Progressive muscle relaxation (PMR) is a method of deep muscle relaxation that does not involve any medications, meaning it is a
non-pharmacological intervention.
The idea behind progressive muscle relaxation is that there is a relationship between a person's mind and body.
The body responds to its environment by creating certain mind or body states such as
anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
,
stress, and
fear
Fear is an unpleasant emotion that arises in response to perception, perceived dangers or threats. Fear causes physiological and psychological changes. It may produce behavioral reactions such as mounting an aggressive response or fleeing the ...
. When the body is in these states, the muscles tense up. Progressive muscle relaxation aims to reverse these body states back to more neutral, relaxed states.
The technique is a two-step process.
It involves learning to relieve the tension in specific muscle groups by first tensing and then relaxing each muscle group.
When the muscle tension is released, attention is directed towards the differences felt during tension and relaxation so that the patient learns to recognize the contrast between the states.
Progressive muscle relaxation is used in many ways.
It can influence conditions like anxiety,
insomnia
Insomnia, also known as sleeplessness, is a sleep disorder where people have difficulty sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low ene ...
,
stress,
depression, and
pain
Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...
and may have beneficial long term effects.
It is also effective for many populations, including both children and adults.
[Torales, Julio & O'Higgins, Marcelo & Barrios, Iván & Gonzalez, Israel & Almirón, Marcos. (2020). An Overview of Jacobson’s Progressive Muscle Relaxation in Managing Anxiety. Revista Argentina de Clinica Psicologica. XXIX. 17-23. 10.24205/03276716.2020.748.] People in many different situations can learn to perform progressive muscle relaxation.
It is simple to learn and is used in hospital and non-hospital settings.
History
Progressive muscle relaxation was initially developed by American physician
Edmund Jacobson.
He first presented the technique at Harvard University in 1908.
[Jacobson, E. (1929). Progressive relaxation. Chicago: University of Chicago Press] Jacobson continued to work on this topic throughout his life and wrote several books about it.
In 1929, Jacobson published the book ''Progressive Relaxation'', which included a detailed procedure for removing tension in the muscles.
Relaxation is the opposite of tension, so his work led to the use of the word "relax" to describe the act of becoming less tense, anxious, or stressed. Jacobson believed that rest and
relaxation were different concepts.
He explained that people can be tense when they are resting, but they cannot be tense when they are relaxed.
Jacobson designed the progressive muscle relaxation so that it could address a large number of mental and physical conditions.
In his 1934 book,''You Must Relax: A Practical Method of Reducing the Strains of Modern Living'', Jacobson noted the potential applications of his technique.
He claimed that progressive muscle relaxation could be beneficial for
illness
A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
, heart disease, insomnia, and
indigestion
Indigestion, also known as dyspepsia or upset stomach, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier ...
.
However, he believed that only qualified physicians and experts could teach other people the technique.
The initial progressive muscle relaxation technique that Jacobson developed required weekly instruction and daily practice.
Eventually,
Joseph Wolpe
Joseph Wolpe (20 April 1915 in Johannesburg, South Africa – 4 December 1997 in Los Angeles) was a South African psychiatrist and one of the most influential figures in behavior therapy.
Wolpe grew up in South Africa, attending Parktown Boys' ...
shortened Jacobson's technique to a 20 minute exercise.
Wolpe used progressive muscle relaxation to counteract people's fear response.
Progressive muscle relaxation developed over many years as other scientists and doctors made changes to the technique.
There are many variations of the progressive muscle relaxation technique today.
During the 1970s, medical institutions recognized relaxation techniques such as progressive muscle relaxation as safe and effective
alternatives to drug treatments for certain conditions like anxiety, insomnia, and
hypertension
Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
.
The medical world also viewed muscle relaxation as a technique that could effectively promote well-being.
However, medical institutions now describe progressive muscle relaxation as a type of complementary medicine since the term "alternative" may imply that the therapy is a replacement for modern medicine.
Progressive muscle relaxation can be effectively used with other modern medical treatments or other complementary therapies that promote health.
The technique today
Individuals should perform progressive muscle relaxation in a comfortable place.
A person can begin the exercise while sitting or standing.
It is important to breathe throughout the entire exercise,
because some sources recommend breathing in while tensing the muscles and breathing out as the muscles are released.
The exercise should not cause pain or discomfort.
Individuals who have injuries should speak with a doctor before performing the exercise. Many individuals choose to visualize the muscles tensing and relaxing as they perform the exercise.
Some institutions suggest to slowly tense each muscle group starting with the forehead and ending with the toes.
Other exercise instructions recommend starting from the bottom of the body at the feet and working up the body toward the forehead or starting on one side of the body and slowly move through the body to the other side.
Sources group muscles differently, but some muscle groups that are commonly used include:
* Forehead
* Eyes/Cheeks
* Mouth/Jaw
* Neck
* Back/Shoulders
* Chest
* Upper Arms
* Hands/Fists
* Abdominal Muscles/Waist
* Hips/Buttocks
* Thighs
* Calves/Feet/Toes
To begin the exercise, the individual slowly breathes in and tenses the first muscle group, then holds the breath and tension for 3–5 seconds.
Next, the individual would slowly breathe out while releasing the tension and relax the muscles for 10–15 seconds.
The individual can try to visualize how the tension feels like and how it is slowly fading out of their body. Then, the individual breathes in and tenses the next muscle group, repeating this process for all of the muscle groups.
Applications
Anxiety
PMR is still modernly used to manage anxiety.
Anxiety is an emotional reaction to anticipated threats in the environment.
PMR can be effective at reducing
test anxiety
Test anxiety is a combination of physiological over-arousal, Stress (biology), tension and somatic symptoms, along with Worry, worry, dread, fear of failure, and Exaggeration, catastrophizing, that occur before or during test situations.Zeidner M. ...
in students.
It is also effective at reducing anxiety and improving quality of life in patients with various types of cancer.
In addition,
heart disease
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina pectoris, angina, myocardial infarction, heart attack), heart failure, ...
patients and
coronavirus
Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the comm ...
patients who feel isolated have also used PMR to help reduce their anxiety.
Some studies have found that PMR is effective for both young and old populations, although it is particularly effective at reducing anxiety in older population.
Depression
PMR is effective at reducing the severity of depression in patients with various conditions like heart disease,
coronavirus,
and
cancer
Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
.
Some studies have also shown that women can effectively use PMR to manage
postpartum depression.
Stress
Relaxation techniques such as progressive muscle relaxation can alter the body's physical and emotional response to stress by impacting the
sympathetic nervous system
The sympathetic nervous system (SNS or SANS, sympathetic autonomic nervous system, to differentiate it from the somatic nervous system) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous sy ...
.
The sympathetic nervous system helps the body activate the fight-or-flight response. The sympathetic nervous system is more active when a person is stressed or in danger.
PMR impacts this system by reducing
cortisol
Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone.
Cortisol is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal corte ...
, which is a hormone involved in the stress response of fight-or-flight situations. PMR can also lower
blood pressure
Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...
,
metabolism
Metabolism (, from ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the co ...
,
heart rate
Heart rate is the frequency of the cardiac cycle, heartbeat measured by the number of contractions of the heart per minute (''beats per minute'', or bpm). The heart rate varies according to the body's Human body, physical needs, including the nee ...
, and
respiratory rate
The respiratory rate is the rate at which breathing occurs; it is set and controlled by the respiratory center of the brain. A person's respiratory rate is usually measured in breaths per minute.
Measurement
The respiratory rate in humans is mea ...
,
which are usually heightened during the stress response.
PMR is effective at relieving different types of stress.
Healthcare workers have used PMR to reduce their
occupational stress
Occupational stress is psychological stress related to one's job. Occupational stress refers to a chronic condition. Occupational stress can be managed by understanding what the stressful conditions at work are and taking steps to remediate tho ...
.
The technique also improved healthcare workers' physical and mental health since occupational stress can lead to
burnout, heart disease, and depression.
PMR has the potential to reduce stress very quickly, especially if the stress is related to something that will happen in the near future.
Insomnia
Non-pharmacological treatment of
insomnia
Insomnia, also known as sleeplessness, is a sleep disorder where people have difficulty sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low ene ...
has become an alternative replacement or complement to routine medical care.
People can use progressive muscle relaxation as a treatment for some cases of insomnia, particularly chronic insomnia.
People use PMR to reduce physical tension and interrupt the
racing thoughts processes that affect sleep. In general, PMR addresses insomnia by helping people fall asleep more easily, sleep longer, and get a deeper sleep.
Cancer patients often experience insomnia due to pain.
Some studies reported that the progressive muscle relaxation technique has a beneficial effect on insomnia cancer patients.
Coronavirus patients who feel isolated have also used PMR to improve their sleep quality.
Pain relief
Pain is one of the most frequent symptoms in patients undergoing surgery or cancer chemotherapy and various treatments are proposed for its relief, including complementary relaxation techniques.
Overall, PMR is effective at reducing pain in cancer patients,
although the biological process behind this relationship is not known.
Progressive muscle relaxation may reduce the perception of pain and provide pain relief that patients experience after undergoing surgery. However, a study on
orthopedic surgery
Orthopedic surgery or orthopedics ( alternative spelling orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
patients found that using PMR after an orthopedic surgery did not impact the intensity of pain patients experienced.
Women have used PMR to treat chronic pelvic pain, and the technique has had a positive effect.
In many cases, the chronic pain itself was still present, but the perceived threat of pain was eliminated.
Chronic pelvic pain is often associated with pain resulting from the functions of the abdominal nervous system (often called "neuropathic pain").
Patients often use PMR to manage their chronic pelvic pain when prescribed medications are unsuccessful.
In this case, PMR aims to release tension of the muscles in the abdomen and lower back.
Schizophrenia
Progressive muscle relaxation has been used in psychiatric settings as an alternative means of coping with subjective stress and states of anxiety.
A few modern studies have reported that PMR has a beneficial effect on psychological distress, anxiety, and well-being in patients with schizophrenia.
Sports
Professional sports athletes experience a lot of physical and mental tension. It has been hypothesized that progressive muscle relaxation techniques may help athletes achieve optimal performance and prevent injury.
[Honkomp, Lindsey. "If You're Reading This, Release the Tension in Your Shoulders: A Study of Progressive Muscle Relaxation and Anxiety Relief For Injury Prevention in Athletes." (Jan 2021).]
Long term effects
According to ''
Encyclopedia of medicine'' by Miller-Keane, long term effects of practicing progressive muscle relaxation include:
*A decrease in generalized level of anxiety
*A decrease in anticipatory anxiety related to phobias
*Reduction in the frequency and duration of panic attacks
*Improved ability to face phobic situations through graded exposure
*Improved concentration
*An increased sense of control over moods
*Increased self-esteem
*Increased spontaneity and creativity
See also
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References
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Body psychotherapy
Massage therapy