- What Is Progressive Muscle Relaxation (PMR)?
- Why Do Progressive Muscle Relaxation?
- PMR Technique
- Progressive Muscle Relaxation Benefits
- Uses of Progressive Muscle Relaxation
- Progressive Muscle Relaxation for Kids
- Progressive Muscle Relaxation FAQs
What Is Progressive Muscle Relaxation (PMR)?
Progressive muscle relaxation is a method for achieving a state of deep relaxation of the whole body through the tensing and relaxing of specific muscle groups.
Dr Edmund Jacobson developed the technique in the 1920s after discovering that hospital patients experiencing more muscle tension took longer to recuperate and had poorer outcomes. Jacobson’s first book explaining the method, Progressive Relaxation, was the origin of the use of the word “relax” in the sense we most often use it today: “to make or become less tense, nervous or worried”.
While Jacobson originally designed the practice to counteract anxiety and tension, PMR is popular to this day among physical therapists and is used for many different goals, such as quitting smoking, enhancing sports performance, and reducing insomnia.
PMR can be done with a facilitator or instructor in an individual or class setting, or at home. While some physical trainers teach PMR in eight-week courses, you can also find soothing instruction videos online. Many of these videos combine the core technique with breathing exercises or guided meditation.
Why Do Progressive Muscle Relaxation?
Have you ever felt so nervous you had a knot in the pit of your stomach? Ever had a tension headache? Been scared stiff? Our bodies and emotions are strongly connected. When we feel anxious, stressed, or afraid, our bodies tend to respond with muscular tension. Progressive muscle relaxation is a method that helps relieve that tension. The idea is that relaxing the muscles will relax the mind as well, to “break this cycle” of stress and muscle tension, as WebMD puts it.
According to Medicinenet, “psychological stress may worsen the symptoms of almost every known medical condition”, giving the examples of “cardiovascular diseases, asthma, multiple sclerosis, chronic pain, acne, fibromyalgia, and depression”.
Progressive Muscle Relaxation Technique
The basic technique consists of two main steps:
First, the individual focuses their attention on a given group of muscles, for example the right hand. While taking a deep, slow breath, the muscles are tightened as much as possible for about five to eight seconds. As in the example of the right hand, it is squeezed into a tight fist.
It is important for the subject to really feel the tension. If done properly, this tensing will cause discomfort, mild pain, and even shaking. Only the intended muscle group should be tense, without the surrounding muscles. Fine discernment between muscle groups becomes easier with practice.
The second step involves quickly and suddenly letting go, while exhaling, and then remaining in this relaxed state for about 15 seconds, before moving on to the next muscle group. Visualization will help you relax, for example by imagining the tension flowing out through the fingertips like water. The most important part of the whole exercise is in understanding how tension and relaxation feel different. In time, this will help you to become better able to control any tension and relaxation.
Setting and Preparation
There are several factors to consider when choosing the time/duration and place to practice:
- Ideally, you will be able to set aside 15 minutes twice a day for the first week or two of practice, to establish the new habit and routine of working with PMR.
- It‘s best to practice in a quiet place without distractions, to minimize being disturbed. Dim or soft lighting is most suitable.
- Wear loose clothes or loosen your tie, belt, waistband, etc., and remove your shoes.
- It is recommended to avoid practicing right after a large meal or the consumption of alcohol.
- Choose one of the following positions:
- Use a comfortable chair that supports your head
- Lie down on the floor or on a mostly flat mattress or sofa (though this may increase the risk of falling asleep)
- It is better to first practice when you are calm, as it will then be easier to do when feeling anxious.
When beginning, spend a few seconds to take some deep, slow breaths. Close your eyes and try to let your muscles relax. Direct your attention to your body and any physical sensations.
Once you have been through the two main steps with all muscle groups, relax with your eyes closed for a few seconds, and take some time to enjoy your deep state of relaxation. When you open your eyes, get up slowly to avoid orthostatic hypotension – a sudden drop in blood pressure caused by standing up quickly – which can lead to fainting. Some people count backwards from five to one with deep, slow breathing, before saying “Eyes open. Supremely calm. Fully alert”.
Stop immediately if you feel intense or shooting pain at any point during PMR, and consult your doctor.
Muscle Group Order
It is best to start at the bottom of your body with your feet and work up, or to start at the top with your forehead and work down, in order to remember to tense each of the muscle groups.
The following is the most popular, recommended sequence for progressive muscle relaxation. Start with the right side if you are right-handed, or the left side if you are left-handed.
Progressive Muscle Relaxation Script
We are working on a handy script for our readers to download and start practicing – to be added soon.
Shortened Progressive Muscle Relaxation
One of the huge benefits of regular practice is that you will learn to relax more deeply in increasingly shorter spaces of time. Essentially, you condition yourself so that, just by getting ready, by sitting in that chair or loosening your clothes, you are already relaxing. The body and mind start anticipating what’s next: a state of deep and refreshing looseness of body.
After a couple of weeks, once you have become familiar with the technique, you can use a shortened exercise, which takes just 10 minutes a day. It is important to keep doing this to maintain your ability to relax. Shortened PMR works the same, but is practiced using only the following larger muscle groups:
- Lower limbs (both feet and legs)
- Stomach and chest
- Arms, shoulders, and neck
Throughout progressive muscle relaxation practice, you will notice that you are better able to identify unconscious tension and choose to let it go. This is because you are literally growing the neuron connections needed to wilfully relax your muscles. With practice, you can associate these pathways with a word, to instruct yourself to relax. Eventually, this word will become so strongly associated with letting go of muscle tension that your response to the word becomes automatic: a conditioned reflex.
Once you have mastered the basics, cue-control is best practiced with shortened PMR. You can begin as usual, applying and holding the tension to a muscle group while slowly inhaling. As you let go, slowly exhale while saying a cue word or phrase, such as ‘Let go’ or ‘Relax’. After about five weeks of practice, you should become conditioned to feel relaxed by this cue alone. You can then use it to let go of tension when you don’t have time to go through the full procedure.
It’s advisable to choose one cue word or phrase and stick to it. Here are some more cue-word suggestions:
- Serenity now
- It will be OK
“Release Only” Technique
The ultimate aim of progressive muscle relaxation is to gain control over the unconscious tension in your muscles that is present throughout the day . Once you have learnt to quickly recognize what tense muscles feel like and what relaxed muscles feel like, you can start doing only step two, the release part of the exercise, working through each of the muscle groups using your cue word.
Eventually you will be able to perform a ‘body scan’, to recognize where you may be unconsciously holding tension and then, using your cue word and imagery, you will be able to let it go.
Usually this is begun at the top of the head, working downwards, as though relaxation were being poured over your head and flowing down through your body.
Biofeedback Technique With Progressive Muscle Relaxation
If you’re not sure whether you’re doing progressive muscle relaxation correctly, there is a method which will help you find out. Physical trainers can use external measuring devices, to indicate how relaxed you are while practicing PMR. This feedback helps you to focus on making subtle changes, enhancing your power to use your thoughts to better control your body.
Electrodes and sensors attached to you send signals to a monitor, which represents your body activity. Types of biofeedback include:
- Muscle activity
- Heart rate
- Breath rate
- Blood pressure
- Skin temperature
Progressive Muscle Relaxation Benefits
Here are some of the most common long-term effects of progressive muscle relaxation:
- Reduces mental symptoms such as anxiety, stress, fear, confusion, depression, and fatigue
- Helps with falling asleep and staying asleep
- Reduces likelihood and duration of panic attacks
- Reduces pain such as stomachaches, backaches, and headaches
- Helps with concentration
- Advances control of mood and management of stressful situations
- Increases spontaneity, flow and creativity
Uses of Progressive Muscle Relaxation
Progressive muscle relaxation can be used as both a type of prevention and treatment for many different conditions and situations:
Racing thought processes and physical tension can cause insomnia. Practicing progressive muscle relaxation in bed at night may help you drop off to sleep and wake up less often during the night. However, if using progressive muscle relaxation to treat insomnia, it’s best to do extra practice during the day when you are able to stay awake for the full exercise.
Professional sportspeople may experience constant physical and mental tension. Progressive muscle relaxation has been used to relieve stress in daily life, and has even been shown to help with sports performance.
Many of the benefits of progressive muscle relaxation, such as decreased stress, increased self-control and improved management of stressful situations, can lead to a greater sense of wellness in those with mental health issues. PMR has even occasionally been used as a complementary treatment for people with schizophrenia.
Childbirth and Labour
Expectant mothers who wish to avoid a C-section or epidural can minimize the pain of natural childbirth by using progressive muscle relaxation. It can also be used to help manage stress and improve general health during pregnancy. It is advisable that mothers-to-be start training several months in advance, so as to be able to practice PMR even during the high-stress situation of childbirth.
Progressive muscle relaxation increases blood flow to the muscles, leading to enhanced local metabolism and reduced pain and muscle spasms. It may also reduce pain perception. For these reasons, it has been proposed as pain relief for patients after surgery and chemotherapy, as well as for treatment of chronic pain.
Cigarette craving, withdrawal symptoms, and even systolic blood pressure have been shown to be reduced by progressive muscle relaxation.
For the purpose of quitting smoking, PMR is normally practiced using only step two, relaxing each muscle group one at a time, without squeezing the muscles as in step one.
Stress can get in the way of maintaining weight loss goals, by triggering bad habits such as emotional eating. To keep anxiety from leading to this loss of motivation, it helps to learn to manage stress through progressive muscle relaxation.
PMR is often recommended to weight loss surgery patients as part of their aftercare regimen.
Progressive Muscle Relaxation for Kids
Children tend to have a more difficult time controlling their emotions, and an anxious or tense child can experience stomach aches, nausea, headaches, extreme moods, low self-esteem, insomnia, and concentration difficulties as a result.
Progressive muscle relaxation for kids is practiced in much the same way as with adults, following the procedure for each set of muscles.
It is best if an adult reads a script to the child in a slow, calming tone of voice, using lots of relatable imagery to help the child understand exactly what she or he should be doing with each muscle group.
The child may find the exercise more enjoyable if you join in with them. However, teens may prefer to do it alone, so work out how the child will be most comfortable. Encourage the child to practice, perhaps introducing the technique into a bedtime routine.
Progressive Muscle Relaxation FAQs
Q: Is progressive muscle relaxation enjoyable?
A: Yes. However, the effects are only seen after many sessions, so PMR requires a degree of personal motivation. However, in time the pleasurable relaxing response will kick in quickly, and the initial effort will be forgotten.
Q: Can PMR be used to get to sleep at night?
A: Yes, PMR can help you to fall asleep quickly. However, it is best to consider this in addition to your basic, twice-daily practice. If you do fall asleep during your ordinary practice, don’t worry; rather, be happy for the work done up until the moment of sleep.
Q: What is the difference between PMR and autogenic training?
A: Both are relaxing techniques. However, while PMR generates a state of relaxation initiated primarily by muscular activity, autogenic training starts with the mind. Practitioners learn to use words to trigger a feeling of warmth and heaviness throughout the body, and includes exercises to influence heart rate, respiration, abdominal warmth and forehead coolness. While PMR might achieve these as secondary gains of muscle flaccidity, autogenic training aims to achieve these changes directly, as its primary focus.
Q: What is the difference between PMR and meditation?
A: Both PMR and meditation can bring about similar effects of bodily and mental relaxation. However, relaxation is a possible secondary effect of meditation, rather than its primary aim. While it can be practiced secularly, meditation traces its roots to spirituality and religion, primarily aiming to train the mind, rather than the body, in traits such as concentration, mindfulness, and contemplation.
Q: Are there any risks associated with PMR?
A: According to the National Center for Complementary and Integrative Health (NCCIH), people with heart disease should talk to their health care provider before doing progressive muscle relaxation. However, this is not necessarily a contraindication as the technique is also used by doctors to treat heart disease.
“Symptoms of Anxiety and Tension and the Accompanying Physiological Changes in the Muscular System.” The Journal of Neurology, Neurosurgery, and Psychiatry. 1954. ↩
“Effectiveness of Progressive Muscle Relaxation and Biofeedback Relaxation in Lowering Physiological Arousal among Students with Regard to Personality Features.” Procedia - Social and Behavioral Sciences. 9 October 2015. ↩
“Effect of Progressive Muscle Relaxation Technique on Pain Relief during Labor.” Acta Medica Iranica. 2006. ↩
“The effect of progressive muscle relaxation on pregnant women’s general health.” Iranian Journal of Nursing and Midwifery Research. November - December 2015. ↩
“Preliminary Effects of Progressive Muscle Relaxation on Cigarette Craving and Withdrawal Symptoms in Experienced Smokers in Acute Cigarette Abstinence: A Randomized Controlled Trial.” Behavior Therapy. March 2015. ↩
“Somatic Complaints in Children with Anxiety Disorders and their Unique Prediction of Poorer Academic Performance.” Child Psychiatry and Human Development. June 2008. ↩
“Progressive Muscle Relaxation in Cardiac Rehabilitation: A Pilot Study.” ResearchGate. November 2001. ↩