Progressive Muscle Relaxation

Progressive muscle relaxation [PMR] is a relaxation technique of stress management developed by American physician Edmund Jacobson in 1934. This progressive muscle relaxation technique is focused on tensing and releasing tensions in the 16 different muscle groups. Jacobson reasoned that since muscular tension is usually followed as a by product of anxiety, one can lower and reduce anxiety by understanding and learning how to self relax those muscular tension. (McCallie et al., 2006)

Joseph Wolpe (Conrad and Roth, 2006 ) further adjusted this technique for use with systematic desensitization in 1948. Subsequently, both Bernstein and Borkovec in 1973 (Bernstein and Borkovec, 1973) came out with adjustments to the technique to suit cognitive behavioral stress management. Empirical proofs also supports the use of progressive muscle relaxation in high level tension responses and mind body techniques such as: irritable bowel syndrome, insomnia, reducing tension headaches, adjunct treatment in cancer and chronic pain management in inflammatory arthritis.(McCallie et al., 2006)

Let us take a closer look at what exactly is progressive muscle relaxation and how does this technique work. The idea behind progressive muscle relaxation is simply that of isolating one muscle group at a time, then intentionally creating muscle tension for 8-10 seconds, and then allowing the muscle to totally relax so as to release the tensions.

Taking for instance, when we take our right hand and tighten it into a fist with all our force, we can feel the muscle tension slowly increase in our hand and all the way up to the forearm. The longer we hold the tension and force, the more tense the arm becomes. The body will then become conscious that it does not feel comfortable in this position at all, where pain might even start to occur.

The above demonstrates an instance of intentionally exaggerated muscle tension in the body. When such tension exists around the forehead, one would usually experience headache and if it is around the neck area, a neck ache would be experienced. When the body continued to hold the muscle tension and then all at once, relax and totally let go, a difference will be felt when the hand is allowed to flop down onto the lap. The muscles around the arm now start to relax, and the muscle tension slowly flows away and disappears.

Based on the principle of muscle physiology, this process of relaxation is proven to work. The muscle has to relax whenever tension is being created in a muscle and then release. This happens because the muscle does not have a choice and it must react in this manner.

The interesting part of this process is that the muscle will not only quickly relax back to its pre-tensed state, and when it is allowed to rest, the muscle will become even more relaxed that it was before the tension was created. When this procedure of creating tension in the muscles and then releasing of the tension is applied to every major muscle group of the body, all of these muscles will become more relaxed prior to the beginning.

The main idea to initiating the relaxation response in this way is to take control of the voluntary muscles through creation of tension in them, followed by forcing them into a state of relaxation. When the body is aware of the presence of the tension, it will respond by triggering the muscles to relax, where the rest of the other components of the relaxation response will naturally follow.

Lesser oxygen is needed for relaxed muscle and hence the rate of breathing is slow. Since the heart does not require to be beating so fast to supply oxygen out to tense muscles, heart rate and blood pressure decline. Thus the normal blood flow will returns to the belly and digestion resumes where the belly is calmed and also the hands and feet are warmed up. As a result, this series of body adaptations all occur and fall naturally into place as the voluntary muscles are being directed into a state of relaxation, and changes in mood followed which make the body feeling calm and refreshed.

The progressive muscle relaxation procedure teaches you to relax your muscles through a two steps process. Through repetitive practices, the body quickly learns to recognize and differentiate the associated feelings between a tensed muscle and a completely relaxed muscle. Using this simple knowledge, the body can then induce physical muscular relaxation when the body first becomes aware of the signs of the tension that accompanies anxiety. With physical relaxation, the mental will also be more readily focused and able to maintain more calm.

To further enhance the benefits of being both physically and mentally relaxed, the body need to always stay as relaxed as possible. This is achievable if there is a positive transfer of the muscle relaxation technique into daily activities. Using the principle of Taichi, it focuses on slow rhythmic movements in a graceful manner where they mind and body is in a relaxed condition while the body is maintaining the correct postural alignment.

When we talked about the body being in a relaxed position, it does not mean that the muscles are not being used. In fact, Taichi can be considered as a high intensity aerobic exercise when practiced using the correct scientific approach and postural alignment. However, for many amateur Taichi practitioners, it is often difficult for them to maintain both physically and mentally relaxed especially when they are too focus on trying to remember the Taichi movements and applying the taichi principles.

Thus, the progressive muscle relaxation techniques offer a good foundation or pathway where individual can use it to initiate the body relaxation, then transferring this relaxation state into Taichi practice where it can further be used to achieve both mind and body relaxation and lastly to habitualise it into daily activities.

Hence, as we can see there is a positive transfer of muscle relaxation from practicing progressive muscle relaxation technique to taichi and lastly to maintain this state of well being and feeling of relaxation during normal daily physical activities.

To begin practicing the progressive muscle relaxation technique, we can either sit in a comfortable chair or lying on the bed. The main objective is to get as comfortable as possible, and tries to avoid wearing any tight clothes or shoes and also not to cross the legs. As for the breathing, take a gradual deep breath and let it slow gradually and slowly.

What we are going to perform is alternately tensing and relaxing specific major groups of muscles. After tension is released, the muscle will become even more relaxed than before the tensing. Focus on the feel of the muscles, especially the distinction between tension and relaxation. Over time, the body will become aware of any tension felt in any specific muscle and be able to reduce that tension. This is known as kinesthetic awareness. Before performing the progressive muscle relaxation, if one has any problems regarding pulled muscles, broken bones, or any medical contraindication for physical activities, need to consult the doctor first.

1. Hands - Clench the fists tightly to tense it and then relaxed. Next, the fingers are extended fully to create tension and relaxed.
2. Biceps and triceps - Elbow flexion to tense the biceps and relaxed by dropping the arm. Next, the triceps are tensed up and then relaxed by dropping them.
3. Shoulders - Pull back the shoulders to tense the muscle and then relax them. Next, push the shoulders forward or hunch it to create tension and then relax.
4. Neck (lateral) - Keep the shoulders in a neutral and relaxed position, the head is then rotated slowly to the right, as far as possible and then relax. Next rotate to the left and relax.
5. Neck (forward) - Press down the chin and tuck into your chest to tense the muscle and then relax. Hyper extension of the neck is not advisable as it could create too much stress on the neck.
6. Mouth - Open up the mouth as wide as possible to create tension and then relaxed. Next, the lips are pressed together as tightly as possible to create tension and then relaxed.
7. Eyes - Open the eyes as wide as possible to tense the muscle and then relax. Next, close the eyes tightly to tense it and then relax.
8. Gluteus - Press the gluteus together tightly and raise pelvis slightly off chair to create tension and then relax.
9. Quadriceps - Fully extend both legs and raise them above the ground to tense the muscles and then relax. Next, press the feet (heels) into the floor or foot rest to create tension and then relax.
10. Abdominal - Suck in the stomach as much as possible to create tension and then relax completely. Next, push out the stomach to create tension and then relax.
11. Calves and feet - Plantar flexion to create tension and then relax. Next, dorsi flex as much as possible to create tension and then relax.
12. Toes - Fully extend the toes outward to create tension and then relax. Next, bend the toes up as far as possible to create tension and then relax.

Lastly, let the whole body to remain relax for a while and feel the relaxation of all the muscles. After continued practices, there should be a gradual progression in muscle relaxation and then habitualising this into Taichi practices and finally to daily activities. These relaxation exercises will not eliminate tension, but when it arises, the body will be aware immediately, and the body will be able to respond positively to remove the tension away.

REFERENCES

BERNSTEIN, D. A. & BORKOVEC, T. D. (1973) Progressive relaxation training: A manual for the helping profession. Champaign, IL: Research Press.

CONRAD, A. & ROTH, W. T. (2006 ) Muscle relaxation therapy for anxiety disorders: It works but how? Journal of Anxiety Disorders Volume 21, Pg 243-264.

HOLLAND, J., MORROW, G., SCHMALE, A., DEROGATIS, L., STEFANEK, M., BERENSON, S., CARPENTER, P., BREITBART, W. & FELDSTEIN, M. (1991) A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms. Journal of Clinical Oncology, Vol 9.

MCCALLIE, S, M., BLUM, M, C., HOOD & J, C. (2006) Progressive Muscle Relaxation. Journal of Human Behavior in the Social Environment, Volume 13, Number 3, 13 July 2006 , pp.51-66(16).

OHMORI, F., SHIMIZU, S. & KAGAYA, A. (2007) Exercise-induced blood flow in relation to muscle relaxation period. Vol 6

SERMSAK LOLAK, M., L, G., CONNORS, J, M., SHERIDAN & WISE, T. N. (2008) Effects of Progressive Muscle Relaxation Training on Anxiety and Depression in Patients Enrolled in an Outpatient Pulmonary Rehabilitation Program. Vol. 77, No. 2, 2008