Self-Massage and Pacing with the Perrin Technique: What Happens Between Appointments?

The Perrin Technique doesn’t begin and end at the osteopath’s treatment room. Where appropriate, it can include a home programme designed around the individual.

For some people, that may involve prescribed self-massage. It can also mean thinking carefully about daily activity, rest and how to make a treatment plan manageable alongside the demands of everyday life.

The key is to make the programme realistic. If you’re living with ME/CFS, you may already be using most of your available energy to manage essential tasks. Adding a long list of new activities is unlikely to be a helpful starting point.

When I discuss home care with a patient, I want to understand what is practical for them, not simply what could be included in a programme.

What role does self-massage play?

Self-massage may be recommended as part of the Perrin Technique. The specific areas and instructions should be explained by your practitioner, as the programme needs to be appropriate to your circumstances.

It is not about pressing harder or doing as much as possible. The aim is to follow the guidance you have been given and understand how it fits into your overall plan.

If a technique is difficult to carry out, takes too much effort or doesn’t fit comfortably into your routine, tell your practitioner. The programme may need to be reviewed rather than pushed through regardless.

I also think it is important to distinguish between receiving hands-on treatment from a practitioner and carrying out self-massage at home. They are related parts of the approach, but they are not necessarily identical.

Why pacing matters when you have ME/CFS

Pacing means managing activity with an awareness of your current energy limits. It is particularly relevant when post-exertional malaise (PEM) is part of someone’s experience.

A person may manage an activity at the time but notice that their symptoms increase later that day or over the following days. If you only judge an activity by how you feel while doing it, it can be easy to underestimate its effect.

That is why I’m interested in what happens after activity as well as during it. The details can be useful when discussing how to manage appointments and any home programme.

Pacing is not a competition to do more each week, and it should not be treated as a rigid schedule. The aim is to recognise your current limits and avoid repeatedly overextending yourself. What is manageable may change, so it is worth reviewing your routine in light of your own experience.

Making a home programme realistic

When someone is already dealing with fatigue, brain fog, pain or other symptoms, even a seemingly simple task can require careful planning. A home programme needs to take that into account.

In practice, this may mean:

• Keeping the starting point manageable. A smaller programme may be more realistic than several new tasks at once.

• Considering when to do it. Think about how a task fits around your existing routine and the activities you need to manage that day.

• Allowing time to understand your response. Avoid adding several new activities at once if that makes it difficult to work out what you can comfortably manage.

• Discussing difficulties early. If the programme feels too demanding, let your practitioner know so it can be reviewed.

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These are practical considerations rather than a checklist you must complete. Your individual recommendations should come from the assessment and discussion with your practitioner.

What should I pay attention to after an appointment?

It can be useful to notice how you feel after treatment, later that day and over the following days. You don’t need to keep a detailed diary if that would be burdensome, but a few notes may help you explain your response at the next appointment.

You might record whether your usual symptoms changed, whether everyday activities were manageable and whether you needed more recovery time than expected.

Some patients report a temporary increase in familiar symptoms after treatment. A strong reaction is not the aim, and feeling worse is not a requirement for progress. If symptoms are new, prolonged or concerning, seek appropriate medical advice and contact your practitioner to discuss what happened before continuing with the same plan.

The information you share can help inform decisions about the techniques used, the length of sessions and the home programme.

How often should the Perrin Technique be carried out?

Appointment frequency varies according to the individual assessment and response. Many patients begin with weekly appointments during an initial 12-week assessment period, but this is not a fixed schedule for everyone.

The purpose of follow-up is to review how you are managing and whether the approach remains appropriate. That includes considering your experience between appointments, rather than making decisions based only on how you feel in the treatment room.

The same applies to home care. A programme should be reviewed when needed, particularly if your circumstances or capacity change.

A home programme should support your everyday life

Self-massage and pacing are intended to fit into a broader approach, not become another source of pressure. If a recommendation is difficult to manage, that is useful information to share with your practitioner.

With the Perrin Technique, the home programme is considered alongside the assessment and hands-on treatment. The details should reflect the person receiving it and their current circumstances.

If you are considering the Perrin Technique in London, an initial consultation is an opportunity to discuss your symptoms, daily routine and what a realistic approach might involve.

Frequently asked questions

Do I need to do self-massage every day?

Follow the instructions provided for your individual programme. The frequency and techniques recommended should be discussed with your practitioner rather than assumed to be the same for everyone.

What if I struggle to keep up with the home programme?

Let your practitioner know. The programme may need to be simplified or adapted to fit your current capacity. You should not feel obliged to continue a task that is proving difficult without discussing it.

Is pacing the same as avoiding all activity?

Pacing is about managing activity in relation to your current limits; it is not a universal instruction to avoid everything. If you have ME/CFS, your approach to activity should take account of your symptoms and medical advice.

Should I continue if I feel worse after treatment?

Do not assume that worsening symptoms are necessary or a sign that treatment is working. Contact your practitioner to discuss your response, and seek medical advice if symptoms are new, prolonged or concerning.

Written and clinical reviews by Rakhee Mediratta October 2026: Rakhee has more than 19 years of clinical experience and has treated over 5,000 patients. Her approach to the Perrin Technique includes considering how hands-on treatment and any home programme fit into a person’s daily life.