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| Soreness can be a sign of stress. |
What is it?
Progressive Muscle Relaxation is a technique that relieves anxiety and stress through the action of alternately tensing and then relaxing individual muscle groups throughout your body. Although you might expect it to have been a recent development by physical therapists (and it is, indeed, used in physical therapy), it was actually created by a psychologist in the early 1920s. This psychologist noticed that his patients with anxiety and stress disorders would frequently complain of muscle aches throughout their bodies, in particular in their necks, shoulders, and backs. He recognized that muscle tension and anxiety must be related or even causal, and so the relief of the physical symptoms would bring relief of the mental ailment as well. Thus, PMR has both a physical and mental component.
We have all experienced the neck ache and tension headaches that go along with or follow a stressful day, and if we do not take care of the tight muscles, we can eventually experience a great deal of pain, torn muscles, and other injuries. PMR is a way to consciously relax our muscles and release built up tension, allowing us to start fresh. Before bed is an excellent time to do a full session of PMR, because it will prepare you for a restful night's sleep and allow you to begin the next day fresh, without carrying over the anxiety and stress of the previous day.
Before beginning your practice of PMR, there are two important points to keep in mind. The first is that you need to set aside a specific time in your daily schedule, for at least the first two to three weeks that you are doing this routine. The best way to start and maintain a muscle relaxation practice is by incorporating it into your daily routine. Set aside a time either once or twice a day for your practice. A full PMR routine takes about 20 minutes. It is best to practice PMR on an empty (or mostly empty) stomach, as this will be better for your digestion. You may find that it’s easier to stick with your practice if you do it first thing in the morning or last thing at night, either before other tasks and responsibilities get in the way, or after you are finished with them for the day. The second point is don’t practice when you’re sleepy, unless you intend to go to sleep. This techniques can relax you so much that you if you start off sleepy, you will become much more so, especially if your PMR time is in the late afternoon or evening, or early in the morning. If you are doing your PMR as your last task before bed, that's fine - but again, try to not fall asleep halfway though your routine. It's important to do the full PMR sequence when you first begin.
I'm ready. How do I do it?
When you are ready to try PMR, you should take off your shoes, loosen your clothing (or wear loose clothing to begin with), and lie down or sit in a chair that allows you to relax completely. Lying down on a flat surface such as a carpeted floor or yoga mat is ideal, but lying flat on a couch or bed is acceptable. An easy chair would also be a reasonable choice, especially if you feel that you might have difficulty getting back up from the floor. You should make sure to do your PMR practice in surroundings that are conducive to relaxation – in front of the TV or while your family is running around and shouting are not good venues for a relaxation routine. Try to practice PMR in a quiet, relaxed atmosphere without harsh lights or noises, where you will be able to focus on the sensations of breathing and relaxing without outside distractions.
Breathe and Focus
Before you do any muscle relaxation, it is important to make yourself aware of your breathing. It should be deep, steady, and even. Closing your eyes with help you to block out other thoughts, forcing you to be more away of your body and how it feels. Place your hands over your abdomen, and focus on the feeling of your stomach and chest moving as you inhale and exhale. Begin breathing in through your nose and out through your mouth. Take about ten deep breaths, focusing only on your breathing. If your mind starts to wander, bring it back and refocus on just your breathing. Remember: don't beat yourself up if you lose focus, just bring yourself back and keep going. Know that just by trying, you are making progress!
Begin with the Feet
Once your mind is focused, you can begin the muscle relaxation sequence. Although some therapists prefer to begin the sequence with the head and face, most begin with the feet, as we will do here. Keeping your eyes closed and your breathing steady, begin the PMR by focusing on the muscles of your dominant foot. Slowly, over a count of five, tense up the muscles in your foot. You should focus on making the muscles as tight as possible, while keeping the rest of your leg relaxed. This muscle group isolation is the key to PMR. Many people, when they begin, find that it is difficult to isolate only one small group of muscles, but over time this will become easier. If you find that you are tensing up muscles that you did not intend to, relax and begin again with the intended muscle group.
Once the muscles in your dominant foot are tense, hold them at that high level of tension for a slow count of ten, making sure that you are continuing to breathe. It may help you to visualize the tension, perhaps as a red energy in your foot, making it uncomfortable and tight. When you reach ten, slowly release the muscles. You should allow the tension to slowly ease back out of them, rather than letting it go all at once. Again, this may be difficult at first, but it will grow easier with time. As you relax, picture that red energy releasing and flowing out, being replaced by something clean and pure, maybe a white or golden glow. When your foot feels totally limp and loose again, breathe and relax for a count of twenty.
Next shift your focus to your other foot. Again, tense the muscle for a slow count of ten, accompanied by breathing and visualization. As you release, feel the tension easing slowly out, allowing your muscles to relax entirely. Breathe and count slowly to twenty, then move on to your calf on your dominant side and repeat the procedure, making sure to focus only on this one muscle group. If you find yourself tensing your whole leg, or the calves of both legs, release the tension, breathe and regain your focus, and try again. This will take practice, so try not to be frustrated if it’s not easy at first. If you find yourself becoming too frustrated, you can stop your PMR practice at any time. After all, this is meant to relax you, not cause more stress.
Legs and Buttocks
After you have done the tense and release procedure in each calf, move up to your dominant thigh, and then your non-dominant thigh. These muscles can be particularly tricky to flex on their own, as it is easier to flex them in concert with your calves and buttocks. After your calves are relaxed, move up to your buttocks. Tense and relax each buttock individually. Remember that each time you move to a new muscle group, you should relax for a few breaths, tense the muscles for a slow ten-count, relax the muscles slowly, and then breathe for a twenty-count. Do not rush through the PMR routine, as that would negate the point of the whole exercise (although there is a shortened form of PMR, which will be covered later in this chapter). A full session of PMR takes around twenty minutes, but may take up to half an hour when you first begin, because of the need to stop and refocus. Make sure that you have set aside enough time to complete the routine, so that you are not distracted by other commitments.
Abdominal Muscles and Torso
After your buttocks, move up to your abdominal muscles. When you tense these muscles, imagine that you are pulling your belly button in to touch your spine. Your abdominals consist of several layers of overlapping muscles, running up and down, left and right, and diagonally across your belly area. Try to visualize all of these different layers tightening and pulling in, dropping towards the floor. After your abdominals are fully relaxed, move up to your chest muscles. It may be easiest to tighten these by exhaling completely and then hold the exhale, with your lungs empty and the muscles flexed. When you release the tension, slowly inhale, until you feel your belly and ribs expand, and then return to your normal, steady, deep breaths.
Arms and Hands
Next it is time to move on to your arms. Beginning on your dominant side, clench your fist as tight as you can, hold for ten, and then slowly release. Make sure that your breathing remains slow and steady, as fist clenching is a common sign of anger and distress, and your heart rate and breathing may increase with the gesture. After you have released your fist, move up your arm to you bicep, and flex the muscle. As you do this, keep your hand open and relaxed. It is very tempting to make a fist while flexing the bicep, but you want to focus only on the bicep muscle group. After tensing and releasing both the fist and the biceps of your dominant side, repeat the procedure with the hand and upper arm of your non-dominant side, taking your time and relaxing between each group. When both arms have been relaxed, you may wish to shake them out gently before moving on.
Shoulders
After the arms, you will move on to your shoulders. To correctly tense the shoulders, pull them up towards your ears and back, feeling the muscles of your shoulder blades flexing. Be careful to not tense your neck at the same time, as the neck is a separate muscle group. Hold your shoulders up and back, pressing your shoulder blades together as much as you can. Then, breathe and slowly release the tension. Your neck is next, and is often the more tense muscle to begin with, which mean that it will feel as though the most change has taken place there after a PMR session. Many people report that tension headaches ease away after they have relaxed their shoulders and neck. To completely relax the tension in your neck, you may find it helpful to gently roll your head from side to side, or lightly stretch your neck, pulling your ear to your shoulder on each side. This opens up space in your vertebrae, and allows built up toxins and gases to release, making your neck feel less tight.
And Finally, Your Face
Finally, you will move on to muscle groups in your face. Begin with your jaw, clenching it as tightly as possible. For people with TMJ, this may be a little painful, but should relieve the pain of TMJ once the jaw is relaxed. After the jaw, focus on your lower facial muscles. Purse your lips and tighten your cheek muscles, and imagine that you are pulling your facial muscles towards your nose. Hold for ten, then breathe and release for twenty. The last muscle group in PMR is the forehead and scalp. To tighten these muscles, raise your eyebrows and wrinkle your forehead, imagining that you are trying to look at a point above you, without moving your head. Slowly lower your eyebrows and relax.
Check in with Yourself
The last step of PMR is to do a mental scan of your body. Are there any areas that are still tense? You can tense and release that muscle group again, focusing particularly on the release of tension. After your first PMR session, you may find several “trouble spots,” but as you become more experienced with the technique, you will find that you end your sessions totally relaxed, and more resilient to tension and stress throughout your day. For at least the first two to three weeks that you are practicing PMR, it is recommended that you practice every day, or even twice a day. Each of these sessions should be a full, bottom to top PMR session, to ensure that you have gained the muscle control and experience necessary to make PMR truly effective.
Making it a Routine and using the Short Form
After you have finished your initial practice and you feel that PMR has become both easy and effective for you, you can cut back on the full sessions and use the short form of the routine to supplement your regular sessions when you are short on time. Although the short form takes less time and is easier to do away from home, it is not a total replacement for the once or twice a week full session. The shorter sessions are effective at removing tension, but are generally not as effective as a full session focused on each muscle group in your body.
The short form of PMR follows essentially the same routine as the long form, but instead of working with each muscle group individually, the routine is compressed so that the muscles are blocked together into four major groups. As you go through these groups, you should follow the same routine as for the long form of PMR. Begin by closing your eyes and relaxing onto a flat surface or comfortable chair. Lie or sit still and relax, focusing on your breaths, making each one as deep and steady as you can. Then, for each group, tense the muscles as tightly as possible while imagining the tension being held there. Count slowly to ten, while continuing to breath deeply. After the ten-count, slowly release the tension and breathe while counting slowly to twenty.
The first group in the short form of PMR is the combination of the feet, legs, and buttocks. You will follow the tense-and-release routine with all of these muscles at once, and then relax your whole lower body at the same time. The second group includes the muscles of the abdomen and chest. Tense your entire torso as though it were one muscle, remembering to pull your abdominal muscles in towards your spine, and holding your breath on an exhale to tense the chest muscles. Relax these muscles fully by taking a deep breath that fills your chest and pushes your abdomen outwards. The third short-form group is the arms, shoulders, and neck. Make a fist with each hand while simultaneously flexing your biceps and pulling your shoulders up and back. Then, release the tension and gently shake out your arms and fingers, rolling your shoulders slowly forward and back. The fourth and final grouping in the short form of PMR is the complete set of facial and scalp muscles. Tense your jaw, pull in your muscles toward your nose while pursing your lips, raise your eyebrows, and wrinkle your forehead. Hold the tension for a slow count of ten, and then release.
When you finish a PMR routine, either the full routine or the short form, make sure that you stay still for a minute and breathe. You can visualize yourself relaxing totally, and this visualization can take any form that you like. One popular visualization is that you are floating on water in sunlight. Your body is weightless, totally supported by the water, and the sunlight is warming and cleansing you. Another common visualization is that you are allowing yourself to melt into whatever surface you are relaxed on, allowing all of the muscles and bones in your body to dissolve away into peace and relaxation. A third helpful scenario is imagining a warm waterfall of liquid relaxation pouring over your body. You can visualize the lingering muscle tension as a kind of mud or grime, being washed away as the liquid relaxation sluices over you.
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