Ergonomics of Sleep

Ergonomics of Sleep
I recently sprained my Acromio-Clavicular Ligaments(i.e. the ligaments that hold your collar bone and shoulder blade together). This is apparently fairly common, but I had not heard of it before.

The symptoms were
• Sharp pain down my entire arm, centered in the upper arm
• Inability to lift my arm more than 45°, especially against pressure or while holding anything
• Pain on rotating the arm to the outside or inside
• etc
As a side effect, I had difficulty getting to sleep. Once asleep, I had difficulty staying asleep.

Applying the principles of ergonomics, I decided to look for the neutral positions – especially neutral shoulder and arm positions.

There are 3 basic sleep positions – on the stomach (not generally recommended), on the side, and on the back. Variety is the spice of life – and changing sleep positions frequently is normal and healthy. When you are in pain however, the positions you choose may be limited.

The most neutral posture in on the back. I tried that first.

Initially, I found that my shoulder pain increased unless I elevated my arm slightly, so I got a thin pillow to place under my arm from slightly above the elbow to slightly past the wrist. This worked fairly well. But I had also hurt my back, and the flat posture was irritating. I placed another pillow under my knees to lessen low back tension.

As time went on, I began to need more variety in position, so I tried sleeping on my better side. This was a mistake - instant pain in both arms.

Part of the problem (especially for women) with sleeping on the side is that we are not straight. When our arms are extended along our bodies, the hips usually create a bump, placing the elbow into a very non-neutral configuration. In my case, this was a painful non-neutral posture.

I found a small pillow to fill the hole and create a more gentle slope between my arm pit and my hips. This worked fairly well. I was able to get to sleep. As soon as my arm fell off my side, I woke with a jolt.

A better solution is to create a table of pillows as tall as your body to rest the arm on. Even better, use a full body pillow. Then you can alternate between a more balanced posture leaning slightly forward (upper leg and arm supported by the pillow) and leaning backward, with the pillow behind you. The pillow acts as a wedge, so that you lie at about a 30° angle up from flat.

Using pillows as props solves some problems but introduces other issues. Sleep research has shown that we change our position between 3 and 45 times during an average night. Introducing the pillows makes this natural change very difficult to impossible.

Our bodies heal during sleep. Pain interrupts sleep. In addition, anyone recovering from an injury is forced into new sleep postures. We ARE creatures of habit, and the new postures take getting used to.

If you are injured, it may take some time to find a way to sleep through the night – and your sleep may not be as deep and reviving as you really need. As you heal, things do get better. Last night, I feel like I really slept for the first time in 10 days. I’m looking forward to my bed tonight!

I’ve put in samples of different pillows carried by Each one is different. I have two of these and use them even when I'm not injured.

The cervical pillow is great for sleeping on your back. There is a lump on each side and they are different sizes. Choose the one that fits snugly into the curve of your neck as you recline, without pushing your head upward and without making your head fall backward out of alignment(Sorry, no picture). This style is frequently advertised on TV, but is not my favorite.

The Dog-Bone Pillow is designed to serve a similar purpose, but is more compact. It is easily used for either side or back lying since it incorporates the narrow and deeper curve within a single shape. If you need a pillow between your knees to keep your hips aligned, it will generally serve that purpose as well.

The full body pillow is great for side-lying. It does take up a bit of room, but will fit across the head or foot of your bed when you are not using it.

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