Photo of my Garmin vivoactive watch with ivory strap on my wrist. The watchface shows a big digital clock, date on the top left, remaining batter on top right. The Pacing Rate is displayed as a white thin bar below the digital clock. A red bar is superimposed on the pacing bar to indicate visually the rate, which is also written below the bar as '12% Very low'. To the right of the digital clock, the number 64 in red indicates my beart rate, heart rate is displayed in red as 64, and step count is displayed in blue as 420.

How to use a pacing app on a Garmin watch

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Note: Scroll down to find instructions for installing the Long Covid Pacing Watchface app onto your Garmin watch

Note: I am not funded or affiliated with either Garmin or the Long Covid Pacing App for Garmin. The following information is how I believe the apps work, based on my own experience of playing around with them.

I’ve decided to bite the bullet and get some data to help me to pace, especially as I’ve been flaring and crashing for 2 months again.

What is pacing?

Pacing is a management technique that is absolutely crucial for those of us with energy limiting conditions, and all the more so for neuro-immune-autonomic conditions like M.E/CFS, Long COVID, and dysautonomia. But I feel like I’m working blind when I try to pace.

To be effective, pacing isn’t just about pacing physically, but also cognitively and emotionally. And the kicker with these health conditions is that you can’t rely solely on how your body is feeling – it only warns you when it’s far too late. (if you want to know what pacing is, or if you’re a seasoned pacer but could do with some expert pointers and validation, I’d highly recommend Natasha Lipman’s podcast episode with Occy health therapist Jo Southall).

A new era – wearable tech for pacing

I’ve wanted to track my body metrics for years so that I can pace better, but the tech just wasn’t there. Now that Long Covid is, sadly, here, and is affecting so so many people, the community has swelled and we have a bigger pool of very talented and driven fellow chronic condition peeps to make these things happen (in spite of, I should add, medical institutions such as the NIH…that is for another blog post!). And I think we’re now at a stage where the applications and tech that these startups and independent developers are creating have ironed out enough glitches for the stuff to be really useful.

I am also hoping that being able to see the funky stuff my body is up to will help me to stop gaslighting myself. There are very few, if any, tests that doctors have access to in clinic to pinpoint issues with dysautonomia and M.E/CFS. This leads to, at best, non-committal, and at worst, medical gaslighting. So having some metrics that show the strain that my body is under will help me give me confidence that I am on the right track and look after myself better.

My choice of tech – Garmin Vivoactive and the Long Covid Pacing app

After much research, I’ve decided to go for the Garmin Vivoactive 5 so that (i) I have the right tech in my watch to capture the particular data that is most useful for pacing and (ii) I can access the independent developer apps that the chronic illness community is building. Specifically, I’m interested in the Long Covid Pacing for Garmin apps developed by Jens Hansen for his wife who has Long Covid. (I want to stress here that I am in an incredibly privileged position to be able to afford this tech, which sadly is completely out of reach for most people).

Diagram of the 'resilience' display on a garmin watch. Index of resilience is shown as a big number surrounded by a circle that is cut into red and grey to indicate the resilience left. There are also 2 bars below the resilience index, that show the heart rate and body battery values as a point on the bars.

Jens’ apps enable you to see, in real time, how well you are pacing by using two indicators.

One indicator uses a heart rate threshold. Research suggests that, to pace well, you need to keep your heart rate below a certain level. The Long covid pacing apps alert you when your heart rate exceeds this level. So you can use the display or the alarm to know when you need to reduce your activity in order to stay in your pacing zone.

The other indicator is an overview of your current resilience, giving you an idea of how many spoons you have left that day. The resilience value is different from the Garmin body battery, in that it takes into account how people with M.E and Long Covid are impacted severely by activities that would be considered low energy activities by healthy people. I am still learning about the Long Covid Pacing for Garmin apps so I will update you on how the resilience value is worked out, and how useful it is for me, in a future blog post.

How to set up the pacing app?

Firstly, you need to decide how you want to use the pacing functions available. There are 3 apps that have been developed by Jens, each providing something slightly different:

  1. The Long Covid Pacing watchface app – a pacing watchface app that displays useful pacing info
  2. The Long Covid pacing app – continuously runs and triggers an alarm if you reach a pacing threshold
  3. The Long Covid pacing datafield app– allows you to use a pacing threshold alarm within a Garmin activity such as walking or swimming.

I think that can install all 3 apps onto your watch if you’d like to use all of the available functions. I’ll update this blog post when I get around to trying the other apps out.

Important: The Long Covid Pacing Watchface app does not provide sound or vibration alerts. If you’d like a sound or vibration alert if your heart rate exceeds your pacing threshold, you can use one of the other 2 Long Covid pacing apps – the Activity app, called the Long Covid Pacing App, and the data field app, called the Long Covid Pacing Datafield app.

Note: If you use the Garmin Connect IQ web app rather than the mobile app to search for ‘long covid pacing’, the search results show 5 apps. This appears to include all versions – the non-AMOLED display version and the AMOLED display version. AMOLED is a type of higher-resolution display. The non-AMOLED apps are not avaliable for install onto my Garmin Vivoactive 5

Warning: The Long Covid Pacing AMOLED app includes a warning about using the app continuously, due to a risk of the display burning into the screen. For continous use, the pacing watchface is recommended.

I want to start with the easiest option – The Long Covid Pacing Watchface app which displays pacing information in real time on the watchface. For the purposes of our instructions, I shall refer to it as the pacing watchface.

1. Installing the pacing watchface

  1. Download the Garmin Connect IQ app onto your mobile phone and log in. The Garmin Connect IQ mobile app enables you to install new apps onto your watch.
  1. Search for long covid pacing app. Three Long Covid Pacing apps display in the search results. Screenshot of the search results. 5 LongCOVID pacing apps are shown, which includes the datafield, watchface, and general app. Each icon is a slightly different tone of blue.
  2. Select the Long Covid Pacing Watchface AMOLED app. The page for the watchface opens.image at top of page shows a woman in an orange sports top, walking. Two examples of the watchface are shown. One watchfae is white, the other is red with '+5' indicating heart rate has exceeded the pacing threshold by 5 BPM.
  3. Tap install. The word queued displays, indicating that the app is downloading and installing on your watch. After a short time, the permissions request window appears.
  4. Tap the allow button to allow access to the personal data required by the watchface app. window displays on top of the install page: This app requires access to (i) Your Garmin Connect fitness profile (ii) heart rate, barometer, temperature and altitude history. Two buttons are displayed - Cancel and Allow.
  5. A message window appears to confirm that your watchface is installing. Window displays on top of app page showing Long Covid Pacing icon and a message 'Congratulations installing your WATCH FACE'. The window has a 'Got It' button
  6. Configure the watch to display your new pacing watchface if it is not displaying as your Garmin watchface. As an example, the following instructions configure the watchface on a Garmin Vivoactive 5:
    1. Hold down the lower bezel button on your Garmin Vivoactive 5 watch.
    2. Select watchface from the menu.
    3. Swipe left to navigate to the Long Covid Pacing Watchface
    4. Tap the pacing watchface to select it as your Garmin watchface.

2. Configuring the pacing watchface to your body

  1. Navigate to the Long Covid Pacing Watchface page (Note: If you are continuing with these instructions after completing the install steps, you will already be on the pacing watchface page so can skip to step 2):
    1. From the Garmin Connect IQ mobile app, select My Device from the bottom menu
    2. Select My Watch Faces
    3. Select LongCOVID pacing Watchface AMOLED
  2. Tap the Settings button.
  3. Tap on disease pattern. A radio button option is displayed.
  4. Select your health condition from the options available – LongCovid or ME/CFS. Note: The app information states that HR max limits for pacing are calculated according to research findings, and are different depending on whether you have M.E/CFS or Long COVID. A window sits over the settings page. The window displays radio button options of 'LongCOVID' and 'ME/CFS'
  5. Calculate your personal HRMaxPacing number:
    1. Calculate your HRmax:
      • For females: HRmax = 206 - (age x 0.88) For example, for a 43 year old female: HRmax = 206 - (43 years x 0.88) = 168
      • For males: HRmax = 207 - (age x 0.7). For example, for a 43 year old male: HRmax = 207 - (43 years x 0.7) = 177
    2. Multiply your HRMax by 0.5 for ME/CFS, 0.6 for long COVID.
    3. Round this number up to the nearest integer (i.e. the nearest round number). This number is your HRMaxPacing value.
      • As an example, I am a 41 year old female with ME/CFS. My HRMax value is [206 - (41 years x 0.88)] = 169.9 . So My HRMaxPacing value is 169.9 x 0.5 = 85
  6. Tap on the Heartrate for Pacing setting. Enter the HRMaxPacing value calculated in the previous step.
  7. Configure any other settings you’d like to change. Note: I’d recommend you keep the default values for now. You can consider modifying the numbers to better fit your own disease severity as you learn your own pacing limits by trying out your Garmin watch.

Note: You can configure multiple settings for the watchface. For more information, see the Long Covid Pacing for Garmin website page Settings as Watchface.

3. Understanding the pacing watchface

Quick start: A low pacing rate value is good. The higher the pacing rate, the closer you are to overload.

There are 2 watchface displays. By default, the Pacing Rate watchface is displayed whenever you tap your watchface.

Pacing rate: The pacing rate is displayed on the watchface and is calculated by working out how close your current HR is to your max HR pacing value. In other words, how close are you to the threshold which the pacing research says you want to stay below for good pacing.

Screenshot from the Long Covid Pacing for Garmin website

Resilience Display: The Resilience display includes the resilience index, heart rate and body battery. The resilience index ranges from ‘good’ (5) to ‘stable’ (3) to ‘caution’ (1).

Important: It takes 5 days of monitoring before the Resilience index can be calculated.

I’m playing with the pacing watchface at the moment, and building up my 5 days worth of data so that I can access the Resilience display. I’ll update you with my experience and also get another blog post up here once I’ve installed and played with the other 2 available pacing apps – the pacing datafield app and pacing alarm app.

I’d love to hear how you’re finding the Long Covid Pacing for Garmin apps. Please do leave a comment.

If you’d like to learn more about the other Long Covid Pacing for Garmin apps and follow my experience of using them, hit the ‘Subscribe’ button.