Hi there, I'm Lucy Macdonald, physiotherapist. Welcome back to my
virtual clinic. Today I'm going to be talking to you about pacing because
recently I've been seeing a fair few patients who have been recovering from
covid-19 and they're suffering from fatigue, now in the same way that with
people who have chronic pain it's really important when you are feeling fatigued
that you pace yourself and I'm gonna be giving you some really really nice
straightforward ways of doing that because it can be a challenge, but before
I do that I want to say thank you very much to those of you that keep sending
me lovely messages of support, I'm so glad that you're finding all these
videos so helpful, please do subscribe and let me know what you'd like me to do
a video on next. So pacing now pacing is really really
important because our bodies respond well to small incremental build-up of
exercise, now if you've been in bed for a long period of time then that exercise
might literally be getting up, going and making a cup of tea and then going back
to bed again, if however you're more active than that then it might be just
increasing a little bit of your walking or perhaps even if you're at the level
of running that you might just increase your running little by little, whatever
it is it's really important that you build up in small increments, now before
I go any further if you have had covid-19 please do make sure that before
you do any exercise you check in with your GP, so you check in with your doctor
so that they can do all the correct testing on your heart and your lungs to
make sure that you are ready for exercise, so once you've had all that
cleared the next thing to do as I say is to start to build in small increments,
now what you need to do is you need to look at every aspect of your life and
you need to take all of those things into consideration and one of the best
ways of doing that is to do an activity diary ,so all you need is a piece of
paper and a pen as you can see from my not very high tech version here, now what
you need is you need to write down in the
rows on the side you need to put the date and the day of the week and then
along the top here you put down all of your activities, as I say this is
applicable if you're recovering from chronic pain or if you have
fatigue, so along the top here you want to put all of your day-to-day activities
now as I say if you're very low level then those things will be different to
this so they might be simple things like getting out of bed to go to the loo,
getting out of bed to make a cup of tea, standing cooking a meal, those kind of
simple day-to-day things so do make sure that you put every element of your day
in there, numbers of hours you've been awake versus asleep etc, so along the top
here I've written walking, sitting, standing, work, physio exercises, other
exercise so if you do any other type of exercise like cycling or running or
anything else and then a column for your sleep, a column for your for stress
levels and food now I've put all of those in as a sort of general idea but
if you're higher level or lower level you can obviously change the categories
according to what you do most days, so for example if walking is
something that you find tiring or aggravates your pain then you need to
have a separate column for perhaps going walking to get your groceries versus
the walks that you go to the park for general enjoyment, so do make sure you
have a column for each, now at the end of each day and it's important that you do
at the end of each day rather than sort of trying to catch up after a week you
need to put down roughly the amount of time that you're spending on all of
those, now once you've done those things then you can look at it and you can look
at what your baseline is, so this enables you to create a baseline because it's
really really difficult to build from something that you don't know what
you're building from, so this is where this comes in really really useful you
create a baseline from which you can then make adjustments so once you've got
your baseline then you start to look and you think of
each category and you think right which is my most important category which would I
like to improve the most first and you choose one category and you increase
that category and that category only, it's important that you do it really
scientifically so that you keep all of the other variables exactly the same and
you just increase one component, so for example if you're wanting to return to
walking and cycling then you can only increase either running or cycling by a
small amount then you leave it two days to see how your body responds to that
because it can take 72 hours for the inflammatory process to take place so
you leave it 72 hours to see how your body has responded to that increase in
activity and if your body's responded to it well and you're fully recovered from
it then you can continue to increase perhaps a small element of one of the
other components, so that's the activity side of things and just to make a
note of these other things, now whether you're recovering from pain or from
fatigue it's really important to make sure you're getting decent sleep and if
you're not getting decent sleep then that's another reason that you must go
back and see your GP because sleep is absolutely essential for full recovery
and your GP may be able to give you something to help with that, likewise
with stress if you're struggling to manage your own stress then it's really
important that you go and see your GP and talk to your GP about that and if
you're concerned about speaking to your GP then please do speak to a loved one a
friend or family member who can support you in that, last but not least
your food, it's really really important that when you're recovering you're
getting all the good stuff into your body so tempting as it is to to go for
the foods that give us automatic pleasure they're not necessarily the
ones that are gonna give us the long-term benefits
so trying to avoid things like sugar, alcohol, smoking, processed foods and
going for more things lots and lots of veggies, your healthy fats, your complex
carbohydrates and of course your lean protein as well to make sure that you're
really putting all the things into your body that are going to
help you recover and putting them down on a list like this and writing down
something around your food you know have you had a positive day with your
vegetables, have you had your five a day or whatever it is that will help you to
establish positive habits will really make a difference with your long term,
now once you've filled in these for a few weeks what you'll find is that
you're able to look back and reflect on the activities that you've been doing,
you'll be able to notice the improvements that you've made and you'll
also be able to notice the slip-ups that you make, so what is it that results
in you feeling getting flare-ups in your pain or your fatigue levels and
you can therefore change your habits accordingly, so you can become in
effect your own physio because as physios that's something that we do we
guide people through to building up their activity levels to return you back
to the things that you love doing but it starts to be able to give you some
insight into how you can be doing that yourself, so I hope that's been helpful
please do get in touch if you would like me to to go through one of those
programmes with you in more detail, you can contact me lucy@octopusclinic.com
please do go to our website we've got loads of really useful exercises and
things on there and lots of advice, please make sure you subscribe and do
let me know what you would like me to do a video on next, in the meantime stay
healthy, bye!