Pacing for Chronic Illness: Why It’s More Than Just “Doing Less”

If you’ve ever been told to ‘pace yourself’ when living with Chronic Fatigue Syndrome (CFS/ME), fibromyalgia, chronic pain, Long COVID or similar conditions, you’ve probably noticed how vague that advice can be. Pacing is often oversimplified and sold as the solution to post-exertional malaise (PEM) and flare-ups. The truth? Pacing is not a cure. It’s one set of tools and strategies designed to help you live more sustainably and avoid setbacks.

Here’s how I teach pacing in a way that keeps you engaged in life—rather than stuck doing less and less.

Why Pacing Is Misunderstood

‘Just pace yourself’ sounds simple, but in practice, most people interpret it as ‘do less.’ While reducing overexertion is part of pacing, it’s not about complete avoidance or inactivity. Good pacing is about finding the sweet spot where you can stay active without tipping your body into a flare or crash.

My approach focuses on:

  • Staying as active as possible without triggering symptoms

  • Preventing the boom-and-bust cycle

  • Building long-term sustainability rather than short-term survival

The Foundations of Effective Pacing

I break pacing down into several key components:

1. Understanding Triggers and Current Capacity

Before you can pace effectively, you need to know what pushes you into a flare. Triggers can include physical activity, cognitive load, emotional stress, environmental factors, or a mix of these. Awareness of your baseline capacity helps you plan and adjust before symptoms escalate.

2. The Traffic Light System

Think of your symptoms as your body’s language. The traffic light method is a simple framework:

  • Green: You feel stable, low symptoms. Activities here are usually safe.

  • Yellow: Warning signs—mild symptoms, fatigue, or pain starting to creep in. Time to slow down, rest, or modify.

  • Red: Crash territory. You’re in a flare or PEM. This is when deep recovery is essential.

Pairing this with interoceptive practices (noticing internal body signals) can improve your ability to respond before you hit red.

3. Proactive vs Reactive Rest

Most people only rest when symptoms hit hard. Proactive rest means scheduling breaks before you feel awful. This helps prevent crashes and allows your system to recover gradually.

4. Structuring Your Day for Sustainability

Instead of packing all your activity into a few hours and then collapsing, spread tasks out. Alternate between different types of activity (physical, cognitive, emotional) and insert regular pauses.

5. Activity-to-Rest Ratios

For some, this might look like 20 minutes of activity followed by 10 minutes of rest. For others, it could be 50:50. Ratios are individual and may change daily based on symptoms and capacity.

6. Creating an Energy Budget

Similar to Spoon Theory, this helps you allocate your limited energy across essential and enjoyable activities. Creating an ‘energy budget’ keeps you realistic and prevents overspending.

7. High-Quality Rest and Recovery Practices

Not all rest is equal. Scrolling social media is not the same as restorative rest. Practices like breathing exercises, guided relaxation, gentle somatic work, or simply lying in a quiet space can help the nervous system truly settle.

What Pacing Is Not

  • It’s not avoidance of life

  • It’s not permanent restriction

  • It’s not the cure for chronic illness

Pacing is a flexible framework for preventing setbacks and creating stability so you can build capacity over time.

Final Thoughts

Pacing takes practice and self-compassion. There’s no perfect formula, and your needs will change day to day. Think of it as learning your body’s language and responding kindly, before symptoms have to shout.

Rob Nash

Heal and Thrive is an evidence-based clinical exercise physiology and health coaching practice supporting people living with chronic pain, fatigue, and invisible illnesses including ME/CFS, fibromyalgia, Long COVID, dysautonomia, POTS, and autoimmune conditions.

https://www.healthrive.com.au
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