The Nuance

Relaxing Your Muscles Can Relax Your Mind

Progressive muscle relaxation therapy is one of the simplest science-backed treatments for anxiety

Credit: Delmaine Donson / Getty Images

During the early days of the novel coronavirus outbreak, doctors in China noticed that many people hospitalized with Covid-19 were developing anxiety and sleeping problems. These patients were forced to spend weeks cut off from contact with friends and family, and so the doctors partly attributed their woes to the unsettling effects of social isolation.

At a hospital in Hainan province, a physician study team decided to treat their patients’ isolation-induced anxiety and sleeping problems using a relaxation technique known as progressive muscle relaxation therapy, or PMR.

“Progressive muscle relaxation teaches you how to relax your muscles through a two-step process,” explains Mohammad Jafferany, MD, a clinical professor of dermatology, psychiatry, and behavioral sciences at Central Michigan University. Jafferany was not involved with the Chinese research, but he has studied the clinical effects of PMR. “First, you systematically tense particular muscle groups in your body,” he explains. “Next, you release the tension and notice how your muscles feel when you relax them.”

Twice a day for five consecutive days, a group of Covid-19 patients at the Hainan hospital listened to piped-in instructions that guided them through a typical PMR therapy session. They lay down on their backs and then tensed and relaxed the muscles of their hands, arms, head, neck, torso, and legs. According to the results of that study, which was published in May in the journal Complementary Therapies in Clinical Practice, the patients’ scores on a clinically validated anxiety measuring tool improved by 22%, and their sleep scores improved by 30%. Meanwhile, the study team observed no anxiety or sleep benefits among a control group that received standard care but not PMR.

“First, you systematically tense particular muscle groups in your body. Next, you release the tension and notice how your muscles feel when you relax them.”

The Chinese study is just one of dozens of research efforts stretching back decades that have found relaxation therapy to be a highly effective treatment for stress, anxiety, and all their attendant symptoms and side effects. It may not have the hype of trendier or newer mental-health remedies, such as mindfulness meditation or CBD oil. But experts say PMR is among the surest ways to calm an anxious mind and body.

How progressive muscle relaxation works

The conventional view of muscle tension is that it’s the product of top-down processes; the brain interprets something as concerning or stressful, and this causes the muscles to tighten up. But experts say that the relationship between physical and mental states tends to run in both directions.

“One of the things we know about anxiety is that many things can feed into it, and one of them is muscle tension,” says Michelle Newman, PhD, director of the Laboratory for Anxiety and Depression Research at the Pennsylvania State University.

It may be helpful to think of negative thoughts and worries as anxiety manifested in the mind while tension is anxiety manifested in the body. “Any one of those things can start the anxiety process and trigger the others in a sort of upward negative cycle,” Newman explains. “And intervening in any one of them can break the cycle.”

According to Newman, PMR is a tool of cognitive-behavioral therapy, or CBT, which many experts now consider the “gold standard” in psychotherapy. CBT’s aim is to change the recurring thought patterns or behaviors that promote negative mental states, including the ones associated with anxiety. And Newman says that progressive muscle relaxation is one of the more common techniques that cognitive-behavioral therapists employ with their patients. In fact, some of her research has found that among people with generalized anxiety disorder, progressive muscle relaxation techniques were just as effective as thought-based CBT exercises or interventions.

“Doing a quick scan of tension every hour and then taking the time to release that tension gets people into the habit of sustaining and functioning with a lower level of tension throughout the day.”

Her work is just the tip of the iceberg. One 2015 study in the journal Stress determined that progressive muscle relaxation not only lowers a person’s subjective feelings of psychological stress, but it also significantly lowers the body’s circulating levels of the stress hormone cortisol. There’s also a nearly endless stream of research papers linking muscle relaxation therapy to symptom improvements among people with cancer, arthritis, and other medical conditions. For a 2020 study, Central Michigan University’s Jafferany found that PMR even helped reduce skin symptoms among people with psoriasis, a chronic inflammatory condition that causes itchy and painful skin rashes. Any condition that stress or inflammation makes worse, muscle relaxation therapy can likely make better, he says.

Not only is PMR effective for a variety of anxiety- or stress-associated conditions, but it’s also “more straightforward” than mindfulness meditation and some other popular stress therapies, Newman says. Many people struggle with meditation practices; tensing and relaxing muscles is easier. “But one of my personal pet peeves is that when people do it, they don’t do it optimally,” she says.

How does one do PMR optimally? “You should practice twice a day for 15 minutes each time,” she says. There are literally hundreds of guided PMR practices online, but this one from the U.K.’s National Health Service is a good place to start. Most practices involve tensing individual muscle groups, such as the muscles of the hands or forehead, for five to 10 seconds while breathing slowly and calmly. Next, deeply and fully relax those same muscles and concentrate on the difference between how your muscles felt when they were tense and how they feel now that they’re relaxed. The specifics of PMR routines vary, but many start with the limbs before working their way to the torso and, finally, the head and face.

Along with those two daily practice sessions, Newman says that you should take time every hour for a quick “body scan” to identify and release points of tension. “The idea is that people get into the bad habit of creating and sustaining muscle tension,” she says. “Doing a quick scan of tension every hour and then taking the time to release that tension gets people into the habit of sustaining and functioning with a lower level of tension throughout the day.” People who practice these techniques consistently will gradually become better at quickly identifying and releasing muscle tension.

“The more you build up tension, the harder it is to let it go,” Newman says. “And tension triggers more stress and anxiety, which feed back into tension.” Muscle relaxation therapy breaks up that debilitating feedback loop.

I write about health and science. I live in Detroit with my wife and kids. I’m trying to learn German, but my progress so far is nicht gut.

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