What It Really Means to “Pace Yourself”
Experts explain how balancing daily life with rest to manage arthritis symptoms can work for you.
If you have arthritis, you’ve likely heard that you need to “pace yourself ” to help manage your condition. But what does that mean, exactly?
“The general idea is to plan for a ‘just right’ amount of activity, balanced with mini rejuvenating breaks,” says Stacey Schepens Niemiec, PhD, assistant professor of research in the Division of Occupational Science and Occupational Therapy at the University of Southern California in Los Angeles. “The aim is threefold: preventing symptoms from limiting what you can do; reducing the need for long periods of inactivity that come after overdoing it; and, ultimately, increasing function.”
Pacing, stresses Anna L. Kratz, PhD, a clinical psychologist and assistant professor of physical medicine and rehabilitation at the University of Michigan in Ann Arbor, isn’t always about avoiding doing too much. It’s also about staying out of a cycle of doing too little.
“Figuring out how to stay physically active is one of the cornerstones to aging well with arthritis,” says Kratz. “Pacing is one way to plan and moderate activity so the timing and intensity work for you.”
Learning to Pace
There is no one-size fits all approach, and experts stress that figuring it out will require some trial and error.
Self-awareness. “You have to recognize patterns to address them,” says Niemiec. “Try keeping a diary to track your activities and subsequent symptoms for a couple weeks.”
It’s not just physical activities like yardwork or exercise that can flare symptoms, says Kratz. “Oftentimes, things like dealing with the stress of a toxic person or a long call with tech support or a credit card company lead to the most exhaustion and pain,” she says.
Prioritizing. Making space for the activities most important to you – and letting go of less meaningful ones – can help. “When you have arthritis, you need to prioritize your health in a new way,” says Kratz. “This can be hard because it can get at the core of how you see yourself – someone who keeps a spotless house or is always on the go, for example.”
Planning. Making a plan – rather than reacting to symptoms – is the foundation of pacing, says Douglas Cane, PhD, a clinical psychologist specializing in pain management at the Nova Scotia Health Authority in Canada.
Think about how a given activity is likely to affect you, and make a plan that’s likely to get you through it without causing a flare. Planning may include choosing your “best” time of day to tackle a stressful task or making sure you get good sleep and nutrition in the days before an important event.
Consistency and repetition. Things aren’t going to be a lot better tomorrow just because you paced well today, says Cane. “Doing it consistently for months – not days or weeks – may allow people to gradually increase their overall functioning.”
Niemiec stresses that activity pacing takes practice, motivation and perseverance. “It’s OK to experience setbacks. In fact, they are inevitable,” she says. “The trick is to pick yourself up and try again.”
Studies of activity pacing show it can be hard to do in the real world. One reason, says Cane, is that it can conflict with our basic self-view.
“When people first start trying to pace to manage symptoms, it often doesn’t feel very good emotionally,” he says. “It ties in to your whole sense of self-identity and self-worth. Often who we are and how we feel about ourselves is tied up in what we do and the roles we fill.”
Getting past that barrier typically means doing some re-evaluation and putting the brakes on our tendency to judge ourselves. “Many people have a set of standards about what they need to do or be, and those standards are often not up to date with where they are physically,” says Cane.
Practicing self-compassion can help you bring your expectations in line with your current physical reality, says Kratz. She advises dealing with yourself the same way you would a close friend.
“Imagine your friend came to you and said, ‘I know I don’t have the energy or stamina to do everything I used to do, but I feel I have to do these to be a good mom,’” she says. “What would be your own best advice for your friend? You need to be more like your own best friend and be more compassionate and understanding of yourself and your situation.”
Tips for Pacing
Experiment. Learn how much you can do on both “good” and “bad” days without flaring symptoms. Give yourself time to figure it out and don’t compare yourself with others – or with what you could do before arthritis.
Consider your pain expectations. With a chronic condition like arthritis, you may never be 100% pain-free. Pacing can’t eliminate pain, but can help you stop before pain gets out of control.
Get expert help. Occupational therapists can help tailor pacing strategies to fit your unique needs and challenges.