pacing - Musculoskeletal Health Australia (MHA)

22/Apr/2020

Updated July 2022

Feeling overwhelmed, exhausted, stressed and frustrated by 2022? You’re not alone! It’s been a bumpy ride. Filled with uncertainty, new pressures, lots of unknowns and a lack of control, many of us are feeling anxious, upset and vulnerable. When you have a musculoskeletal condition and live with regular pain and fatigue, the urge to retreat to your warm, cosy bed and pull the covers over your head can be very tempting.

But you’re strong. You can take control of the situation and do something proactive by examining your self-care plan. Ask yourself – “is my plan realistic now? Or does it need updating in light of the changes to my world?”

What is self-care?

Self-care is a popular term these days, with lots of different definitions and uses.

The World Health Organisation defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker” (1).

That’s a rather dry definition, so for the everyday person with a musculoskeletal condition, we describe self-care as the things you consciously and deliberately do to take care of your physical, mental and emotional health and wellbeing.

It includes everything from exercising regularly and staying active, eating a healthy diet, getting a good night’s sleep, caring for your mental health, managing pain and fatigue, seeing your healthcare team regularly, learning about your musculoskeletal condition, and staying connected with family and friends. It also involves things like good hygiene, avoiding risky behaviours and actions, and using medicines and treatments appropriately.

So to create a self-care plan for yourself that’s realistic and achievable, let’s get real, start small and appreciate the things you can do right now.

Get some sleep

Easier said than done I hear you say! But getting good quality sleep is crucial for our everyday functioning. If it’s an issue for you, especially at the moment, part of your 2022 self-care plan may be to look at ways you can improve your sleep quality and quantity. We have resources to help you – including nurses you can speak to on our Help Line (see details at bottom) and info on our website. Or if it’s a problem you feel you need extra help with, talk with your doctor (in person or via a telehealth consultation) to get professional help.

Eat a healthy, nutritious diet

While it’s tempting when you’re feeling crappy to eat foods you think of as comforting (e.g. chocolate, cheese, ice cream, biscuits, alcohol) you need to enjoy them in moderation. While they may make you happy for a while, it’s only temporary. Too much of a good thing can lead to weight gain and other health issues. Eating a variety of healthy foods, in a range of colours will make you feel better overall and will give you more energy. And on the days you’re feeling great, prepare some healthy meals you can pop in the freezer for the days you’re feeling lousy.

Stay active

Regular exercise has many health benefits for people with musculoskeletal conditions. It helps improve your symptoms, including pain, stiffness and fatigue.

When you exercise, your body releases chemicals such as endorphins, serotonin and dopamine into your bloodstream. They’re sometimes called ‘feel-good’ chemicals because they boost your mood and make you feel good. These chemicals also interact with receptors in your brain and ‘turn down the volume’ on your pain system.

Being active is also essential for your overall good health and wellbeing. It helps keep your muscles, bones and joints strong so that you can keep moving. It reduces your risk of developing other conditions such as heart disease, osteoporosis and diabetes. It boosts your mood, benefits your mental health, helps with weight control and improves sleep. If you’re not sure where to begin when it comes to starting an exercise program, talk with your doctor, physiotherapist or exercise physiologist for some advice.

Take care of your mental health

It’s really easy when you’re constantly surrounded by virus talk and the doom and gloom of the 24 hour news cycle to become overwhelmed. Especially if you’re also worried about your health, family, work and finances. And when you’re stressed and not looking after yourself properly, it can affect all aspects of your life including your family life, your ability to focus on work properly, sleep well, eat well…and so it becomes a vicious cycle.

The good news is there are lots of things you can do to look after your mental health during this time (read our blog for tips and strategies) including getting professional help if you need it. Again you can access the help you need in person or via a telehealth consultation. Talk with your doctor if you want more information about getting professional help.

But a really simple thing you can do immediately is to limit your exposure to the news – pick a time when you’ll catch up on what’s happening – for example the evening news or morning bulletin – and then turn it off and tune it out.

Cleaning – plan, prioritise and pace

Cleaning – yourself, your kids, your home can be an enormous challenge. Hands up if there are days you feel like you need a nap after having a shower in the morning? It happens to most of us living with chronic pain at one time or another. But the best thing you can do is to plan, prioritise and pace yourself.

Even before you get out of bed, while you’re lying in your warm, little cocoon, plan what you’d like to do during the day. Maybe have a notepad and pen beside your bed, or use a note app on your phone and write it all down. You can even do your planning the night before.

OK, seeing it in one place, you can see that it’s a lot 😕.

So now to the second P – prioritise. What are the things you really need to do? Do you really need to wash your hair today, or can you use the dry shampoo? Do you really need to vacuum the entire house, or just the living area? You know how you’re feeling on any given day – so plan, then prioritise.

Which then brings us to the 3rd P – pacing. Whatever you’re doing – cleaning, exercising, cooking, working, gardening, playing with the kids – pace yourself. It’s not a race – so be generous with your time and build in space for rest breaks.

And finally, when it comes to cleaning, don’t forget hand washing. We still need to do it regularly and thoroughly. We also need to be careful how we cough, sneeze and blow our noses. Check out our hygiene 101 blog for more info.

Make time for the things you enjoy

When you’ve given the basics of your self-care plan some TLC and revised it for the current world, now take some time to consider other aspects of your self-care. You may not have the time, energy or inclination to do these sorts of things most days, but schedule time to do the things that make you happy, relaxed, or pampered at least once a week – like a bubble bath, taking an hour to curl up with a good book, having a moment of peace and quiet in your garden to relax, doing a jigsaw puzzle, a video chat with your bestie. We all need these moments to help us recharge, especially when life is so crazy and unsettled.

Contact our free national Help Line

Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

4 ways I practice self-care living with a chronic illness
The Mighty
6 ways to love your body on bad days with a chronic illness
Healthline
Self-care tools for chronic health conditions
Michigan State University
The importance of self-care with chronic pain conditions
Pathways
What self-care is — and what it isn’t
PsychCentral

Reference

(1) Self-care interventions for health, World Health Organization.

Lisa Bywaters

19/Mar/2020

Didn’t think we’d ever be writing those words!

Update – 28 April 2020. This blog has been updated in line with the new restrictions on gatherings and physical distancing, and to include a video from Dr Adam Castricum Sport and Exercise Physician on the importance of being physically active during isolation.

COVID-19 has had a massive impact on our worlds – our health, travel, work, finances, schooling, family life, and all the little freedoms we once took for granted. Isolation has seen our physical world become much smaller.

While we struggle with all of these things, an important area when it comes to our health that many of us are finding difficult to wrap our heads and bodies around is getting enough exercise.

If you live with a musculoskeletal condition like arthritis, back pain or osteoporosis you know how important exercise and being active is. It helps us manage our condition, our pain, our weight, and our mental health. It also helps us sleep better and gives us the opportunity to socialise with others.

However not being able to attend our classes, fitness centres and sporting clubs means we need to look at alternative ways to exercise.

Here’s a few ideas to help you stay active during the pandemic:

Schedule time for it. Our lives have turned upside down, so having a regular routine, including time for exercise is really important, for both our physical health, but also our mental health and wellbeing.
Exercise with others. Grab your family and go for a bike ride, walk around the park, shoot hoops in the driveway, play leapfrog on the lawn. Or connect with friends via video apps and exercise together. Along with having a regular time for exercise, having an exercise buddy – whether in person or online – will help keep you motivated and accountable.
Get outside and go for a walk, jog or run. It’s still a great way to stay active. If you’re doing it with a friend, make sure you’re abiding by the latest restrictions regarding gatherings and physical distancing. And don’t forget – COVID-19 doesn’t spread to our dogs, so take them for a walk. They’ll love it! And avoid walking, jogging or running in busy areas, or during busy times.
Use an old fashioned DVD and exercise in front of your TV. Or stream an exercise program online. Or use an exercise app. There are so many to choose from. Just make sure that the exercises are performed by people who know what they’re doing.
Dance around the house. Get the blood pumping with some of your favourite, high energy music, and shake it off!
Walk/run/skip around your home and yard – use the space you have available. At the beginning of the Chinese lockdown there was news of a man who ran a marathon in his own apartment! While you don’t have to go to that extreme, it highlights that you can do all kinds of things in small spaces if you’re a little creative.
If you have a WII Fit, or any of the electronic karaoke/guitar/music games that plug into your TV, set it up and go for it. Sing, dance and game to your hearts content. If you don’t have any of the electronics, just do some air guitar or air drumming. We’ve all done it, and it’s so much fun.
Get creative! One of our families has told us about how they’re blowing up balloons and using them as balls. For example, keeping them off the ground while they sit on opposite sides of the table, hitting balloons with fly swats and other improvised rackets for a game of tennis. We can be very creative when we need to be – let your inner exercise guru loose!
Use what you have around the house. You may already have exercise balls/bands and weights to use, or you can improvise with cans of soup for weights, steps ups on your stairs etc.
Incorporate incidental exercise. Check out our blog on how the little bits and pieces you do over the course of your day – for example cleaning, talking on the phone – can be made more active and really add up.
Go for a ride. Use an indoor stationary bike, or hit the streets or park on your bicycle.
Consider hiring or buying (new or second hand) exercise equipment such as a treadmill, exercise bike or cross-trainer. You can use the equipment to add variety to your exercise program, and it’ll also come in handy for those days it’s too wet or cold to venture outdoors.

There are lots of things you can do to remain active during this pandemic, and stay safe. These are just some of them. For more information, visit our website or call our MSK Help line weekdays on 1800 263 265. Or email helpline@msk.org.au.

More to explore

The importance of being physically active – video
Dr Adam Castricum Sport and Exercise Physician Olympic Park Sport Medicine Centre, 27 April 2020
COFIT19 for adults
Australasian College of Sport and Exercise Physicians
This infographic gives you tips on how you can remain active in your isolation ‘bubble’.
Home exercises
Exercise & Sports Science Australia (ESSA)
ESSA accredited exercise professionals have put together a range of workouts that you can do in the safety of your own home.
What’s the bare minimum amount of exercise you need to stay healthy during a lockdown?
ABC Life, 9 April 2020
How to stay fit and active at home during the coronavirus self-isolation
The Conversation, 26 March 2020

Lisa Bywaters

31/Jan/2020

With our crazy, busy lives it can sometimes feel next to impossible to squeeze in time for exercise. Add to that the unpredictability of living with a chronic condition, and our planned activities can often go flying out the door.

But there are things you can do to be more active. Incidental exercise – or the little bits and pieces you do over the course of your day – can really add up. It’s important to note that incidental exercise should not replace your regular, structured exercise program, but they’re a great way to boost your activity levels.

Here are some things you can do to increase your incidental exercise.

Watching TV? Whether you’re watching the latest episode of your favourite show or binge watching an entire series, get up and move around during the ads. No ads? No problems. At the end of each episode, do something active. Go outside and check the letterbox. Take the dog for a walk around the block. If you have an exercise bike or treadmill, use it while watching your show.
Love reading? Download an audio book and listen to it as you go for a walk. Just be mindful about how far you walk. It’s easy to get caught up in a book and walk further than you planned! Which has the potential to aggravate your condition and pain levels if you do too much.
Going for a long drive? Make your journey more interesting, and more active by scheduling stops for you to stretch, walk around and discover new areas. It’s amazing what you can find when you take the time to explore.
Shopping? Park your car a little further away from the shops than you normally would. Walk up or down the travellator or escalator – even if it’s just for part of the ride – rather than just standing in place.
Work meeting? Take it outside. Suggest that you have walking meeting. You get to be active and less sedentary, with the added benefit of fresh air.
Catching public transport? Get off a stop before your usual one. Explore your neighbourhood while getting some exercise and breathing deeply.
On the phone? Walk around while chatting, rather than sitting down. But avoid moving about if you’re texting or looking at your screen. Our aim is to increase activity levels safely, not get injured in the process!
Gaming? Fun! But it’s so easy to get caught up in the heat of the battle/chase/adventure, so set your phone alarm to go off every 30 minutes so you can get up and move.
Cleaning? Go hard. Give the tiles an extra vigorous scrub. Flatten your recyclables rather than just tossing them straight into your recycling bin. Clean your windows (groan – but how good do they look when you’re done?). Vacuum the house and use all of the little attachments (who knew they made such a difference?).

Obviously there’ll be times when these activities are not possible or practical – especially if you’re having a flare. However some of them may actually help with your pain – things like standing and moving when your back is really sore, breaking up long trips with stops and stretches – they’ll provide exercise and pain relief.

Give incidental exercise a try. Before you know it, you’ll be feeling more energised and noticing a difference with your pain levels, sleep quality and mood.

Plus your house will be sparkling! Win-win!