Physical activity: Managing uptime and downtime

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​​Different types of pain call for different levels of physical activity. When you have acute pain, for example from a sprained ankle or a muscle injury, reducing your activity for a short time helps the injured tissue to heal. With acute pain, the pain message prevents you from making your injury worse. Acute pain usually lasts only for a few days or weeks until the injured tissue heals.

However, physical activity plays a central role in managing any chronic pain. This is because the pain signals in chronic pain are not usually a warning of injury. In this case, being inactive for a long time can cause problems. When you become more active, you not only make your muscles, bones, heart and lungs stronger and healthier, but you also change the nerve activity and your brain so that you experience less pain.

​​A good way to work towards a more active lifestyle is to list activities that you want to do and make a plan with your healthcare team that gradually prepares your body for these activities. This is important because you may or may not have been active before your pain condition developed.

Balancing downtime and uptime

It is important to think about how you spend your days. You can see your time as a balance between:

  • downtime – the time you spend sitting or lying down, for example when watching TV, reading or using an electronic device
  • uptime – the time you spend doing everything from gentle movement to intense physical activity.

Limiting downtime

It is very important to limit the amount of time that you are inactive. For people with chronic pain, there is a strong link between being inactive and increased pain-related disability.

Too much downtime can:

  • lead to muscle weakening, which can increase your pain
  • negatively affect your mood
  • lead to joint stiffness, which can make movement painful and difficult.

Another name for downtime is sedentary time. It is recommended that you have less than two hours a day of sedentary time during your waking hours.

The downtime you spend on a computer, sitting in a car or bus, using your phone, gaming or reading a book can add up quickly throughout the day. Take a look at the tips below to find out how you can limit your downtime and increase your uptime.

Increasing uptime

Just as more downtime can be harmful, more uptime can help most people with chronic pain take part in the active parts of their lives more frequently. Regular activity can:

  • make you feel happier
  • reduce your stress levels
  • improve your sleep
  • build your muscles
  • improve your cardiovascular (heart and lung) fitness and strength.

A lot of your uptime probably includes activities that you do already, such as laundry, making the bed, cooking, cleaning, walking on the treadmill while watching TV, walking outside with friends, climbing stairs and dancing. Here are some tips for building even more activity into your daily routine.

Tips to limit downtime and increase uptime

Follow these tips to keep your downtime within the two-hour daily limit.

  • Swap sedentary activities (for example watching a movie or playing video games) for enjoyable active ones (ice-skating or bowling or playing twister or charades, if you can).
  • When you are at school, work or home, take advantage of short breaks to go for a little walk. For extra motivation, get yourself a pedometer or a fitness tracker to keep track of the number of steps you take every day. These simple devices allow you to assess your activity level and monitor your progress.
  • Build physical activity into the parts of your life that are usually sedentary (for example watch TV while walking on a treadmill, sitting on a therapy ball, stretching or practising balancing or strengthening exercises).
  • Take the stairs instead of the elevator if you’re going up or down only a floor or two.
  • Set a timer on your watch, phone or computer to remind yourself to get up every half hour and move around for a bit.
  • If you have to schedule a meeting with teachers or colleagues, suggest that you have a “walking meeting” instead of a seated one.
  • Be patient! If you’re new to exercise or activity, it will take more than a few days for you to notice the benefits of exercise. But don’t give up!
  • Go easy on yourself. It is important to pace your uptime so that you don’t over-exert yourself. It’s also okay if you miss a scheduled activity now and then.
  • Your healthcare team may recommend that you avoid certain activities when you have an increase in pain. Always follow this advice.


Pacing Pain Management Unit, Royal National Hospital for Rheumatic Diseases. Pain 101

Last updated: May 2nd 2016