Relaxation
Presented by
Dr. Anaz A
MPT - MSS
Contents
Muscle tone, Postural tone voluntary Movement
Degrees of relaxation
Pathological tension in muscle
Types of stresses
Effect of stress on the body mechanism
Indications of relaxation
Methods & techniques of relaxation-Principles & uses
General
Local
Jacobson’s
Mitchel’s
additional methods
MUSCLE TONE
Muscle tone is the resistance to passive stretch or movement in a muscle.
under ordinary circumstances, living muscles are never completely free from tension, as they retain a
quality of firmness known as muscle tone even when they are as relaxed as possible.
The efferent fibres of the nerve reflex pathway transmit impulses that produce a sustained contraction of
the small intrafusal muscle fibres of the muscle spindles. While the large extrafusal fibres concerned with
the production of voluntary movement remain relaxed.
POSTURAL TONE
The contraction which persists in the muscles concerned with the maintenance of posture (chiefly the anti-
gravity muscles) is called postural tone.
Postural tone is maintained by reflex mechanism (myotatic or stretch reflex).
VOLUNTARY MOVEMENT
Contraction in any one group of muscles is accompanied by a reciprocal relaxation of the antagonist group to
allow movement to take place smoothly.
This fact is important during the consideration of methods designed to obtain relaxation of a particular group
of muscles
DEGREE OF RELAXATION
The degree to which the muscular tension can be reduced is known as the degree of relaxation
It is possible to estimate the DOR by palpating the muscle (eg: massage)
PATHOLOGICAL TENSION IN MUSCLES
A marked persistent increase in muscular tension or tone is a feature of many pathological conditions that
affect The nervous system, Especially lesions in the higher motor centres.
Types of stress
There are two types of stress;
Eustress
Distress
Eustress Distress
• Eustress is the positive stress that stimulates a • Distress is a negative stress that may cause
person to function better. illness.
• This is called as friendly stress or positive • This is also called as harmful stress.
stress. • Negative stress could be also described as a
• It has a good influence on human in terms of burning out.
physical and mental ability • It is a contributory factor in minor condition
• It also provides the sense of urgency and such as headaches, insomnia, ulcers, etc
alertness needed to survival when confronting
threating situation.
Effect of stress on body mechanism
Physical changes Behavioural symptoms
Increased heart rate Nail biting
Increased BP Fidgety movement
Psychological changes Fearfulness
Lack of concentration Addiction
Head ache Musculoskeletal disorder
Insomnia Research NIOSH
Loss of memory Back and upper extremity musculoskeletal
disorder
Inability to make decision
Forgetfulness
Confusion
Indications of relaxation
High blood pressure
Eating disorder
Anxiety disorder
Substance abuse
Attention deficit disorder
Depression
Sleep disorder
Migraine headache
General relaxation
Basic conditions for general relaxation
I. Support
II. Comfort
III. Restful atmosphere
I. Support
1. Lying supine
2. Half lying
3. Total suspension
4. Prone lying
5. Side lying
1. Lying supine
Each arm abducted slightly and flexed at the
Use elbow slightly by supported pillows
Firm surface
Good sprint mattress Avoid
Use head pillow (to prevent rolling of head) Plint or beds that sag (Cramp thorax causing
additional strain to the respiratory muscles)
Pillow under the knee (to release the tension of
hamstring, also pelvis will rollback crdeating a
straight spine)
Feets in the mid position help by sand bags
2. Half lying
Similar to the previous but breathing is easier as there is less weight on the back and abdominal
pressure
An armchair makes quite a good substitute for a plinth or bed, the thighs are fully supported and the
feet rest on the floor, or a footstool, or a T-shaped footrest.
3. Total suspension
Each unit of the body is suspended by a suitable sling placed under the centre of gravity of the part,
and attached by a vertical rope to a strong overhead support.
The arms are abducted slightly with the forearms pronated and the feet are held in the mid-position by
a supported sling and rope.
The inclusion of tension springs gives additional comfort and a feeling of buoyancy as they stretch
and recoil with the respiratory movements
4. Prone lying
The head is turned to one side and may rest on a small pillow,
if more comfortable. A firm pillow under the hips and the lower abdomen prevents hollowing of the
back, and for women it should extend higher to avoid too much pressure on the breasts;
Lower leg is elevated so that the knees are slightly bent and the toes free.
A degree of medial rotation at the hips, causing the heels to fall apart, still further induces relaxation
of the legs.
Many find this position comfortable and use it for sleeping; others dislike it because of the rotated
position of the head
4. Side lying
The measure of relaxation obtained is governed by the efficiency with which the shoulder and pelvic
girdles are stabilised.
The arm and leg which are uppermost may be rested on the supporting surface instead of on pillows,
but some of the weight then falls on the trunk and this impedes respiration.
The head pillow supports the neck and head in alignment with the body, and must not be too high.
The majority of people sleep on the side, but few are conscious of the part suitable positioning for
relaxation plays in promoting it.
II. Comfort
removal of constrictive clothing (corset & Belts)
the room should be warm and have fresh air
In winter – additional lights and blankets, hot water bottles at the feet
Use warm bath
Have light well balanced meal
Brisk walk in the open air
Attention to empty the bladder before
III.Restful atmosphere
LOCAL RELAXATION
Hold-Relax and Contract-Relax•
With the hold-relax (HR) procedure, the range-limiting muscle is first lengthened to the
point of limitation or to the extent that is comfortable for the patient. The patient then
performs a pre-stretch, end-range, isometric contraction (for 5 to 10 seconds) followed by
voluntary relaxation of the tight muscle. The limb is then passively moved into the new
range as the range-limiting muscle is elongated
Agonist contraction
The "agonist" refers to the muscle opposite the range-limiting muscle. "Antagonist,"
therefore, refers to the range-limiting muscle. Think of it as the short muscle (the
antagonist) preventing the full movement of the prime mover (the agonist).
To perform the AC procedure the patient concentrically contracts (shortens) the muscle
opposite the range-limiting muscle and then holds the end-range position for at least
several seconds. The movement of the limb is independently controlled by the patient and
is deliberate and slow, not ballistic.
Jacobson’s relaxation
The Mitchel method of Physiological Relaxation
Also known as the reciprocal method of relaxation
If one group of muscles is instructed to tighten the opposite group of muscles receives an instruction to
relax
ORDERS TO THE ARMS
Shoulders-"Pull your shoulders towards your feet"-away from the ears, making the neck longer.
STOP
Feel that your shoulders are lower down and that now there is a wider space between them and your
ears.
Elbows - "Elbows out and open" Keep your arms supported, then push them slightly away from your
sides, opening out the elbow joints.
STOP
Feel the positions of your arms and elbows, and the pressure of your arms on their support, through the
sensations of your skin.
Hands "Fingers and thumbs long and supported” open out your fingers and thumbs, keeping your
wrists resting on their support
STOP
Feel your fingers and thumbs fall back onto their support. Don't let your hands touch each other or
they will register this instead of their position, Feel that the hands are still, the pads of the fingers
touching their support. Be aware of your thumbs as they lie beside the fingers.
Nerves from the hands take up a large part of the conscious brain where sensation is recognized, use
this to feel case, concentrate on the pleasure of feeling your resting hands.
ORDERS TO THE LEGS
Hips- "Turn your hips outwards"- Feel your thighs and legs roll outwards.
STOP
Feel that your legs have rolled outwards.
Knees- "Move your knees gently until comfortable
STOP
Feel the comfort in your knees.
Feet - "Push your feet away from your face" bend the ankles downwards gently pointing your toes.
STOP
Feel that your feet are softer at the ankle joints, because all the lower leg muscles are now relaxed.
ORDERS TO THE BODY
"Press your body into the support"-using the floor, bed or back of chair not the seat.
STOP
Feel the pressure of your body on the support
Orders to the Head
"Press your head into the pillow or chair"-feel the movement in your neck as you do this.
STOP
Feel the weight of your head in the hollow you have made. As your brain registers that the head is supported, it relaxes all
the neck muscles.
Breathing orders
"Take a deep breath" - feel your tummy swell out as you breath out "then breathe out easily". Repeat twice. The ribs
move in and out. Breathe at a natural rate.
Orders to the Face
Jaw-"Drag your jaw down" - do not open your mouth, just unclench your teeth inside your mouth and gently pull your
jaw down.
STOP
Feel the space between your upper and lower teeth, that the skin over your cheeks is smooth with your lips still gently
touching each other.
Tongue - "Bring your tongue down and let it lie in the middle of your mouth" - if it is stuck against the roof of your
MOUTH
STOP
Feel the tip of your tongue touching your lower teeth.
Eyes - "Close your eyes" if not already closed. Let your eyelids close down over your eyes, do not screw them shut
STOP
Forehead-"Smooth the skin over your forehead from your eyebrows into your hair, continuing
the movement over the top of your head and down the back of your neck" - widen the space
between your eyebrows and hairline, making it wrinkle free.
STOP
Feel the smoothing of the skin of your forehead and your hair moving back as the large muscle of
your skull slackens and relaxes.
You have now completed the whole sequence
THANK YOU
