How to manage chronic illness: Ask a Physiotherapist!

Self-Management for Chronic Illness

With over 3/5 Canadian adults living with a chronic illness, it is important to be able to help my clients find ways to self-manage these illnesses. Self-management includes providing them with strategies and tools to monitor and understand the impact of their illness on their daily lives. As someone who also lives with a chronic illness, I have first-hand experience on implementing these strategies into my lifestyle to help manage fluctuating energy levels.
Exercise can help combat side effects of various illnesses through reducing inflammation, improving joint mobility, reducing pain, improving physical function, improving sleep quality, and decreasing fatigue. High levels of evidence have suggested that physical activity can help reduce fatigue in individuals with chronic illnesses, including rheumatoid arthritis, multiple sclerosis, lupus, and fibromyalgia. However, it can be challenging to feel motivated to exercise, especially when you feel as though your tank is not always full. Energy conservation strategies can be implemented to enable you to successfully complete your daily tasks and get the most out of each day.
Try following the P’s of Energy Conservation:

1. Pacing
  • Take breaks as you need to for longer tasks
  • Balance activity and rest
  • Take your time with each task, do not rush!
  • Try to complete a task before starting the next
2. Planning
  • Make a schedule ahead of time to plan for your days and week ahead
  • Organize proper rest periods
  • Spread out errands throughout the week
  • Be realistic
3. Prioritizing
  • What tasks HAVE to be done?
  • What is most important to you?
  • Make a list in order of priority for your day
4. Practice
  • Trial and error, find what works for you!
  • Practicing these tips will help you find a good balance
  • What works for one person might not work for another, so be patient!
5. Positioning:
  • What positions are most comfortable for you?
  • Proper body positioning can help you conserve energy and reduce fatigue/pain
  • Sitting with proper posture
  • Avoid staying in one position for too long
  • Keep moving!

What is most important, is finding what works best for you! Everyone will have a different schedule that works best for them. Your physiotherapist can help you with these strategies and discuss what is your best recipe for successful energy conservation!

By Paula Hepburn 
Registered Physiotherapy Resident
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Toronto Physiotherapist Paula Hepburn

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1. Canada, P. (2017, April 11). Government of Canada. Retrieved March 19, 2021, from
2. Cramp, F., Hewlett, S., Almeida, C., Kirwan, J. R., Choy, E. H., Chalder, T., … & Christensen, R. (2013). Non‐pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database of Systematic Reviews, (8).
3. Estévez-López, F., Maestre-Cascales, C., Russell, D., Álvarez-Gallardo, I. C., Rodriguez-Ayllon, M., Hughes, C. M., … & McVeigh, J. G. (2020). Effectiveness of exercise on fatigue and sleep quality in fibromyalgia: a systematic review and meta-analysis of randomised trials. Archives of Physical Medicine and Rehabilitation.
4. O’Dwyer, T., Durcan, L., & Wilson, F. (2017, October). Exercise and physical activity in systemic lupus erythematosus: a systematic review with meta-analyses. In Seminars in arthritis and rheumatism (Vol. 47, No. 2, pp. 204-215). WB Saunders.
5. Razazian, N., Kazeminia, M., Moayedi, H., Daneshkhah, A., Shohaimi, S., Mohammadi, M., … & Salari, N. (2020). The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis. BMC neurology, 20(1), 1-11.

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