If the answer is yes, you might find yourself in the ‘BOOM or BUST’ cycle, just like the picture above.
In the most simple terms, it is when you find yourself using your pain as a measure of how much activity you can do i.e. good day = more activity and bad day = less activity. This is quite a normal place to find yourself when you are in pain, as it makes sense to use the good days for doing more and the bad days for doing less. However, being in the ‘BOOM or BUST’ cycle isn’t normally the best place to be, as it means you are not in control, your pain is in control and sometimes it might feel like you’re stuck going nowhere.
It’s important for you to know that you are not stuck where you are and that you can change things. Recognising that how things are at the moment aren’t really helping you move forwards is a big part in addressing the issue. The other part of the equation is understanding that if you want something to be different, you will have to do things differently. In other words, if you keep doing things the ways you’ve always done them, you’ll always get the same result.
One of the things that can be really effective at helping people regain some control over their painful complaint is pacing.
Firstly, pacing is not stopping things. It is not giving up, giving in or just admitting to the fact that ‘this is how things will be forever’. Pacing is simply ‘doing things differently’ and as we have said, if you want something like your ability to walk the dog, play with the children, work or walk do be different, you will have to look at doing things differently to get there.
Pacing in its simplest form is about adjusting, modifying or breaking things up into smaller or different chunks.
Think of this funny example...
Most people can’t (or shouldn’t) eat a whole cake in one go, but if you ate it in small slices, you’d get there in the end. As we’ve said, pacing is all about breaking things up and doing things differently to get a different, and hopefully better, result.
You are very likely to have tried various adjustments to things that are sore or difficult, but it’s worth remembering there is often more than one way to approach a problem.
Do you recognise yourself in one of these poor pacing habits?
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Overactive Pacing |
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‘Boom & Bust’ Pacing |
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Underactive pacing means that you are doing too little activity to help keep up your strength, stamina and flexibility in your muscles, ligaments, joints and bones. More of your time is spent resting, sitting or lying down, which is understandable. However, this can actually add to your pain as the lack of fitness makes muscles and other tissues tight, weak and painful.
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Often people use pain and energy levels as a guide to their activities and pacing them. This means they risk doing too much activity on good days (overactive), which makes their pain worse. They are then forced to rest while the pain settles down (underactive). This is a mixed style of pacing, which is unhelpful.
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Over time, people become less able to cope with activity and smaller amounts of activity produces an increase in pain. |
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Pacing, done right and done consistently, can help. People who have learnt to use pacing skills often report:
Have you ever had sunburn?
Most people have at some point and most people know that it happens when you spend too long in the sun. Sunburn isn’t pleasant and once you’re burnt, jumping in the shade or putting sun cream on doesn’t really help. Sunburn makes your skin sensitive; it hurts when you move or put clothes on; it makes the shower feel hotter than it actually is; it normally means you will struggle to sleep well that night and most importantly, it normally means you can’t spend as long out in the sun the following day. Most people would agree that sunburn is not a good result on a sunny day and waiting until you’re burnt before jumping in the shade doesn’t work.
A paced approach to being out in the sun would be like spending some time in the sun but breaking the day up with some time in the shade. It might need some planning before you start your day i.e. to make sure you’ve got your sun cream on, a hat or a t-shirt to hand and a bit of a plan when you’re going to jump in the shade. Spending some time in the sun and the shade over the course of a day might not guarantee that you won’t get burnt, but it will reduce the chances quite a bit. With a paced approach to being in the sun, you are less likely to get burnt, less likely to have painful skin, more likely to sleep better that night and most importantly, more likely to be able to go out in the sun again the following day without any issues.
Put simply, you can apply the basic idea of pacing to prevent sunburn to anything that might make your pain worse, like walking, standing too long or cutting the grass.
The honest answer is no, with a 'but'. Any new skill takes time to get really good at and pacing is no different. Often the biggest challenges people report is that they struggle to change the way they’ve done things for years before, or they simply forget to do it. We’ve got some tips at the bottom of the page to help you with this.
Remember, pacing is something that can help, but it requires you to look at things you do or have done in the past with a different mind-set or approach. Done correctly, pacing can help most people.
Not necessarily. Sometimes doing less works for some people but equally, sometimes doing things in a different order, spreading things out over a longer time or asking for help can be just as effective. Taking breaks or doing something different before your pain either comes on or gets too uncomfortable is the trick to making pacing work.
Using your pain as an indicator to stop or do something different is best seen as 'trying to close the barn door after the horse has bolted.'
No. Some things in life can’t be stopped and therefore, simply stopping or avoiding things just aren’t realistic options for most people. Pacing is not about stopping things - it is about helping you continue to do things and eventually regain some control over them. Pacing is about increasing your options, not reducing them.
Sure! Let’s say your goal is to cook a meal for the family. Think about how you can break the cooking down into separate stages. Baselines can then be used in each stage -cooking a meal can be broken down into smaller steps:
You may have noticed the 3 building blocks that are needed for success with pacing:
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