Step 5: Practice Relaxation Techniques Daily
Pain and Muscle Spasm
Years of experience and research have taught us that with chronic pain comes muscle spasm. Muscle spasm is a reflex; it’s your body’s reaction to pain that you have no control over. Tense muscles can produce anxiety, depression, fear of more pain, bad posture, and immobility. Tension also causes headaches, indigestion, and palpitations. This muscle spasm serves no useful purpose in chronic pain.
Many individuals with chronic pain do not recognize that they have muscle tension because they have had pain for so long. There are those people with chronic pain who strongly believe they have no need to learn relaxation techniques, but nothing could be further from the truth. The only way to make a meaningful impact on tension is to practice relaxation techniques (this is not sitting on the couch in front of the T.V.!).The Benefits of Relaxation
Relaxation, the opposite of tension, has many benefits in individuals with chronic pain. Unfortunately it is not an automatic process and needs to be learned and practiced regularly to be effective. The beauty of relaxation techniques is that they can be used anywhere, at any time, and without the need to take a pill. The benefits of relaxation include:
- Relief of muscle spasm
- Release of natural pain relieving endorphins
- Reducing anxiety and fear
- Regaining a sense of control and confidence
Several relaxation techniques exist, all with their advantages and disadvantages. The best technique for you is the one you feel most comfortable with. Relaxation techniques include:
- Controlled Breathing
- Progressive Muscular Relaxation
- Tai Chi
This type of relaxation can help you cope with stressful situations or intense pain episodes. Position yourself either sitting or lying down with a straight spine.
- Take in a deep, comfortable breath through your nose while counting slowly to four. As you inhale, first fill the lower section of your lungs, then fill the middle part, and last fill the top. Feel your abdomen expand. Hold your breath for 3-4 seconds.
- Exhale slowly through your mouth. While you exhale say calming words such as “relax”, “easy does it”, or other words that suggest releasing of tension. As you exhale, feel your abdominal muscles contract and try to let your jaws, shoulders, and arms go limp.
- Continue for five minutes. If you become light-headed, alternate six regular breaths with six deep breaths.
Progressive Muscular Relaxation
Progressive Muscular Relaxation (PMR) was developed by Jacobson in 1939 and is widely used today. PMR uses the pendulum method – if you want the pendulum to swing in a particular direction, then you first have to pull it back in the opposite direction and then let go. In Progressive Muscular Relaxation, first you deliberately apply tension to certain muscle groups, and then you let go, and pay attention to how the muscles relax as the tension flows away. The aim is to work systematically through the body. Usually a person starts with the hands, working up to the shoulders, then works from the feet up to the shoulders again, leaving the face and neck for last. There is no reason to rigidly stick to a particular order, but it might be more difficult to start with areas in which physical and emotional tensions seem to concentrate, such as the shoulders, neck and face.
How to do Progressive Muscle Relaxation
There are two steps in the self-administered Progressive Muscle Relaxation procedure:
- Deliberately tensing muscle groups.
- Releasing the induced tension.
Step One: Tension – The process of applying tension to a muscle is essentially the same regardless of which muscle group you are using. First, focus your mind on the muscle group; for example, your right hand. Then inhale and simply squeeze the muscles as hard as you can and hold to the count of 5; in the example, this would involve making a tight fist with your hand.
Note: Beginners usually make the mistake of allowing muscles other than the intended group to tense as well; in the example, this would mean that there will be a tendency to tense muscles in your right arm and shoulder along with those of the right hand. With practice you will learn to make very fine discriminations among muscles; for the moment just do the best you can.
It’s important to really feel the tension. Done properly, the tension procedure will cause the muscles to start to shake. You might feel some intensifying of your pain but it should be within an acceptable range for you.
Note: Be careful not to hurt yourself, as compared to feeling mild pain. Contracting the muscles in your feet and your back, especially, can cause serious problems if not done carefully; i.e., gently but deliberately.
Step Two Releasing the Tension- This is the best part because it is actually pleasurable. After the count to 5, just suddenly but gently let go. Let all the tightness and pain flow out of the muscles as you simultaneously exhale. In the example, this would be imagining tightness and pain flowing out of your hand through your fingertips as you exhale. Feel the muscles relax and become loose and limp, tension flowing away like water out of a faucet. Notice the difference between tension and relaxation.
Note: The point here is to really focus on the change that occurs as the tension is let go. Do this very deliberately. You are learning to make some subtle distinctions between muscular tension and muscular relaxation.
Stay relaxed for about 15 seconds and then repeat the tension-relaxation cycle. You’ll probably notice more sensations the second time.
Note: It is of utmost important to coordinate your breathing with the tension relaxation cycle. Every time you let go, exhale and feel the tension go out from the concerned muscle group along with the outgoing breath. The breathing must be relaxed and preferably abdominal. Muscle Groups
Here is an order that we find easy to remember which will help you not to forget any muscle group.
- Hands: Clench the fists.
- Arms: Tighten biceps and lower arms together, without the hands.
- Shoulders: Inhale, hold your breath and raise your shoulders as if to touch your ears.
- Feet: Screw up your toes.
- Front of legs: Point your foot away from you so that it is almost parallel with your leg.
- Back of Legs: Flex your feet upwards, stretching your heels away from your body.
- Thighs: Tighten them while pressing your knees down into the floor. Pull your knee caps to your hips.
- Bottom: Clench your buttocks together.
- Stomach: Hold your stomach muscles in tight.
- Lower Back: Press the small of your back into the floor.
- Chest: Breath in, hold your breath, and tighten all your chest muscles.
- Shoulders: Breath in, hold your breath and raise your shoulders as if to touch your ears.
- Stretch your head up, as if your chin could touch the ceiling.
- Bend your head forward until your chin reaches your chest.
- Mouth and Jaw: Press your lips together and clench your teeth.
- Eyes: Close them up tight.
- Forehead and scalp: Raise your eyebrows as if they could disappear.
- Face: Screw all the muscles up together.
After learning the full PMR procedure, you will spend about 10 minutes a day maintaining your proficiency by practicing a shortened form of the procedure. But in the beginning it might take longer and it would be a good idea to tense and relax one limb at a time instead of both together. With time and practice, approximately 3 to 6 weeks, you may shorten the exercise gradually. For example, you could try collapsing some of the muscle groups until you only work on your arms, legs, abdomen, chest and face. Ultimately, you will acquire something that will probably become an indispensable part of your daily life, and the initial drudgery of practice will be long-forgotten.
It is recommended that you practice full PMR twice a day for about a week before moving on to the shortened form. Of course, the time needed to master the full PMR procedure varies from person to person.
Here are some suggestions for practice:
- Always practice full PMR in a quiet place, alone, with no electronic distractions, not even background music.
- Remove your shoes and wear loose clothing.
- Avoid eating, smoking, or drinking. It’s best to practice before meals rather than after, for the sake of your digestive processes. Never practice after using any intoxicants.
- Sit in a comfortable chair if possible. You may practice lying down, but this increases the likelihood of falling asleep.
- If you fall asleep, give yourself credit for the work you did up to the point of sleep.
- If you practice in bed at night, plan on falling asleep before you complete your cycle. Therefore, consider a practice session at night, in bed, to be in addition to your basic practice.
- When you finish a session, relax with your eyes closed for a few seconds, and then get up slowly. (Orthostatic hypotension-a sudden drop in blood pressure due to standing up quickly-can cause you to faint.) Some people like to count backwards from 5 to 1, timed to slow, deep breathing, and then say, “Eyes open. Supremely calm. Fully alert.”
Give PMR a try! It only takes a few minutes out of your day; and the rewards of enhanced recovery, better muscle control and the ability to more effectively manage stress are well worth the investment.
Disclaimer: If you continue with this procedure, you do so at your own risk. American Pain and Wellness cannot be held responsible in any way for any consequences arising out of practicing Progressive Muscular Relaxation. The information given is strictly for personal use.