Activity pacing for persistent pelvic pain

If you have persistent pelvic pain (PPP), it’s important to keep moving. Physical activity can help reduce your pain sensitivity. Low impact activities such as swimming or walking, or mind-body practices like yoga and stretching, can help.

It’s important to find a balance between activity and rest that suits you. When you ‘pace’ your activity and energy levels, it may help you feel more in control.

What is pacing?

Pacing means gradually increasing your physical activity without increasing pain and fatigue. When you find a good balance between activity and rest, you can keep moving and do things you want to do.

How to pace your activity

• Choose the type of activity you want to do.
• Track how much activity you can do without having a pain flare.
• Record three days of activity (they don’t have to be consecutive days).
  • You can record your activity in different ways (e.g. minutes, distance or repetitions).
  • Work out the average amount of activity you can do without a pain flare. This is your ‘baseline’.
• Work out your ‘starting point’ by reducing your baseline by 20%. This encourages you to move, even on bad days.
• Gradually increase your activity by 10% each week.

Example

Activity: walking.

• Day 1: 20 minutes
• Day 2: 30 minutes
• Day 3: 25 minutes
• Total: 75 minutes

Baseline: 25 minutes (total divided by 3)

Starting point: 20 minutes (baseline menus 20%)

Your baseline and starting point

Use the example to work out your own baseline and starting point. Then aim to increase your activity by 10% each week.

Activity: enter your activity

• Day 1: enter your minutes
• Day 2: enter your minutes
• Day 3: enter your minutes
• Total: total your minutes

Baseline: calculate using total divided by 3.

Starting point: calculate using baseline minus 20%.

Track your activity

It’s important to keep track of your activities and how you feel afterwards. You can use a journal, a spreadsheet or an app on your phone.

Record:

• the activity you did
• when you did it
• the minutes, distance or repetitions you did
• how much rest you had
• how you felt during and after the activity (e.g. pain and fatigue levels).

Helpful tips

• Focus on activities you want to do.
• Start with smaller, easier activities.
• Schedule pacing into your day.
• Have planned rest breaks.
• Try to stick to your plan.
• If you’re having a difficult day, try to stay active but take more rest breaks and reduce your activity if you need to.

Things to remember

• If you’re having a good day, don’t be tempted to do more.
• If your activity is getting easier, or you want to try a new activity, work out a new baseline and starting point.
• It’s normal to have sore muscles for a day or so after doing a new or more challenging activity. This will reduce as your muscles get stronger. This is not a pain flare.
• Don’t be concerned about mild discomfort that goes away about 30 minutes after the activity. This is not a pain flare.

Where to get help

You can work with a physiotherapist or exercise physiologist while you are learning how to pace your activity.

Find more information, resources and references.