Pacing – The Art of Rest in Chronic Illness

By: Kelli Kieselbach

Pacing is the term given to the strategy of managing fatigue and other symptoms in chronic conditions including post-viral fatigue, Long Covid, fibromyalgia, chronic fatigue syndrome (ME/CFS) and many others.

What this looks like can be slightly different for everyone, but it essentially means being strategic about how you coordinate your life scheduling rest around activities and listening to your body, stopping before your body reaches tipping point. This requires understanding your baseline (which can unfortunately fluctuate), recognising your triggers and structuring your day, week and even month accordingly.

The idea with pacing is to be one step ahead of your body to avoid flares and reduce the severity of post-exertional malaise otherwise known as PEM. PEM is a delayed exacerbation of symptoms (especially fatigue) that occurs in response to mental or physical exertion. For example, having to go out to a doctor’s appointment and doing a load of washing in one day could lead to a significant worsening of symptoms in the days following before returning to baseline. Some of you will know this pattern all too well!

How to Get the Most Out of Pacing

Here are my three top tips for effective pacing.

1. Once you’ve established your threshold for what you can comfortably do in a day, resist the temptation to push past it even on good days.

Pushing through could lead to a crash the next day. A good rule of thumb (especially with any physical activity) is to only exert yourself to roughly 80% of your capacity. If you feel you are ready to re-establish your boundaries do this very slowly, gradually adding in activities one at a time and leaving rest days in between.

2. Don’t use up your energy budget just doing the boring day to day stuff like cooking, cleaning, and work commitments.

Make space for things that bring you joy, relaxation, and fun. This is important for healing and improving quality of life. Schedule something into your day that you enjoy. This could be as simple as listening to music or talking to a friend on the phone. If possible, find a new hobby that fits within your limitations. This may mean thinking outside the box and finding ways to focus on what you can do and not on what you can’t.

3. Use concepts like the ‘energy budget’ or the ‘spoon theory’ to educate those closest to you and help them understand why they need to respect your boundaries.

It can be difficult for an able- bodied person to understand why you need to rest BEFORE you get too tired and why it’s difficult to be spontaneous. Using analogies like the ones above can help them understand why you need to be so cautious about what you do and when you do them.

Navigating a new normal is distressing and frustrating for someone with a chronic illness, especially conditions that are unpredictable in nature. Pacing as one part of a holistic approach that can help you manage symptoms better and improve quality of life.

Article supplied with thanks to Kelli Kieselbach.

About the Author: Kelli Kieselbach is a Naturopath and Nutritionist with a passion for a holistic and natural approach to health and wellbeing. She also works to educate Christian ministry leaders in self care and avoiding burnout.

Feature image: Photo by Dave Goudreau on Unsplash