Participation in any activity uses energy. Following an injury, where you may have fractured several bones, daily tasks can become very tiring and you will need to consider how to conserve energy.  

General principles of energy conservation

There are four main principles of energy conservation (known as the four ‘P’s)


This involves planning the week ahead and distributing heavy, high energy consuming tasks. A heavy, high energy consuming task could be hoovering or making the bed.

Planning involves:

  • Identifying an appropriate time of day to perform particular tasks. For example, performing the most difficult at the time of day when you typically have the most energy.
  • Alternating heavy, high energy consuming tasks with light tasks.
  • Thinking ahead and gathering all necessary supplies before starting a task. For example, having soap, shampoo, a towel and clean clothes close to hand before washing, or using a backpack to carry items if you have crutches.
  • Ask yourself; can I delegate this task to someone else? This may include a friend/relative, but also a carer/agency if appropriate. It could also include shopping online, or by phone.
  • As you recover/improve, slowly increase the number of heavier, high energy consuming, tasks you take on.


  • Allow frequent rest periods. For example 10 minutes of rest for every hour of activity.
  • Rest before you become tired. This will allow you to recover energy at a quicker rate than resting only after completing a task.
  • Allow sufficient time so there is no need to rush - fast walking takes twice as much energy as slow walking - and use a slow, rhythmic pace.
  • Time/energy can be saved by using, for example, ready chopped vegetables.
  • A slow cooker can be used, so meals can be prepared when energy levels are high, and eaten when they are low.
  • Rest after a meal.
  • Becoming fatigued can increase the risk of accidents, such as having a fall.
  • As you recover/improve, take fewer or shorter rest periods and gradually increase the pace at which you complete tasks.


There are 3 types of activities you will encounter in your daily life;

  • Activities you need to do
  • Activities you are expected to do
  • Activities you would like to do.

Try to prioritise the activities you need to do. You should include activities that provide you with meaning and quality of life, not just obligations that need to be met. This helps to maintain low levels of stress.

You may find it useful to ask yourself;

  • Is the task necessary?
  • Is it worth the extra expenditure of energy?
  • What would happen if this task was not done?


This includes the position/posture you adopt while completing a task, but also the positioning of equipment and the environment around you. Things to consider are:

  • Sit or perch to work, it requires less energy than standing. You may find it useful to use a perching stool in the kitchen or to wash/dress.
  • If having to move large/heavy objects, then slide/use wheels rather than lift (for example, transporting food on a kitchen trolley rather than carrying). If this is not possible, then consider pushing, and if this is not possible, pulling. Lifting the object should be the final option considered.
  • Divide large loads into smaller ones, so less strength is required.
  • Avoid prolonged holding of heavy objects, as this tires muscles.
  • After washing, put on a bath robe rather than towel drying straight away.
  • Maintain a good posture while completing a task, by avoiding stooping, bending, and over-reaching. Also, use both hands when possible. For example, keeping frequently used kitchen items on the counter top, rather than in high/low cupboards, or using a long handled aid while washing. Poor posture can lead to pain and fatigue.
  • Employ good working conditions, including bright lighting, an adequate temperature, good ventilation, and wearing comfortable clothing.
  • Double-up on equipment, for example, having cleaning fluids both upstairs and downstairs to avoid carrying them up/down stairs.
  • Equipment that is light-weight, self-maintaining - such as a self-defrosting fridge -and electrically powered will use less energy.
  • As you recover/improve, you may want to use equipment less, for example, standing to complete a task rather than sitting on a perching stool, and washing/dressing without the use of aids. Also, you may gradually increase the amount/weight of items you lift, for example, while putting away shopping.

Returning to work

As you recover/improve, you may consider returning to work. If so, it is advisable to contact the occupational health department - if you plan to return to a job in a large organisation - or a community occupational therapist/local job centre, to discuss the following:

  • Having a ‘dry run’ by working for a few hours to see how tired you feel afterwards and to identify any issues that need to be addressed.
  • Staggering the return to work, for example by working for 3 hours, 3 days a week, and gradually increasing the hours/days as able.
  • Any environmental alterations that will be required. For example, ramps/rails/width at doorways, adapting toilets/bathrooms as required, or where frequently used items are kept.
  • Changes that can be made to the nature of your role. For example, undertaking light duties if your normal role is very physically demanding.

managing equipment and casts

Some patients go home with a variety of different pieces of equipment or braces. You may have a spinal brace, a neck collar, an external fixator on your leg or arm or you may have a cast on your arm or leg. Please check with the therapy team or the doctors before you leave the hospital if you can shower whilst wearing your equipment or braces. You should never get your cast wet as it will fall apart.  More information about external fixators can be found here.

Driving after injury

You always need to discuss the implications of your injuries with your GP. You may, by law, have to notify the DVLA and your car insurance, depending on the type of injury that you have sustained. This is very important if you had a head injury or are on any medication for seizures.

Travel Insurance

As above, please discuss the implications of your injuries with your GP. Getting full insurance cover can be difficult if you have had a brain injury or a cardiac injury. However, there are specialist policies available. You can find out more information and useful links on the recreation and leisure page.  

Much of this information has been provided by St Georges' University Hospitals NHS Foundation Trust, Major Trauma Therapy Team @STGTraumaPTOT