Relax and Relax More*

After raising my shoulders and then relaxing it, I felt relaxed. I was totally surprised that the actual muscle tension recorded with surface electromyographic (SEMG)  still showed tension. Only when I gave myself the second instruction, relax even more, that my SEMG activity decreased.

In our experiences, we (Vietta E. Wilson and Erik Peper, 2014)  have observed that muscle tension often does not decrease completely after a person is instructed to relax. The complete relaxation only occurs after the second instruction, relax more, let go, drop, or feel the heaviness of gravity. The person is totally unaware that after the first relaxation their muscless  have not totally relaxed. Their physiology does not match their perception (Peper et, 2010; Whatmore & Kohli, 1974). The low level of muscle tension appears more prevalent in people who are have a history of muscle stiffness or pain, or in athletes whose coaches report they look ‘tight.’ It is only after the second command, relax and release even more, that the individual notices a change and experiences a deeper relaxation.

The usefulness of giving a second instruction, relax more, after the first instruction, relax, is illustrated below by the surface electromyographic (SEMG) recording from the upper left and right trapezius muscle of a 68 year old male with chronic back pain. While sitting upright without experiencing any pain, he was instructed to lift his shoulders, briefly hold the tension, and then relax (Sella, 1997; Peper et al, 2008). When the SEMG of the trapezius muscles did not decrease to the relaxed state, he was asked to relax more as is shown in Figure 1.

Figure 1 Muscle tension

Figure 1. SEMG recordings of the left and right upper trapezius when the client was asked to lift his shoulders, hold, relax, and relax more. Only after the second instruction did the muscle tension decrease to the relaxed baseline level. Reprinted from Wilson and Peper, 2014.

Although the subject felt that he was relaxed after the first relaxation instruction, he continued to hold a low level of muscle tension. We have observed this same process in hundreds of clients and students while teaching SEMG guided relaxation and progressive muscle relaxation.

For numerous people, even the second commands to relax even more is not sufficient for the SEMG to show muscle relaxation and for them to ‘feel’ or know when they are totally relaxed. These individuals may benefit from SEMG biofeedback to identify and quantify the degree of muscle tension. With this information the person can make the invisible muscle contractions ‘ visible,’ the un-felt tension ‘felt,’ and thus develop awareness and control (Peper et al, 2014).

In summary

  1. Instruct people to relax after tightening and then repeat the instruction to relax even more.
  2. Use surface electromyography to confirm whether the person’s subjective experience of being muscularly relaxed corresponds to the actual physiological SEMG recording.
  3. Use the SEMG biofeedback to train the person to increase awareness and learn relaxation (Peper et al, 2014).
  4. Read the complete article from which this blog was adapted: Wilson, E. & Peper, E. (2014). Clinical Tip: Relax and Relax More. 42(4), 163-164.

References

Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. (2014). Making the Unaware Aware-Surface electromyography to unmask tension and teach awareness. Biofeedback. 42(1), 16-23.

Peper, E., Booiman, A., Tallard, M., & Takebayashi, N. (2010). Surface electromyographic biofeedback to optimize performance in daily life: Improving physical fitness and health at the worksite. Japanese Journal of Biofeedback Research, 37(1), 19-28.

Peper, E., Tylova, H., Gibney, K.H., Harvey, R., & Combatalade, D. (2008). Biofeedback mastery-An experiential teaching and self-training manual. Wheat Ridge, CO: AAPB.

 

*This blogpost is adapted from, Wilson, E. & Peper, E. (2014). Clinical tip: Relax and relax more. Biofeedback. 42(4), 163-164.

 


Pain in the neck—there is hope!

Neck pain affects more than 70% of Americans in their life time.  What treatment offers the best outcome: Drugs, spinal manipulation or neck and shoulder exercises? In a superb randomized control study in published Annals of Internal Medicine with 272 patients with acute and subacute neck pain, a few instructional sessions in home exercise with advise or twelve sessions of spinal adjustment was significantly more effective in the short or long term.

From a psychophysiological perspective, becoming aware of the covert neck and shoulder tension, identifying “who or what is the pain in the neck” (the neck and shoulders often reflect emotions), resolving emotional conflicts, practicing many movement and relaxation breaks during the days, and learning to relax the neck and shoulders with or without biofeedback can usually reduce neck and shoulder pains.

Even more impressive is the work by David Hubbard, MD and Richard Gevirtz, PhD. They have demonstrated that whiplash injury can healed very quickly by watching a 12 minute video in the emergency room and practicing simple neck and shoulder exercises, diaphragmatic breathing,  and possible use of biofeedback. It reduces symptoms and medical utilization by more than 80% as compared to the patients who did not see the video.