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 Osteopaths often advice patients to “pace themselves”. 

What does it really mean?

Activity pacing is ‘the regulation of activity level and/or rate in the service of an adaptive goal or goals’The main purpose of activity pacing is to get less pain flare ups whilst  slowly increasing your activities.Activity pacing has 2 parts to it:conserving energy for activities you value (for example, playing with your kids; undertaking a pleasurable recreational activity)setting graduated activity quotas to help you to increase your ability to do activities (tolerance) and reduce your set backs.Pacing is designed to be a tool you use not to ‘react to pain’, but a tool used in a pre-planned way.

Pacing uses a ‘time-orientated’ approach to activity rather than a ‘pain-orientated’ approach. This means activity that is based on a measurement (such as an amount of time, a distance, number of repetitions) rather than pain. This measure gives you a target and a limit for the activity – for example 15 minutes of walking or 20 minutes of light housework. It gives you a basis from which to build ‘activity tolerance’, which is important to allow you to do everyday tasks.

How do I actually do it ?

It’s a 6 step process. Here’s a summary:
Step 1: set a base line eg walking so many minutes per day or number of shirts ironed      etc . Repeat a task  three times over three days within your pain or fatigue limits , measure and divide by three, then reduce by 20 % to get your baseline.  Start slow. 
Step 2: Repeat the task daily for the first week and record
Step 3: Increase by 10 % each week if possible 
step 4: Build up your activity using SMART goals 
step 5: Small bits often. Meaning break activities into small chunks , change your position or posture often  
step 6: Take regular planned breaks – even on days you feel good  eg 20 mins weeding followed by cup of tea , practise relaaxtion and stretching , rest before and after difficult tasks 

 Helpful tips for pacing
*on a good day, do not do more than the pacing schedule allows
*have a plan and aim to change only one or two things at a time
*keep a record of what you’re doing and how much you are doing – write it down
*alternate heavier tasks with lighter or less stressful ones
*do little bits often
*use one kind of task as a break from another
*change your body position/posture regularly
*build up time on a task gradually – start low and increase slowly
*set your baseline
*start doing the task at about 20% less when you start paced activities
*increase the time by up to 10% each week
*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 pacing it up again
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