Pacing Strategies

Pacing means adopting new habits so you are able to participate in daily activities and not overstimulate yourself.

Many patients with vestibular dysfunction become easily overwhelmed by basic daily activities, such as employment, shopping, cleaning, and childcare. Pacing can help you plan your day so you have more control. Dr. Lisa Farrell, PT, PhD gives tips  for patients with vestibular dysfunction that are as simple as A, B, C.

  • Aware
  • Breath
  • Change

Here is a checklist you can use to support your healing:

Note Your Limits

  • Be aware of what is happening right now and recognize how you are handling the situation.
  • Pay attention to your self-talk and make sure that what you say to yourself supports your efforts to heal and live well.
  • Do you talk negatively or positively to yourself? For example, do you think you are lazy when you take a nap? Or, when you rest, do you tell yourself, “I am saving energy to spend time with my family or friends.”
  • Use your breath (gently follow it all the way in and all the way out) to refocus your energy and pause to see if there can be a change.
  • If there is an improvement by being aware and breathing, then acknowledge this with a gratitude statement. A starting phrase can be, “I am grateful that…”
  • If there is no change, then ask yourself, “What do I need to do take care of myself right now?”

Reduce Activity Level

  • Pay attention to individual activities that particularly increase your symptoms and reduce activity level.
  • Set limits on the amount of time you do these activities.
  • Find your limits by experimenting with how long it takes for the symptoms to come on or increase.
  • Once you have found your limit, then reduce the amount of time by 10 – 20% so you can do the activity without causing the symptoms to come on or worsen.
  • Maintain strict limits on time for a period of a 1 – 3 weeks, then test the limits to see if you can tolerate a new amount of time.
  • Delegate the activity by finding someone else to either help you with it or have them do it for you.
  • Eliminate the activities that cause severe symptoms for right now.

Most of the time, the goal is to not avoid activities that cause worsening of symptoms all together, but to allow your body to have success with doing them by figuring out if you can stop the activity before there is a significant increase in symptoms.

Use Activity Shifting

  • Identify whether an activity is considered light, moderate, or hard activity for you.
  • Plan your day to do the heavy activity when you feel your best and plan a rest period after it.
  • Alternate different levels of activity throughout your day.

Rule of Substitution

  • Make sure that you don’t do too many activities by scheduling one more item into your day.
  • Instead of adding an activity that comes up, drop one.

Take Scheduled Rests

  • Take a regularly scheduled break from normal activity to avoid over stimulation.
  • Don’t wait until your symptoms increase to take a break.
  • Plan your day in the morning to include several timed rest periods throughout the day.
  • During scheduled rest periods, stop your normal activity and either sit or lie down with your eyes open or closed. You may practice mindfulness meditation, grounding, listening to music, or audio book/podcasts.
  • The amount and time for each rest period varies from person to person.
  • The goal is not to go to sleep. 
    However, if you do fall asleep, this may be a sign that you are not getting enough quality sleep at night.
  • Rest periods don’t include talking on the phone or in person to someone, or watching TV.
  • It is tempting to skip rest when you are feeling good. However, be consistent by making these rest periods a part of your day.

Keep Pleasure in YOUR Life

  • Pleasurable activities reduce frustration and stress, distract you from your symptoms, and give you things to look forward to.
  • Think about light activities that you do with set amounts of time (so you don’t overstimulate yourself) and incorporate them into every day.
  • Make sure to include gratitude throughout your day (even small things you are grateful for). Write down five things you are grateful for every evening before you go to bed.

Plan Your Day

In the morning, write down a list, in order of priority, what you need and want to do for the day.

Tips when planning your day:
  • Pay attention to the time of day when your symptoms tend to be better and worse and plan to get more done during the time when symptoms are at their best.
  • Be aware of how many hours your body can typically tolerate activity and make sure the plans you have for the day do not take up more time than you can tolerate.
  • Plan to do activities after you have had a rest.
Use these methods to help (described above):
  • Set Limits for Individual Activities
  • Use Activity Shifting
  • Rule of Substitution