Pacing
What is pacing?
Many people with energy-limiting conditions find that too much physical, cognitive or emotional exertion can make their symptoms worse. Pacing is a way of balancing activity and rest to help reduce the risk of symptom flare-ups.
Understanding symptom flare-ups
A response to exertion
Symptom flare-ups can happen after physical, cognitive or emotional exertion.
This can look very different from person to person, but may include severe fatigue, pain, cognitive difficulties, disrupted sleep and other symptoms.
A delayed onset of symptoms
Symptom flare-ups do not always happen straight away. They can begin 12 to 48 hours after exertion and may last for days or even weeks.
This delay can make it difficult to recognise when you have done too much, which can lead to a cycle of overexertion, symptom flare-ups and recovery.
Staying within your energy envelope
Pacing is a way of balancing activity and rest to help reduce symptom flare-ups. It involves finding a manageable level of activity that avoids both overexertion and underexertion, and that you can maintain over time.
Cycle of recovering and relapsing
Using wearable technology
High-accuracy wearable technology can help measure exertion and rest by using heart rate and movement data. Capturing and analyzing this data in real-time may help you to find, and stay, within your energy envelope.
Pacing research
Filter by energy‑limiting condition
Research Articles
- Appelman et al. (2024), Muscle abnormalities worsen after post-exertional malaise in long COVID
- Wright et al (2023), The relationship between physical activity and long COVID: a cross-sectional study.
- Clague-Baker et al. (2023), An international survey of experiences and attitudes towards pacing using a heart rate monitor for people with myalgic encephalomyelitis/chronic fatigue syndrome
- Pagen et al. (2023), High proportions of post-exertional malaise and orthostatic intolerance in people living with post-COVID-19 condition: the PRIME post-COVID study
- Twomey et al. (2022), Chronic Fatigue and Postexertional Malaise in People Living With Long COVID: An Observational Study
- Bond et al. (2021), Effects of Post-Exertional Malaise on Markers of Arterial Stiffness in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- McManimen et al. (2020), Deconstructing post-exertional malaise: An exploratory factor analysis
- Strussman et al. (2020), Characterization of Post–exertional Malaise in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Pace yourself with Visible
Visible uses your body’s data to help you understand your energy, so you can pace with confidence.