In this topic, you’ll learn how to pace. Decide what your goals are first: what do you value most? (see below for guidance on goal setting). Try to think about the two parts of activity pacing mentioned in “The Principles of Pacing”.
Please have a look at the I-Engage app Pacing Page to check out our Pacing tools
Step one: Set the baseline
The key is to find out how long you can do a task without a pain flare. Here, remember that it’s normal to expect some pain increase after an activity. It may last for 20 – 30 minutes and is not a pain flare.
Write the time, distance, or number of times that you can do the activity or task without a pain flare
- Set your baseline based on the most limiting symptom for that activity (e.g., pain or fatigue).
- Taking 3 measures over 3 days often gives the best guide. Take an average of these measures by adding the 3 numbers together and then dividing by 3.
- You should then reduce this number by 20% (or multiply by 0.8) to give yourself a buffer. This is your first week baseline for activity 1.
- Repeat for other activities.
Step two: Repeat the task daily
For the first week, do the activity daily using this baseline time (e.g. standing, doing dishes), distance (e.g. walking), or number (e.g. number of clothes ironed, book pages read, repetitions of an exercise, etc.).
Step three: Increase by 10% per week
Slowly increase the time, distance, or number of repetitions each week by 10% (multiply the baseline number by 1.1). This becomes your baseline for the second week. You may use I-Engage’s pacing tool to help you log, calculate, and manage your paced activities.
Step four: Build up your activity levels using SMART goals
SMART stands for: Specific, Measurable, Attainable, Relevant, and Timebound. Using the SMART acronym to build your goals makes them clearer. Write your goals down to help you to stay on track and act as a reminder of what is important. The next lesson will cover this more in-depth.
Sign up for our CBT eLearning program to learn more about SMART goals.
Step five: Perform small tasks often
Do small tasks often, breaking activities into smaller chunks. This will help maintain the range of your activities and your tolerance. Make sure you alternate your position or posture regularly (e.g. sitting, standing, or walking).
Your body will benefit in many ways from movement. Calculating and recognising your baselines, or tolerance, lends to avoiding pain flares.
Step six: Take regular planned relaxation periods
Taking regularly planned rests and relaxation breaks, even on days when you feel pretty good, is essential. Relaxation releases tension, which can help reduce some of your pain.
Make sure you plan short rests before and after particularly stressful or demanding tasks. Practising relaxation, stretching, and daily walks helps control the pain (even on painful days).
Please reference our pacing activity examples to help you apply this to your own pain management program.
Pain flares sensitize your nervous system. This results in more pain from less activity. When you’re in pain, try using pacing to find a middle ground between completely avoiding activity and ignoring the pain.
Helpful tips for pacing
|On a good day, do not do more than the pacing schedule allows||Change your body position/posture regularly|
|Have a plan and aim to change only one or two things at a time||Build up time spent on a task gradually – start low and increase slowly|
|Keep a record of what you’re doing and how much you are doing – write it down||Set your baseline|
|Alternate heavier tasks with lighter or less stressful ones||Start doing the task at about 20% less when you start paced activities. This will factor in a good buffer to avoid reaching the flare point.|
|Do small tasks often||Increase the time by up to 10% each week, to start building tolerance|
|Use one kind of task as a break from another||On a bad day try to do some activities, but remember to be kind to yourself|
|If you have had a flare-up, go back to a level that you can cope with and start gradually increasing it again|
In the next lesson, you will learn more about setting goals! To move on, continue to the next lesson “Setting Goals” by selecting it from the left-side menu.