Progressively Relaxing: Progressive Muscle Relaxation as a Stress-Management Technique

A personal preface: I have generalized anxiety disorder, and I have tried several stress management techniques through the years, most of which did not work for me (mainly because I was too stressed about doing things incorrectly—so I couldn’t focus enough on the deep breathing or on the “happy place” or on what my senses are telling me for them to actually calm me down). Recently, my counselor introduced me to progressive muscle relaxation, or PMR. This is the first technique outside of medication that I found affective in helping me manage my stress, so I’m sharing this in the hopes that this technique can help some of you as well.

Dr. Edmund Jacobson once said, “An anxious mind cannot exist in a relaxed body” (1974; quoted in McCallie, Blum, & Hood, 2006). Based on this theory, Jacobson developed a technique called progressive muscle relaxation (PMR), designed to eliminate all muscle contractions to allow for the experience a deep sense of relaxation. During this technique, you tense a specific muscle group, maintain tension for 5-7 seconds, and then release the muscle group, focusing on the muscle group as it relaxes (usually for 10 seconds). There are several different methods (i.e. orders in which you can relax the following muscles), but PMR typically involves the progressive tensing and releasing of the: hands and forearms, biceps, face (forehead, upper cheeks, nose, lower cheeks, and jaw), neck and throat, chest/shoulders/upper back, abdominal or stomach region (with the lower back), the thighs, the calves, and the feet (McCallie et al., 2006).

As a physical way to treat anxiety, PMR has been found to affectively treat symptoms occurring in a variety of body symptoms. For example, PMR has been found to affectively treat disorders that have strong muscular components—such as tension headaches—and it is recommended for people with uncomfortably high levels of tension responses that interfere with behavior (e.g. so much tension that you can’t sleep) and/or people who experience a feeling of general tenseness (certainly not a foreign concept to those of us with anxiety disorders). The SNS causes muscles to tense in anticipation of action, thereby allowing you to respond more quickly to a threat/danger and until that danger has passed, and chronic stress then causes unrelieved muscle tension (Stress Directions, 2013). PMR then works by allowing you to focus on your muscles as you relieve tension in them. Further, PMR is often combined with cognitive-behavioral therapy (CBT) to treat a wide array of anxiety disorders, including generalized anxiety disorder (GAD), social phobias, panic disorders, agoraphobia, and some cases of PTSD (McCallie et al., 2006).

Relating PMR more explicitly to physiology, PMR has a wide array of beneficial effects on several body systems—effects that can be linked to PMR’s ability to help people manage their stress. When used in conjunction with CBT stress management and comprehensive hypertension control treatments, PMR has been shown to improve hypertension (McCallie et al., 2006)—which shows how a simple stress management technique can improve treatments for cardiovascular pathologies such as hypertension by helping to restore homeostatic balance that, in turn, restores normal functioning of the cardiovascular system.  Similarly, irritable bowel syndrome—another stress-related disorder characterized by the flatulence associated with stress, as well as constipation and diarrhea (sometimes in alternating bouts; Mayo Clinic) that could be caused as the body tries to expel excess wastes (e.g. in order to help you get away from a predator more quickly) while slowing down the digestive process (e.g. to conserve energy so that you can use that energy to run away from a lion instead of digesting lunch, which can wait until you escape your predator, assuming you live). Further, PMR helps alleviate painful menstrual cycles (dysmenorrhea; McCallie et al., 2006) by restoring homeostasis on the cellular level to, in turn, restore homeostasis to the muscular and reproductive systems. Scientists believe that, in dysmenorrhea, the HPA axis’s release of cortisol, which then inhibits FSH and LH release, interferes with progesterone synthesis. The effects on progesterone synthesis is important because progesterone affects synthesis of prostaglandins and the binding of those prostaglandins to myometrial receptors. Cortisol also directly influences prostaglandin synthesis; thereby, stress has been shown to have both direct and secondary effects on the myometrium (Wang et al., 2004). Further studies suggest that PMR has immune-enhancement effects, and this theory is based on the belief that, as relaxation occurs and we decrease cortisol levels, we behaviorally manipulate the body’s cortisol levels to then reverse the negative effects of stress on the immune system (McCallie et al., 2006)—an effect showing PMR’s effectiveness in restoring normal functioning of both the endocrine and immune systems.

Overall, PMR can be an affective stress-management technique. As an effective stress management technique, PMR then has several implications for restoring normal functioning of several body systems, including the muscular system, the endocrine system, the immune system, the cardiovascular system, and even the reproductive system. If you think PMR may be effective for you,

 

If you would like to try PMR, http://www.counseling.iastate.edu/relaxation-and-self-help-exercises/mind-body-spa has a downloadable MP3 file that will guide you through it (disclaimer: I have not tried the exercise through this source). The best online PMR resource I’ve found and used is http://www.youtube.com/watch?v=xqKIjKyElmo.

 

References

Mayo Clinic Staff. (2011). Irritable bowel syndrome: Symptoms. The Mayo Clinic. Retrieved from: http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106/DSECTION=symptoms

McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Human Behavior in the Social Environment, 13, 54-66. doi: 10.1300/J137v13n03_04

Stress Directions, Inc. Muscular symptoms of stress. Stress Directions. Retrieved from http://www.stressdirections.com/content/view/44/66

Wang, L., Wang, X., Chen, C., Ronnennberg, A. G., Guan, W., Huang, A., …, & Xu, X. (2004). Stress and dysmenorrhea: A population based prospective study. Occupational and Environmental Medicine, 61, 1021-1026. doi: 10.1136/oem.2003.012302