RELAXATION
Muscles which are relatively free
from tension and at rest are said
to be relaxed.
Tension developed in muscles as
they work during contraction and
this tension to a variable degree
as muscles come to rest during
relaxation.
MUSCLE TONE :Its the quality of
firmness retain in the muscle
even they are relaxed as
possible.
POSTURAL TONE: the
contraction which persists in the
muscles concerned with the
maintenance of posture is called
postural tone.
Its maintained and regulated by
a reflex mechanism.
MENTAL ATTITUDES : Mental
attitudes such as fear, anger and
excitement give rise to a general
increase in muscular tension.
it serves a useful for preparing
the muscles for rapid or forceful
action.
Sometimes it disappear when
purpose is no longer exist.
Somecases it persists and
becomes habitual.
PATHOLOGICAL TENSION IN
MUSCLES
Increased tension or tone is a
feature of pathological condition
related to nervous system.
By promoting the relaxation this
can be temporary reduction can
be seen.
Technique
General relaxation:
Support, comfort and restful
atmosphere are basic conditions for
general relaxation .
SUPPORT : various forms and
modifications of lying position are
used , to achieve full support of the
body.
It varies with the condition of the
patient.
LYING SUPINE
Firm surface is essential, it will
mould itself to the body contours
and give even pressure and
comfort (spring mattress).
Plinths or beds which sag are
avoided as they cramp the thorax
and so throw additional strain on
inspiratory muscles,
Pillow below head: to prevent the
head from rolling to either side
and to support neck posteriorly.
Pillow below knee :to relieves
tension on the hamstrings and
iliofemoral ligament, and allow
the pelvic roll backwards so
lumbar spine will be
straightened .
Feet are held in the mid position
by a sandbag or similar device .
Each arm slightly abducted at
the shoulder and flexed at the
elbow , rest on a pillow.
HALF LYING: Its similar to the
previous but breathing will be easier
as there is weight on the back and
abdominal pressure on the under
surface of the diaphragm is reduced.
An armchair makes quite a good
substitute for plinth or bed as thigh
are fully supported and feet rest on
the floor or a footstool , T –shaped
footrest.
TOTAL SUSPENSION: each unit of
the body is suspended by a
suitable sling placed under centre
of gravity of the part.
Its attached by a vertical rope to a
strong overhead support.
The arms are abducted slightly
with the forearms pronated and
feet are held in the mid position by
a supporting sling and rope.
The inclusion of tension springs
gives additional comfort and a
feeling of buoyancy as they
stretch and recoil with the
respiratory movement.
PRONE LYING: the head is turned to
one side and may rest on small
pillow.
Pillow under the hips and lower
abdomen prevent stress on the back.
For women it should extend higher to
avoid too much pressure on the
breasts, Lower leg is slightly elevated
so that the knees are slightly bent
and the toes free .
Medial rotation of hips, causing
the heels to fall apart, still further
induces relaxation of the legs.
SIDE LYING: the arm and leg
which are uppermost may be
rested on the supporting surface
on pillows,
Head pillow supports the
neckand head in alignment with
the body, it should not be high.
COMFORT
Freedom to breathe deeply , warmth
, abdominal inactivity and mild
degree of physical fatigue are
ingredients of comfort.
Pressure should be removed by ;
removing constrictive clothing, such
as belts and corsets.
The room should be warm, but have
free supply of air .
In winter additional warmth can be
supplied by light but warm blankets, a
covered hot water bottle at the feet,
electric blanket, non luminous infra red
irradiation.
Avoid overheating , as it leads to
restlessness.
Hot water bath, well balanced meal,
rhythmic physical activity of short
duration and attention to emptying
bladder before treatment is requires for
general relaxation.
RESTFUL ATMOSPHERE
As physical and mental relaxation
are interdependent, an effort
must be made to secure a state
of mental rest.
Treatment room should be quiet
as possible.
low pitched “ hum”of distant
sound are sometime soothing.
Bright lights and strong colours,
such as red and bright yellow are
stimulating.
Low well –diffused light with
green and peach furnishings
gives a soft and warm glow and
provides an ideal setting for
relaxation.
Manner and bearing of
physiotherapist important.
Physiotherapist must be
confident, appearance should be
tidy and neat dress and punctual
and move calmly without hurry or
hesitation.
They are voice should be low
pitched and clear .
All the information regarding the
routine are given in patient
language .
Conversations should involve
pleasant and restful topics.
Immediate result should not be
expected and are rarely
achieved, often because of
psychological factors beyond the
control of physiotherapist of
patient.
ADDITIONAL METHODS OF
PROMOTING RRELAXATION
CONSIOUSNESS OF BREATHING :under
conditions of quiet and comfort the
patients mind may remain active and
turn on problem.
Patient should concentrate on his own
rhythm of breathing, it should be deep
with a slight pause at end of
expiration.
Expiration is phase of relaxation
and should be accompanied by a
feeling of letting go in the whole
body.
PROGRESSIVE RELAXATION: its
practised by jacobson of chicago,
similar to still pose or savasana.
Patient is being told to contract any
group or series of muscles as
strongly as possible and the let go
and continue to let go.
Another method: patient is urged to
step up preliminary contraction until
he is so tired that he has to let go .
Routine contraction followed by
relaxation is carried out in each area
of the body.
Attention should be given
sequence from limb to limb and
to the trunk and head including
the neck and face muscles until
all areas can remain relaxed at
one and the same time.
If the patient pass to sleep
should be allowed to wake
naturally ;alternatively he must
be wakened gently in sufficient
time for getting up .
PASSIVE MOVEMENT :passive
movement of head and limbs may
assist the degree of general
relaxation in some cases.
It should be in a sequence .
Group movements of joints are
preferable.
Insuspension small pendular
movements are preferrable .
Eventually attaining general relaxation
largely depend upon individual patient
and her physiotherapist dealing with
her.
It can be carried out in when the
oppotunity presents. (train, mountain)
General relaxation can sometimes
carried out effectively in groups,.
(pregnant women, asthmatic,
bronchitic)
Local relaxation
All the principles of general
relaxation should be followed.
Preparatory to massage and
passive movement
Massage and PROM are
presuppose relaxation of the
under treatment.
General state of rest will assist
the process.
FOR RELIEF OF SPASM
Spasm due to pain is protective
and relieved by removal of pain.
If its bcz of fear of pain on
movement rhythmical assisted or
pendular movements stating in
small range and gradually
increasing , will often restore
confidence and assist relaxation.
Contraction against resistance of
the muscles antagonistic to a
specific group may also
encourage reciprocal relaxation
of the latter.
IN PREVENTING ADAPTIVE
SHORTENING
Persistent tension or
hypertonocity of muscles acting
upon the joint produces state of
muscular imbalance.
Positioning the joint to prevent
shortening,
streching,. Reciprocal inhibition.
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