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THE NUANCE

Relaxing Your Muscles Can Relax

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

Markham Heid Aug 12 · 5 min read

 Credit: Delmaine Donson / Getty Images

D uring 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 oA from contact with friends
and family, and so the doctors partly attributed their woes to the
unsettling eAects 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 JaAerany, MD, a
clinical professor of dermatology, psychiatry, and behavioral sciences
at Central Michigan University. JaAerany was not involved with the
Chinese research, but he has studied the clinical eAects 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 Pve 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
benePts 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 eAorts stretching
back decades that have found relaxation therapy to be a highly
eAective treatment for stress, anxiety, and all their attendant
symptoms and side eAects. 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
eAective 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
signiPcantly 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 JaAerany found that PMR
even helped reduce skin symptoms among people with psoriasis, a
chronic in]ammatory condition that causes itchy and painful skin
rashes. Any condition that stress or in]ammation makes worse,
muscle relaxation therapy can likely make better, he says.

Not only is PMR eAective 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 Pve to 10 seconds while breathing slowly and calmly.
Next, deeply and fully relax those same muscles and concentrate on
the diAerence between how your muscles felt when they were tense
and how they feel now that they’re relaxed. The speciPcs of PMR
routines vary, but many start with the limbs before working their way
to the torso and, Pnally, 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.
 The Nuance Anxiety Stress Therapy Health

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