Managing pain and fatigue

A young man with short, wavy red hair, blue eyes, and light skin smiling, wearing a dark blue polo shirt, standing against a plain light-colored background.

In this section adults with cerebral palsy share experiences of pain and fatigue, along with information and strategies they’ve found helpful for approaching and managing these common concerns.

Managing fatigue

How you could use the ‘5 D’s to manage fatigue?

Here we share stories from young adults with cerebral palsy about how they were able to use this concept to think about fatigue and use the strategies within the 5 D’s to manage fatigue.

But first, a quick refresh of the concept:

Orange square with the word 'Do' in white text

Do the task - Because you want to, can’t do the other Ds or you have to be the one to do it.

Purple sign with white text reading 'Do with adaptations'

Do the task but with some adaptation, for example assistive equipment.

Text reading 'Delegate' on a teal speech bubble or button.

Delegate the task - Ask someone else to do it.

Pink button with the word 'Defer' in white text.

Defer to task - do it later.

Blue rectangular button with rounded edges and the word 'Drop' written in white text.

Drop the task - If you don’t want to, or can’t do it.

Sahra’ story - getting into wheelchair basketball

Person in a wheelchair on a wooden indoor sports court, wearing athletic clothes.

Sahra is really excited to start wheelchair basketball. She wants to push herself really hard at the training sessions twice a week but knows that will tire herself out physically and mentally afterwards.

Using the 5 D’s might help Sahra to manage her fatigue during the week.

Orange button with the word 'Do' in white text

“Push hard at training - it’s important to me to do this, I just need to manage my other activities around it.”

Purple sign with white text that says 'Do with adaptations'.

“Usually I walk with crutches to training but it’s a long way. Using my wheelchair to get there would save some energy.”

Green campaign button with the word 'Delegate' in white text.

“I spend a lot of energy setting up my equipment and getting changed. I could hire a support worker for the sessions to help with that so that I can focus my energy on the training.”

Pink button with the word 'Defer' written in white text

“I might defer some of my other activities for the first few weeks while I get used to the training program.”

Blue button with the word 'Drop' written on it

“I won’t drop the training, it’s my priority…for now. I could drop other tasks on training days. For example, if I prepare a freezer meal earlier in the week I won’t have to cook dinner on training days when I’m really tired.”

Zach’ story - fatigue in the gym

A person in a motorized wheelchair holding a weightlifting barbell at a gym, wearing fingerless gloves and protective wristbands.

Zach has been going to the gym for a few months doing the same program. He enjoys the sessions but he feels wiped out for days afterwards and doesn’t have much energy for his usual activities.

Using the 5 D’s might help Zach to manage his fatigue during the week.

“I could adapt my program to do less. I would like my physio to provide advice on reducing the number of exercises, or changing the weights, reps or sets.”

Purple sign that says 'Do with adaptations'

“I could just keep doing the gym the same. But it’s been months now and the exhaustion hasn’t improved. I want something to change.”

Green button with rounded edges labeled 'Delegate' in white text.

“I would like my physio to talk to the personal trainer about changing the program and take charge of checking in with me in a few weeks time.”

“I am already deferring some of my other activities as I don’t have the energy. I would like to defer less.”

“I don’t want to drop the gym program just yet. I would like to try adapting the program and delegating some of the monitoring first.”

Lewis’ story - getting the dishes done

Person wearing green rubber gloves washing a pot in a stainless steel sink.

Lewis has dishes that need to be done.

Although they can stand to do the dishes, they get tired and sometimes don’t have energy later in the day.

Using the 5 D’s to think about managing this task could help to make sure this important task gets done but they also have enough energy to do other important things in the day.

Orange square with rounded edges and the word "Do" written in white text in the center.

“I can stand at the sink and wash all the dishes but this may not leave enough energy for other important things.”

“Adapt how I wash the dishes by washing them while sitting down or using a dishwasher. This might help conserve energy.”

Green rectangular button with rounded edges labeled 'Delegate' in white text.

“I could get a support worker to wash my dishes, especially on busy days. While I can wash the dishes it’s often better for me to save my energy for other important tasks.”

“I could do some dishes now and some later. I have to be careful with deferring this task as I don’t want the dishes to pile up!”

Blue button with the word 'Drop' in white text.

“I can’t really drop this task - the dishes need to get done one way or another!”

Reflection point

Think about a task or a day when you typically experience fatigue.

How could you use the 5 D’s to manage the tasks in the day and help with your fatigue?

A purple outlined thinking cloud inside a purple circle

Managing pain

How you could use ‘Describe - Impact - Outcome’ in practice?

Here we share stories from young adults with cerebral palsy about how they were able to use this concept to talk about pain and help plan their pain management strategies.

But first, a quick refresh of the concept:

Orange button with rounded edges and the word 'Describe' in white text.

What pain are you experiencing?

Pink button with the word 'Impact' in white letters

What impact does the pain have on you?

Gray button with the word 'Outcome' in white letters

What is your desired outcome?

A young woman sitting on a rowing machine in a gym, surrounded by workout equipment, with artwork on the wall behind her.

Azwar’s story

Orange oval button with white text that says 'Describe'

“For a few days after the gym my leg muscles feel really tight and sore and it’s quite painful when I use them.”

Pink rectangular button with rounded edges and the word 'Impact' in white text.

“I can still walk OK and do all the activities I need to but I can’t do gym again for a few days. This is mostly acceptable to me but I would prefer not to be quite so sore!”

Gray background with the word 'Outcome' in white text

I want to know if I can reduce my leg exercises a bit in the gym and still make strength gains. I want to know how long the muscle soreness should last. I want someone with knowledge of CP to review my program and discuss this with. I want reassurance about whether or not I am damaging my muscles if I am this sore.

Person in a wheelchair entering a swimming pool with assistance, surrounded by pool safety rails and swim staff.

Harper’s story

Orange rounded rectangular button with the word 'Describe' in white text.

“When I go do a hydro session with my support worker I start getting strong cramps in my legs about halfway through my program, usually this is when I am trying to do some weight shifts at the side of the pool.”

Pink background with the word 'Impact' in white text.

“I feel like I can’t concentrate on what my support worker is saying to me or keep my balance properly. I get frustrated and like I can’t focus on the session anymore even though I want to.”

Gray rectangular shape with rounded corners containing the word 'Outcome' in white text.

“I want to talk to my physio about adapting my program so that I have more breaks or change the exercises that cause my cramping.”

Leo’s Story

A smiling man in a wheelchair holding a basketball on an outdoor court with trees in the background.

“I recently started playing wheelchair basketball and I love it! After a while of playing I start getting pain in my wrists.”

Pink sign with the word 'Impact' in white text.

“When the pain starts I can't concentrate on the game as much. It means I'm not playing as well as I'd like to and I am not having as much fun as I want to have.”

Gray speech bubble with the word 'Outcome' written inside.

“I want to speak to my physio and OT about looking at different options such as gloves, positioning, or a different way of pushing that might help with my wrists. I'd also like to speak with other wheelchair basketball players, I'm interested to know if they've had wrist pain, and how they've managed it.”

Reflection point

Think about a time when you experienced pain.

How would you describe the pain, the impact it was having, and the outcome you would have liked?

A purple-outlined cloud inside a circle with purple border.

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