Whether we’re talking pain prevention or surgical recovery, sleep position can greatly impact your shoulder health.
Basic Sleep Position
When you lie on your side, notice the position of your shoulder. If you’re like most people, you position your body in a way that forces your shoulder into a forward position, helping you to prevent the immediate arm pain and numbness which would likely be caused if your shoulder were positioned directly beneath your body. However, this seemingly innocuous forward positioning may actually cause greater amounts of pain in the long run. Basically, when the head of the humerus (a.k.a. the shoulder bone) is repeatedly pushed forward for long periods of time (i.e. every night as you sleep), the joint capsule surrounding it stretches and tightens in order to accommodate the forward position.
As a result of the changes that arise from chronic forward positioning of the shoulder, posterior glide can cause pain of the rotator cuff tendons in the shoulder, when they are restricted by structures that wouldn’t normally be in the way. Because of this potential problem and others, the medical community generally agrees that sleeping on your back facing upward is the least stressful position for your body, causing the least amount of stress to the shoulder and the neck. Especially for those who have previously had shoulder surgery or shoulder problems or pain of any kind, this recommendation is intensified.
Recovery from Surgery
In addition to avoiding sleeping on your side when you’re recovering from surgery (whether that is a rotator cuff repair, acromioplasties, shoulder replacement, or labral repair surgery), you’ll want to be aware that finding a pain-free sleep position will probably be difficult. While lying on your back will typically help reduce stress to the shoulder area, until you fully recuperate, you may find a semi-reclined position more comfortable. If an adjustable bed or “recliner” chair is not available, you can use pillows to prop yourself up from behind in bed. As you become more comfortable, you can begin to lower yourself back into a fully horizontal position. Be prepared to remain at least somewhat reclined for at least six weeks after surgery.
In addition, you may want to place a pillow under your elbow and hand, in order to raise the shoulder into a position allowing for maximum blood flow to the tendons of the rotator cuff as you sleep. (This positioning will not be impeded by a shoulder sling, if you have been instructed to wear one.) On that note, you may benefit from asking your doctor if you can spend a short amount of time without your shoulder sling each day. (And remember to stop using it as soon as your physician allows you to do so.) Additional comfort may be achieved via medications. If the prescribed pharmaceuticals are not allowing you to get the rest you need, be sure to ask your doctor about other options.
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PhysioDC of Washington, D.C. is a boutique physical therapy center which helps patients recover, strengthen, and return to healthy living after they travel or on a day-to-day lifestyle. Located in downtown Washington, D.C., PhysioDC is an excellent resource to contact for all joint and body pain. For more information on physical therapy for your body, visit PhysioDC at www.physiodc.com. PhysioDC is located in downtown D.C. at 1001 Connecticut Avenue NW, Suite 330 (at the corners of K Street and Connecticut Avenue NW).
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