Adapting to Limits
The first step in learning how to pace is to find your limits or Energy Envelope, as described on the Finding Your Limits page. The second challenge is to adapt your life to your current limits.
This work, which can occur as you are refining your understanding of limits, is a gradual process, involving the use of multiple strategies, but benefits can come immediately from even a small change such as taking scheduled rests, or having short activity periods.
The discussion below is divided into two categories: general pacing strategies and techniques for increasing pacing consistency.
1 General Pacing Strategies
Learning to pace is a process of making many small improvements, one or two at a time. Three strategies that we especially recommend are:
Taking Scheduled Rests
Planned rest involves taking scheduled rest breaks every day, regardless of symptoms. For people with light to moderate ME/CFS or FM, this might mean one or two rests of 15 minutes to half an hour each. Those with severe ME/CFS or FM may benefit from taking multiple brief rests a day, for example a 10 to 15 minute rest every hour or two.
Scheduled rest is a popular first strategy because it is straightforward and brings immediate benefits to most people who use it: greater stability, reduced symptoms and greater stamina. Scheduled resting often results in a reduction in total rest time, because regular rests lead to less overdoing and thus fewer crashes.
Using a Pedometer
A pedometer (step counter) is an inexpensive device that can help you with all three parts of pacing:
- Defining your activity limits
- Learning to stay within your limits
- Showing you a safe way to expand your limits.
A common experience for many starting to use the device is to discover that they are too active and need to reduce the number of steps they take each day in order to control their symptoms. Once they find their limit, they use the device to stay within their envelope, checking their pedometer from time to time to see how many steps they have left.
Using a Heart Rate Monitor
Many people with ME/CFS and fibro, especially those with more severe forms, are highly sensitive to their heart rate and experience a relapse if their heart rate goes above a level called the anaerobic threshold (AT), a number that varies from person to person.
Using a heart rate monitor as described in this article helps many people keep their heart rate below their AT, thus preventing many relapses. The article outlines how to find your AT and describes the benefits of monitoring heart rate.
Additional Pacing Strategies
You can find nine more general pacing strategies in this article. They include:
- Limits on individual activities
- Short activity periods
- Use of devices
- The rule of substitution (“pigs at a trough”)
- Mental adjustments
2 Ways to Increase Pacing Consistency
Many people with ME/CFS and fibro would like to pace their lives but find it difficult to do so consistently. If that applies to you, we suggest you work on gaining more consistency by focusing on one strategy at a time, using approaches like the 12 strategies described in the two articles Pacing Consistency, Part 1 and Pacing Consistency, Part 2:
Three that we especially recommend are:
Routine and Reminders
Developing routines is one way to increase consistency. Doing things in a regular and customary way reduces energy expenditure, because you are living by habit rather than continuously confronting new situations. For an example of habit change, see the article titled 25 Reasons Why I’ve Improved.
Habit change can be facilitated by using reminders. For example, you can use a timer to limit the length of computer sessions or post reminder notes on the refrigerator or bathroom mirror.
Pacing may seem daunting at first, but you can think of the process as replacing a set of habits and routines that no longer fit your life with a new, more appropriate set. One bridge from old to new habits is to use detailed and individualized rules.
Rules can take several forms. You might begin by stating a few rules crucial to controlling symptoms. We sugest your phrase your rules with an If/Then structure. For example:
- If I've been on the computer for 20 minutes, then it's time to take a break.
- If it's 11 am, then it's time for my morning rest.
- If it's 9 pm, then it's time to start getting ready for bed.
Keeping a health log, which usually takes no more than a few minutes a day, can help you gain consistency in pacing in at least three ways.
- Records can help you get a clearer picture of your limits and reveal the connections between what you do and your symptoms.
- A log can help you hold yourself accountable by documenting the effects of your actions.
- Records can motivate by showing how pacing pays off.
How important is record keeping? Almost everyone we know who has improved kept records.
More Strategies for Consistency
Additional strategies for consistency include:
- Listening to your body
- Making daily and weekly plans
- Plan your life and live your plan
- Thinking “Sustainability”
- Stop and choose
- Learn assertiveness
- Adjusting expectations