for the day.
Limit the time you work on a task to 15-20 minutes followed by an equal amount of time to rest. Then take the time to ask your body if it's ready to do more (and really listen to the answer). #pacing Click To Tweet
4 . Keep your to do list short. I use Google tasks to keep up with my to do list and I keep it short. I try to limit my to do list to no more than 3 items on a single day. Some days there may be a few more items, if the items are all just small things. Other days, I might just have one item if I know it’s going to be something more taxing. I also generally leave Friday free of tasks so that it can be my catch-up day.
There are days when I don’t check a single thing off my to do list and everything that was listed gets shoved to a later date.
There are also items that I don’t put on my to do list until after I’ve done them. These aren’t priority items, but are things that I just happen to do as I notice the need (this might include unloading the dishwasher or washing a load of towels). But, I add them after the fact so that I can track what I’ve done.
5. Break tasks into smaller chunks. Almost every task can be broken down into several smaller tasks. For instance, doing a load of laundry actually involves at least five smaller tasks – putting the load in the washer, moving it to the dryer, removing it from the dryer, folding the clothes, and then finally putting them away.
Washing dishes can be broken down into emptying the dishwasher and loading the dishwasher. Or, if you don’t have a dishwasher, you might just wash a few dishes at a time, leave them in the drying rack and then go back at a later time and put them away.
Try to think of all your tasks in this way. Yes, it means more overall items on your list, but it makes it a lot easier to stop, rest, and reward yourself for each item.Every task is a series of smaller tasks. Try to break your tasks down into the smallest components and focus on one piece at a time. #pacing Click To Tweet
6. Prioritize your plans. When you are putting together your to do list try to prioritize things that that are most important.
There are a million things on my list that aren’t important. They are there if/when I have time and energy. And, sometimes, those unimportant things are given priority just because they take less energy (whether mental or physical) than another task that might actually be more important.
Each night I look at my list for the next day and I number the items in order of most important. If I can only accomplish one thing tomorrow what is the most important thing, the thing that just shouldn’t wait another day?If you could only accomplish one thing tomorrow, what would it be? #priorities Click To Tweet
7. Work within your time zone. Some of us are morning people. I am not one of those people. I’m more of a mid-morning person. The most productive time for me is between 10am – 2pm. I try to schedule with that in mind and focus on the things that will take more energy during that time period, because that’s the time period when I have the most energy.
Your best time might be late in the evening. You may also find that there are certain days of the week that you are more focused or have more energy. If so, you can schedule your activities around those days for maximum productivity.What's your most productive time of day? For me it's from about 10a-2pm. Working in that time chunk helps me pace and better use my energy. Click To Tweet
8. Schedule the most draining tasks accordingly. Try to schedule the tasks you find are most likely to drain you at a time when they are least likely to impact the rest of your day.
Talking on the phone is the task that drains me faster than any other, except maybe actually having to deal with people face-to-face. If I schedule phone calls or in-person meetings early in the day I am much less likely to get anything else done. However, if I schedule those calls for late in the day I can get other things done before the call and end the day after the call when my energy is lowest.What types of tasks are most likely to drain your energy? For me it's talking to people. I try to schedule calls for later in the day so that I can still have time and energy before to accomplish other tasks. Click To Tweet
9. Pencil in the extras. Don’t commit yourself to extra items that you don’t need to do. Yes, time with your family is important, but baking brownies for the bake sale probably isn’t. As much as you’d like to go for a walk with your girlfriends that might need to be penciled in as well.
Penciling an item in doesn’t mean it won’t happen, but it does mean it’s not something you should stress over.
Don’t allow yourself to make commitments you’ll wish you didn’t have to keep. That only adds stress that is likely to make you feel worse, take more of your energy, and make it even more difficult to do the most important things.
10. Speak up when it’s time to stop. Only you know when your body has had enough. Even if your loved ones are paying attention they are going to miss the signs. Heck, you may miss the signs sometimes.
It’s up to you to let those around you know when it’s time for you to rest. This means you need to speak up loud and clear.
I’ve been guilty many times of not being clear enough when my body is done. I’m the only one who pays for that. And, it’s up to me (and me only) to avoid it happening.
When I’m spending time with others and my body has had enough (or is edging dangerously close to having had enough) I have to let those around me know that I am done for the day. They may be disappointed. They may try to convince me to stop at just one more store, or see just one more sight, but I’m the one who will pay for allowing them to push me beyond my limits. So, I have to set boundaries and say no.
11. Focus your energy on things you want to do. Prioritize the things you actually want to do.
A friend of mine recently posted something on Facebook that I want to explore a bit more. The post was about how kids will seem to have boundless energy right up until they are tasked to do a chore they don’t enjoy. Then suddenly they are so tired.
The post went on to theorize that just the mental work that goes into facing a task you don’t want to do is both mentally and physically draining. Her thought was that maybe this is why adults are so much more tired all the time. We are constantly facing tasks we don’t want to do.
Doing things you don’t want to do drains your energy. Unfortunately, sometimes we have to do things we don’t want to do. Alternatively, completing a task you don’t want to do can result in renewed energy as you are happy to have that task off your plate.
Rather than allowing an unwanted task to stare you in the face for weeks constantly making you tired at the thought of having to do it, just do it and be done. Then reward yourself by doing a task you actually enjoy.Completing a task you've been avoiding brings joy and renewed energy by getting that item out off your to do list and out of your way. Click To Tweet
12 . Work slower. Slow down! We often get so caught up in having to do a task and wanting to be done that we speed through it. Unfortunately, speeding through tasks not only results in more errors, but it also takes more energy.
Breaking tasks down into smaller chunks automatically slows you down a bit. But, don’t be afraid to go even slower. Go as slow as you want or need. Take your time, you’ll be amazed at how much you can do in just a few minutes.
Remember that no matter how many tools you use to help you pace, there will be times when you will do too much. It happens.No matter how many tools you use to help you pace, there will be times when you will do too much. It happens. It's OK. Don't beat yourself up for it. Click To Tweet
Don’t be hard on yourself when this occurs. Just take a break and rest. For me, this often results in an unplanned day off. But, I try to be kind to myself and remember that by taking that time to rest, I will accomplish more later.
Life isn’t a sprint, it’s a marathon, and we’ve got to do our best to make it to the end.
More pacing tips from fellow bloggers:
- Nikki, the Brainless Blogger, reminds us to “pace on the good days and the bad to prevent Boom and Bust flares. We feel good we do too much, then we crash for days. If we pace on good days, as well as the bad days, we can help prevent this cycle of boom and bust” – Chronic Illness & the Art of Pacing
- Melissa of Melissa vs Fibromyalgia suggests using a “rating scale like the CFS & Fibromyalgia rating scale check to check in with how much you’re pushing yourself above what your symptoms suggest you ought to be at. And don’t forget to add your context it’s not just about work – which these scales seem to think.” –A confession on pacing and boundaries
- Sarah Jayne’s advice is “No matter what you are doing throughout the day try to sit down and do some deep breathing whenever you can. If you can’t sit down at least do the breathing excersise. In through the nose out through the mouth. It tends to relax your body and give you a little boost. Every time you get 5 minutes here and there use them. “
- Donna, of February Stars, advises us “to use preemptive rest in addition to pacing your activities. Plan rest breaks into your day regardless of how you are feeling to avoid the boom/bust cycle. Set an alarm to remind yourself to rest if you need it. Plan your rests so that you are stopping before you feel totally exhausted. It’s a good way to manage energy throughout the day and stops you from getting carried away and overdoing things.” – Top 10 Pacing Tips
- Amanda says ” I pace myself using cups of tea. While the water boils and the tea steeps and cools, I get things done around the house. Then I rest while I drink my tea, and repeat. I drink at least 5-6 cups a day, from natural herb ‘energy tonic’ to rooibos to chamomile. ” – Pacing: Whoa, Nelly or Go Nelly!?