What is progressive muscle relaxation?

Overview

The positive effects of relaxation and the contributory influences of prolonged
stress and tension on illness have long been recognized.
Progressive muscle relaxation (PMR) is a technique aimed at reducing the somatic
(bodily) consequences of stress, such as muscle tension, by lowering physiologic
arousal and, thereby, inducing relaxation.

Commonly used models of progressive relaxation are based on the principles identified by American psychiatrist Edmund Jacobson in the 1930s. The basic technique developed by Jacobson involves alternately tensing and relaxing major muscle groups of the body, while concurrently focusing on sensations associated with the tensing and relaxing.

Regardless of the reasons for its application, current PMR methods begin with a rationale for its use. The fundamental premise is that muscle tension, even when it is not overtly perceived, causes anxiety (and often pain, discomfort, and agitation) and that significant a reduction in associated symptoms will result if tense muscles are relaxed.

Participants learning PMR are requested to loosen tight clothing and to sit in a comfortable chair in a quiet setting relatively free from distraction. A trained therapist then instructs and demonstrates how to isolate, tense, and relax muscles, and then systematically guides the person through the different muscle groups in a fixed order.

During the “tensing” phase of the procedure, the person is directed to constrict the identified muscle as tightly as possible while keeping other muscle groups loose and relaxed. Attention is directed to the sensations associated with tensing, such as tightness and discomfort. The tensing phase lasts approximately ten seconds and is followed by the “relaxing” or “releasing” phase, wherein muscles tension is “let go” and muscles are allowed to become limp. The participant then focuses on the feeling of tension and discomfort draining from the muscle and takes notice of the contrast between the warmth and comfort of relaxed muscles and the discomfort of tensed muscles.

After about ten to fifteen seconds of relaxing, the sequence is repeated with another muscle group. A typical sequence of muscle groups addressed in the technique is the following: hands, biceps and triceps, shoulders, chest, neck, mouth and lips, eyes, forehead and scalp, back, stomach, thighs, calves, feet, and toes. After completing the sequence of tensing and releasing phases, participants take an “inventory” of their muscle groups and relax those with remaining tension. The procedure takes about twenty to thirty minutes to complete.

During the procedure, participants are encouraged to avoid blocking thoughts that
might intrude upon their consciousness, and either to allow these thoughts to flow
through their mind or to shift their focus toward their breathing if they find
themselves distracted. For a period of time following the exercise, participants
may engage in slow, steady, and even breathing as a means of enhancing the
relaxation
response. They may also repeat a calming word or phrase such
as “relax,” “release,” or “let go” each time they exhale so that the word or
phrase becomes a cue for promoting relaxation, a practice known as cue-controlled
relaxation.

Typically, two or three guided relaxation sessions are conducted to develop basic proficiency with the exercise. Nonguided practice sessions are encouraged to further enhance skills, with the goal of the person being able to achieve a highly relaxed state without guidance. Common variations to the procedure include abbreviated protocols such as “release only” methods, whereby the tensing phase is eliminated or emphasis is directed at specific muscle groups that are identified as particularly key in inducing overall relaxation. Audiotapes of the relaxation procedure may also be used to develop relaxation skills.

Mechanism of Action

PMR has been found to affect the autonomic nervous system, which, among other
functions, regulates how the body reacts to changes in the environment. These
effects include decreases in heart rate, blood pressure, and muscle tension, and
general arousal. Vasodilation of blood vessels also occurs, causing increased
blood flow throughout the body, most noticeably in the extremities. These
responses are the opposite of those produced by anxiety and
lead to subjective feelings of warmth, comfort, and calmness.

Chen, W. C., et al. “Efficacy of Progressive Muscle Relaxation Training in Reducing Anxiety in Patients with Acute Schizophrenia.” Journal of Clinical Nursing 18, no. 15 (2009): 2187-2196.

Neumann, Donald A. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 2d ed. St. Louis, Mo.: Mosby/Elsevier, 2010.

Nickel, C., et al. “Effect of Progressive Muscle Relaxation in Adolescent Female Bronchial Asthma Patients.” Journal of Psychosomatic Research 59 (2005): 393-398.