Energy Conservation & Pacing

Boom and bust

The pattern is almost universal. A good day arrives, and you use it — you catch up on everything that has been waiting. You pay for it for the next three days. When you finally feel better, there is now even more waiting, so you push again.

Over time the good days get shorter and the crashes get longer. Nobody chooses this cycle; it is what any reasonable person does when they get a window. Breaking it is the core of pacing, and it feels wrong at first, because it means stopping while you still feel fine.

The four Ps

Prioritise

You have a limited budget. Spending it on the things that matter is not laziness, it is arithmetic. Each week, sort what needs doing into: must happen · would be good · could wait · does not actually need doing at all. Be honest about that last category — it is usually larger than people expect, and it is often full of standards nobody but you is checking.

Plan

Spread demanding tasks across the week rather than stacking them. Put the hard thing on a day with nothing after it. Build in recovery time after known-expensive events — appointments, family visits, travel — before the day arrives, not once you are already flattened.

Pace

Break tasks into chunks with rest between them, and take the rest before you need it. A useful starting point: work out how long you can do something before symptoms increase, then do 80 per cent of that, and rest. Consistency beats intensity — the aim is the same amount on a good day and a bad one, which is what stops the cycle.

Position

Sit rather than stand wherever possible. Bring the work to you rather than moving to it. Keep frequently used things at waist height. Slide rather than lift; push rather than pull; use a trolley rather than carry.

Practical changes that buy back the most

Kitchen

• Sit to prep — a perching stool or a chair at the counter.
• Cook double and freeze half.
• Ready-chopped vegetables, tinned pulses, pre-cooked rice. The premium is real and it is usually worth it.
• Soak dishes rather than scrub; let them drain rather than dry them.
• Slide pans along the counter instead of lifting.

Washing and dressing

• Shower sitting down — a shower chair is not a defeat, it is a way to still be functional afterwards.
• Shower at the time of day you have the most energy, not automatically first thing.
• A towelling robe instead of drying off.
• Lay clothes out the night before; dress sitting down; choose clothing that goes on easily.

Housework

• One room a day, not the whole house on Saturday.
• Long-handled tools so you are not bending.
• A launderette, a cleaner, or a family rota if any of those are available. Delegation is a legitimate energy strategy.
• Lower the standard deliberately and out loud, so it is a decision rather than a failure.

Out and about

• Online shopping and delivery.
• Park close, go at quiet times, use a trolley even for a few items.
• Plan where you can sit down before you go.
• Take the mobility aid. A wheelchair or scooter for longer distances is not "giving in" — it is what lets you get to the end of the day with something left.

Track it for two weeks

Most people cannot say where their energy goes, and guessing produces the wrong plan. For two weeks, note each activity, roughly how long it took, and your fatigue level from 1 to 10 before and after.

You are looking for three things: which activities cost far more than they look like they should; what time of day you reliably have most capacity; and what the pattern is on the day after a heavy one. The delay is the part that catches people out — the cost often lands 24 to 48 hours later, which is exactly why the connection gets missed.

Rest that actually restores

Not all rest is equal. Scrolling on a phone is not rest for a tired brain; nor is watching something demanding, nor is lying down while worrying about the list.

Aim for short, planned rests through the day rather than a collapse at the end of it. Twenty minutes, quiet, low light, lying down or fully reclined, before you feel you need it. Long daytime sleeps often make night sleep worse — a rest is not necessarily a nap.

The conversations

• At work. Fatigue is a functional limitation and it can be accommodated — graduated hours, task rotation, protected breaks, remote work. See workplace accommodations.
• At home. Say what you need specifically. "I need help" produces sympathy; "could you do the shopping on Saturdays" produces shopping.
• With yourself. Pacing means saying no to things you can technically do. That is a genuine loss and it is worth acknowledging rather than pretending it is fine.

An important caution

For some conditions — including ME/CFS and long COVID with post-exertional malaise — pushing through symptoms can cause a lasting deterioration, not just a bad day. If your symptoms reliably worsen 12 to 48 hours after activity, pacing is not a productivity technique but a clinical necessity, and graded exercise approaches may be actively harmful. Say this clearly to any clinician planning your rehabilitation.

How an OT helps

An occupational therapist assesses what your days actually contain, finds the specific tasks costing more than they should, and redesigns them — technique, equipment, environment and sequence. The goal is not to do less. It is to get more of what matters out of the same budget.