Ways to Relax
The Relaxation Response
The opposite of the fight or flight response is the ‘relaxation response’. This is where the calming side of your nervous system (called the parasympathetic nervous system) kicks in and puts the body into a state where it can deeply relax, which helps healing to occur.
When the relaxation response kicks in, the following things happen in the body:
• Heart rate slows,
• Blood pressure returns to normal
• Breathing slows and deepens
• Muscles relax
• Normal digestion occurs
Ways to Relax
You probably already have your own methods of relaxing and many of these will serve you well as you prepare for surgery. It’s important when life is busy or stressful to remember to do the things that help us to unwind even more than usual (even though of course it’s much harder if you are busy or stressed)! For some people relaxing activities might be something they do for themselves (like taking a hot bath or shower, reading a book) or it might be something active (going for a walk or doing exercise). It might be something social (spending time with friends or family) or it could involve a relaxing place (being in nature).
Turn to your “My Knee Surgery Plan” document and use the section on ‘Ways to Relax’ (page 6) to make a list for yourself of your favourite ways to relax.
Take the time to think about each one: how well do you switch off your body’s stress response when you do this? How deeply calm and relaxed do you feel afterwards? And, how often do you do these activities? Is there a way you can do them more frequently around the time of your surgery?
In addition to our usual ways of relaxing, you can learn to relax more deeply by specifically practising relaxation techniques. We’ll introduce you to a few of these now and hope you’ll use these to develop your own relaxation skills.
Relaxation Techniques
In order to switch off the fight or flight response, and switch on the relaxation response, we need to find ways to slow our heart rate, our breathing, reduce muscle tension, reduce blood pressure or turn off the ‘butterflies’ in our stomach. But how do we do this? There are some aspects of fight or flight that we can’t directly control, like heart rate or blood pressure, but there are 3 aspects that are under our control, which are our level of muscle tension, our breathing, and our thoughts. Therefore there are three types of relaxation techniques that specifically target each of these:
Muscle relaxation techniques
Relaxed breathing techniques
Imagery techniques (to calm the thoughts)
We’ve provided you with instructions for three different breathing techniques (page 14) and audio recordings for 4 different relaxation techniques:
Diaphragmatic breathing
Progressive Muscle Relaxation
Guided Imagery
Power Break
We encourage you to try all the different relaxation techniques and to practise them regularly – it’s just like learning any new skills – when you first try them out you may find it difficult, but after a bit of regular practise it will get easier to switch on your relaxation response. Don’t worry if at first you can’t relax too deeply – you will improve the more you practise.
Most relaxation techniques involve finding a quiet and comfortable place, getting into a comfortable position, and listening to a recording which will instruct you in how to relax.
Practising Relaxation at Home:
1. Find a quiet place where you won’t be interrupted (this can be tricky – make sure you let others know not to disturb you, turn off phones etc.
2. Rate your level of tension and pain before you begin. Turn to the relaxation diary in your “My Knee Surgery Plan” document and use the scales to rate how tense you are/how much pain you’re experiencing and notice how tense you are / how much pain you’re experiencing.
3. Make yourself comfortable. Loosen tight clothing, take off glasses or shoes – whatever it takes to get comfortable. You can either lie down or sit well supported in a chair with your feet uncrossed, flat on the floor. Your body can cool off a bit so you might want to wear something warm.
4. Listen to the relaxation recording and follow the instructions to relax deeply.
5. Rate your level of tension and pain once again and notice the effects.
Relaxed Breathing Techniques
Abdominal Breathing
Start by getting into a comfortable position either sitting, well supported by the chair with your feet flat on the floor, or lying on your back with your arms at your sides.
Inhale slowly through your nose. Keep your shoulders relaxed. Breathe into your stomach, your chest should only rise a little.
Exhale slowly out through your mouth. As you blow air out, purse your lips slightly, but keep your jaw relaxed. You may hear a soft “whooshing” sound as you exhale.
Repeat for 6 full breaths.
Relaxation Plan
Aim to practise relaxation daily – try to manage one long technique and 3 brief techniques every day. You can keep a diary of your daily practice using the space provided in your “My Knee Surgery Plan” document. This may help you to stay on track while you form a new habit, and to identify the relaxation techniques that are the most effective for you.
It is worthwhile making a plan for how you might use relaxation at the time of surgery to calm your nerves and optimise your recovery.
Turn to page 6 of the “My Surgery Plan” and use the space provided to identify your favourite ways to relax, how often you’d like to practise, the best place to practise relaxation, and also any possible barriers or distractions that would prevent you from practising regularly (e.g. people who might disturb you, phone ringing, routines or habits) and any things you can do to overcome such distractions or barriers.
Thanks for taking the time to read this information booklet. Best wishes for your surgery and for an optimal recovery!