Strategy 4: Relaxation

What is relaxation?

Relaxation is when you intentionally calm your body and mind. We can think about the nervous system as having a volume dial: when the volume is turned up, the nervous system is on high alert, and when the volume is turned down, the nervous system is on low alert. Relaxation is a skill that helps your body shift out of high alert or protection mode and into low alert or recovery mode. Relaxation can involve slowing your breathing, loosening tense muscles, and giving your nervous system a chance to settle.

How are pain and relaxation related?

Pain affects and is affected by your thoughts and feelings (the “psycho” part of the bio-psycho-social model). These thoughts and feelings can change the volume of the nervous system.

Many people feel anxious, stressed, down and worried when they have pain. That is all normal. But sometimes these feelings can make your pain feel worse (as your nervous system is dialled up to high alert), and having more pain can make you feel even more upset or stressed.

How can I use relaxation when I’m experiencing pain?

Relaxation can help calm the body and mind, like ‘turning the volume down’. Some helpful strategies include:

Belly Breathing

Belly breathing or “diaphragmatic breathing” is a form of deep breathing. The diaphragm is a muscle that sits like a dome underneath your lungs. As you take a deep breath in, the diaphragm moves downwards and allows your lungs to fill up.

When we experience pain, our breathing can change. We can take shorter and more shallow breaths. This can be because of physical things, like tight muscles that restrict movement, or because of emotional things such as stress or anxiety. As a result, we tend to breathe from the top of our chest, rather than the bottom. This means our lungs and chest are expanding less, and we aren’t getting as much oxygen in.

Belly breathing helps you use your diaphragm. It can lower your heart rate, blood pressure and stress hormones, meaning it can relax your entire body physically and mentally.

How to belly breathe:

1. Lie down on your back or find a comfortable sitting position.
2. Put one hand on your chest and the other on your belly (below your ribcage)
3. Breathe in slowly through your nose (as if you are smelling flowers). Draw the air towards your belly. You should feel your hand on your belly rise, and the hand on your chest should stay still
4. Slowly breathe out through pursed lips (as if you are blowing on hot soup). The hand on your belly should move down to its original position.
5. Repeat this 10 times

Grounding techniques

Grounding is a form of mindfulness. It is a way to bring yourself back into the present, which can help with anxious thoughts or feelings. Reducing anxiety can help with pain. There are many different types of grounding techniques, some you can try including:

5-4-3-2-1

Working backwards from 5, use your senses to list:

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Noticing colours

Choose a colour (e.g., blue). Look around at your surroundings and slowly find items of that colour. When you find one, take a slow deep breath in and out, before looking for the next one. Do this until you’ve noticed 5 items of that colour.

Progressive muscle relaxation

Progressive muscle relaxation is a two-step process: tensing and releasing. One by one, you tense muscles in your body, then you release the tension and notice the relaxation. It helps to reduce physical tension and reduce stress and anxiety. It also helps you become more aware of the sensations in your body.

Step 1: Tension

Focus on a muscle group, e.g., your left foot. Take a slow, deep breath and squeeze the muscle hard for about 5 seconds. Try to only tense the muscles you are targeting (this can be tricky at first).

Step 2: Relaxing

After about 5 seconds, let all the tightness release from the tensed muscles. Breathe out as you do this. Your muscles should feel loose and limp as the tension releases. It is very important to focus on and notice the difference between the tension and relaxation. Remain in this relaxed state for about 15 seconds, then move on to the next muscle group. It’s ok to skip a part of the body if it feels uncomfortable to focus on it.

Going through each muscle group in the body will take about 15 minutes. You don’t want to rush through this. For example:

• Foot (curl your toes downward)
• Lower leg and foot (tighten your calf muscle by pointing your toes down)
• Entire leg (squeeze thigh muscles)

(Repeat on other side of body)

• Hand (clench your fist)
• Entire right arm (tighten your biceps by drawing your forearm up towards your shoulder and “make a muscle”, while clenching fist)

(Repeat on other side of body)

• Buttocks (tighten by pulling your buttocks together)
• Stomach (suck your stomach in)
• Chest (tighten by taking a deep breath)
• Neck and shoulders (raise your shoulders up to touch your ears)
• Mouth (open your mouth wide enough to stretch the hinges of your jaw)
• Eyes (clench your eyelids tightly shut)
• Forehead (raise your eyebrows as far as you can)

Prayer

If you’re someone who finds comfort in your faith, things like prayer or quiet reflection can be a helpful way to relax and feel more grounded.

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