Contact a healthcare professional if you experience unusual or acute symptoms, such as severe shortness of breath, chest pain, dizziness, or confusion.
Attention note
Fatigue and exhaustion: these tips are important
Attention note
Contact a healthcare professional if you experience unusual or acute symptoms, such as severe shortness of breath, chest pain, dizziness, or confusion.
Pacing
Fatigue
“Fatigue” is a form of pathological exhaustion that is physical, mental, or psychological in nature. Fatigue is one of the most common of the many symptoms of Long COVID.
Pacing means doing less than your strength currently allows. Pacing is a gentle way of using your resources.
Pacing helps when it has become difficult to calculate your day-to-day energy levels and when you are exhausted and feel completely worn out or very tired. Pacing can also reduce setbacks in your healing process.
The art of pacing involves finding your own optimal balance between conserving energy and practicing any activity, as well as continually increasing your activity. The goal: to get out of the ups and downs between good and bad days and returning to a stable energy level and everyday routine.
More information and application tips on Pacing:
- Detailed information and application tips in our Vademecum Pacing part 1: recognizing the limits and Pacing part 2: The 4P’s rule.
- Long Covid Physio. Navigating Pacing. (Podcast)
- #MEAction. Rest. Pace. (Video)
Procedure:
- Identify your current limits in the four activity areas: physical, mental/cognitive, social, and emotional.
- Identify your individual warning sign in each of the four activity areas.
- Accept your current limits.
- Communicate your current limits and get help.
Adjust your daily activities and tasks using the 4P's rule:
- Prioritize
- Plan
- Pause regularly
- Stay positive
- Medinger, Gez. The Why, When and How of Pacing | Long Covid’s Most Important Lesson. (Video discussion with experts)
- Royal College of Occupational Therapists. How to conserve your energy.
Note: for more videos and links see the same page in other languages.
Heart rate monitoring
Heart rate monitoring is suitable for people with Fatigue to avoid crashes/PEM. It refers to the constant measurement of the heart rate with a heart rate monitor and is used for Pacing.
It is often difficult to develop a feeling for the limit of resilience and not end up in a crash/PEM. For many people, subjective perception is not tangible enough. With a defined upper limit (maximum heart rate), pacing becomes tangible and easier to implement.
Crashes/PEM are often triggered by an activity for which the body has to provide the energy mainly without oxygen. The threshold from aerobic (with oxygen) to anaerobic (without oxygen) energy supply is called the anaerobic threshold. Heart rate is an adequate parameter to monitor anaerobic threshold.
- The threshold is very individual and depends on many factors. It can be determined relatively accurately with a cardio-pulmonary stress test.
- It is also possible to calculate a guide value. You can find two ways to do this in our “Heart Rate Monitoring” guide.
Please read the detailed information on heart rate monitoring in our Vademecum (in German, translation will follow).
Post Excertional Malaise (PEM), recognize and prevent "crashes"
Post-Exertion Malaise (PEM) refers to the worsening of symptoms after physical, mental or emotional exertion, it is also referred to as "crash". PEM is a different symptom than a healthy person's "normal" fatigue after activity, excitement, or exertion. For many clinics, researchers, and affected people, PEM is considered the primary symptom of chronic fatigue syndrome (ME/CFS). Many people affected by Long COVID report similar "crashes" even after the smallest physical, cognitive, or emotional exertion.
Early detection of PEM is important and can reduce "crashes" and provide more safety during efforts in everyday life. Early detection also improves physical and mental well-being.
How to recognize and reduce PEM:
- Recognize PEM as a consequence or side effect of overexertion.
- Keep diary to identify patterns of overexertion.
- Search discussion with a doctor or an expert.
- The following methods may help: Pacing / Return to sport / Specific rehabilitation
Here you will find a PDF with detailed information about PEM (in German, translation will follow).
Here you will find two short videos about PEM.
Here you will find a short introduction to PEM.
