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Energy & Pacingยท6 min readยท

The 60% Rule: Why Pacing Is a Medical Strategy, Not a Cop-Out

Working at less than full capacity isn't giving up. For people with chronic illness, consistently staying within your energy envelope is one of the most effective management strategies available. Here's the evidence and the practice.

The advice sounds like the opposite of what you're supposed to do. Work at 60% of your capacity. On purpose. Even on good days.

For people with conditions that involve post-exertional malaise โ€” ME/CFS, POTS, fibromyalgia, Long COVID โ€” this is not a compromise. It is a management strategy with more evidence behind it than almost anything else available.

What pacing actually is

Pacing is the practice of staying within your energy envelope โ€” not exceeding the amount of physical, cognitive, and emotional activity that your body can sustain without triggering a crash.

The energy envelope is different for everyone and different from day to day. It is not determined by willpower or optimism. It is determined by the physiological capacity of a body with an energy-limiting condition. Exceeding it reliably triggers post-exertional malaise. Staying within it, reliably, prevents crashes โ€” and, over time, can create the conditions for the envelope to slowly expand.

Where the 60% figure comes from

The 60% guideline comes from pacing research and clinical practice in ME/CFS and dysautonomia. The core observation: most people with these conditions, when they estimate their capacity on a given day, consistently underestimate how much activities will actually cost. They use 80-90% of their capacity thinking they've used 50%.

The buffer exists to account for this miscalibration. If you aim for 60%, you're more likely to land at a sustainable threshold. If you aim for 80%, you're more likely to exceed your actual envelope without knowing it until the crash arrives โ€” 24 to 48 hours later.

The number is not rigid. The principle is: leave more reserve than you think you need, because your estimate is probably optimistic.

Why good days are the biggest risk

This is the part that surprises most people. Good days are the biggest pacing risk โ€” not bad days.

On a bad day, your body tells you clearly that you're at or over your limit. On a good day, the limit appears much further away than it is. The instinct is to use the extra capacity โ€” to catch up, to do the things that have been piling up, to feel like yourself for a day.

The consequence, reliably, is a crash that costs more than you gained. People with ME/CFS call this the boom-bust cycle: push hard on good days, crash for multiple bad days as a result, push hard again when the next good day arrives, crash again. The cycle keeps the overall average of functioning low even when individual good days exist.

โ€œThe most important pacing skill isn't managing bad days. It's stopping on good ones.โ€

โ€” Roi Shternin

What 60% looks like in practice

The honest answer is that it looks like less than you want to do. That is uncomfortable. It is also the point.

A practical day at 60% might include one substantive task (work, learning, an appointment), one lighter task (email, a short conversation, easy reading), one physical activity that sits within your capacity, and scheduled rest periods that are non-negotiable rather than earned.

The standard is not the productive person's definition of a full day. The standard is what you can sustain across a week without crashing โ€” which is a more useful definition of productivity for anyone managing an energy-limiting condition.

The psychological difficulty of pacing

Pacing is harder emotionally than it sounds practically. Stopping when you feel like you have more to give goes against most of what we're taught about effort and achievement. It can feel like giving up, like underperforming, like not trying hard enough.

It isn't. It's the application of a management framework to a medical reality. The discomfort of doing less than you feel capable of is real. The alternative โ€” the boom-bust cycle, the prolonged crashes, the progressive narrowing of the energy envelope โ€” is worse.

Pacing also requires accepting that some things won't get done. Building a life around 60% capacity means some things come off the list permanently. That is a grief process, and it deserves to be treated as one. But it is also the foundation for genuine sustainability โ€” which is the only basis on which anything else can be built.

Spooniversity's curriculum architecture is built on pacing principles. Every lesson is designed to complete in one energy window. The 60% rule isn't a disclaimer in our design โ€” it's a specification. Flare Mode is available everywhere, one click away.

R

Roi Shternin

Author, keynote speaker, patient advocate. Founder of Spooniversity. Has POTS, ME/CFS, fibromyalgia, MCAS, and CPTSD. Writes from experience.

roishternin.com โ†’

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