Progressive Muscle Relaxation
Progressive muscle relaxation (PMR) is one of the simplest and easiest to learn techniques for relaxation. It is a widely-used procedure that was originally developed by Dr. Edmund Jacobson in the early 1920s. Dr. Jacobson published Progressive Relaxation in 1938, detailing this method of relaxation involving alternately tensing and relaxing 14 different muscle groups.
PMR was originally used to treat symptoms of anxiety, but more recently it has been found to be effective for treating tension headaches, migraines, temporomandibular joint disorder (TMJ), neck pain, insomnia, bipolar disorder, anxiety, backaches, and high blood pressure. (For more information, refer to “Power of the Mind.”) PMR is a recommended practice to relax the body and mind at bedtime to fall asleep more easily and get a deeper night sleep. It was rated an effective nonpharmacologic treatment of chronic insomnia by the American Academy of Sleep Medicine (1999).
What It Is
PMR is a two-step relaxation practice to reduce stress and build awareness of sensations of tension and deep relaxation in various muscle groups. The first step in this practice is to create tension in specific muscle groups and begin to notice what tension feels like in this body part. The second step is to then release this muscle tension and begin to notice what a relaxed muscle feels like as the tension drains away. By moving through the body by alternately tensing and relaxing different muscle groups in a certain order, one builds awareness of how to recognize and differentiate between the associated feelings of a tensed muscle and a completely relaxed one.
Often, it is recommended to create tension and relaxation several times in the same muscle groups, with diminishing degrees of tension, to deepen awareness and train the body to more deeply relax. Through repetitive practice, a person can then induce physical muscular relaxation at the first signs of the tension that accompanies stress. After the practice, there may be one or two areas that are still tense, requiring one to repeat tensing and relaxing that muscle group.
How It Is Taught
PMR can be done lying down or sitting. It is very important to not strain or overly tense the muscle. Just creating a little bit of tension is sufficient to cultivate greater awareness of tension in the body and the relaxation that occurs when contracted muscles are released. If any of the exercises cause discomfort or cramping, ease up, stop or skip this body part entirely so as not to exacerbate any pre-existing injury or cause pain.
Also, pay special attention to not holding the breath while tensing up muscles as this can inadvertently cause stress in the body. One way to avoid this is to synchronize the breath with movements in the body. That is, breathe in while creating tension and breathe out when releasing the tension. This rhythmic pattern of breathing and movement can enhance the feeling of relaxation throughout the body and help calm the mind. You might experiment with saying a phrase to elicit relaxation, such as the word “RELAX,” each time you release a muscle group.
Though this technique is simple, it may take several sessions of practice before it is completely mastered. Once this practice is learned, an abbreviated version can be practiced by creating tension in certain muscle groups. For example, a shorthand method might include tensing only hands and arms or just the forehead, eyes and jaw. It is possible to become so proficient at PMR that it is only necessary to focus on one muscle group to produce these results. Tightening and relaxing the first muscle group for each area of the body, while saying the world “RELAX,” is one way to shorten the practice with experience.
If you find yourself to be very tense already, actively tensing your muscles will not be a helpful practice to deeply relax. If this is the case, you might try passive progressive relaxation instead. (Refer to “Progressive Relaxation.”) It is recommended to consult with your physician before practicing PMR. This relaxation practice is not recommended if a person has a history of serious injuries, muscle spasms, or back problems, as the deliberate tensing of muscles could exacerbate any of these pre-existing conditions.
Progressive Muscle Relaxation Exercise
PMR can be practiced in a comfortable position sitting or lying down in a place that you will be undisturbed for 10-15 minutes. Focus your attention on each of the groups of muscles in the list below and work through them one muscle group at a time. Tense each muscle group and notice how that muscle feels when it is tensed. Hold this tension for five seconds while breathing in. Then, release and relax that muscle all at once. Pay close attention to the feeling of relaxation when releasing the contracted muscle.
Practice tensing this same muscle group one or two more times but using less and less tension each time. This helps build awareness of tension in the body and improves the ability to differentiate between tension and relaxation in certain muscle groups. Experiment with saying the word “RELAX” each time you release a muscle group to deepen the feeling of relaxation in the mind and body.
When you have a good sense of what it feels like to be relaxed in that area of the body, transition on to the next muscle group. Make sure to not hold your breath during this practice. If it begins to hurt, cramp or feel uncomfortable while tensing a certain part of the body, reduce the contraction or stop and move on to the next muscle group. When going through the PMR exercise, it is recommended to start at one part of your body and move systematically. For example, some people start with the feet, others at the face. You may do one side of the body (hand, arm, leg, foot) at a time, or do both sides at the same time.
- Fists – Clench both fists and hold
- Biceps – Bend elbows, tense bicep muscles
- Triceps – Straighten arms, tense muscles in back of arms
- Forehead – Wrinkle forehead in a frown and hold
- Eyes – Close eyes tightly and hold
- Jaw – Gently clench jaw
- Tongue – Press against roof of mouth and hold
- Lips – Press together and hold
- Neck – Gently press neck back and hold. Then bring head forward to chest and hold
- Shoulders – Shrug shoulders as high as you can and hold stomach out as much as possible and hold
- Lower back – Gently arch up
- Buttocks – Tighten muscles in buttocks and hold
- Thighs – Tense by lifting legs off floor and hold
- Calves – Press toes downward, as if burying them in sand
- Shins and ankles – Bend feet toward head and hold
This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.