March 28, 2015

Sleeping Comfort after Shoulder Surgery

Rotator cuff repairs, labral repairs, acromioplasties, and shoulder replacement surgeries are performed on countless patients every day in the United States. Although rehabilitative protocols differ depending on the surgery, there is one common complaint shoulder patients have regardless of the type of surgery. Most patients are not equipped to deal with the pain associated with sleeping. The following is a list of ideas that our patients have compiled over the years that have helped to get them “over the hump” in terms of getting a good night’s rest.

1. You may initially find it easier to sleep in a reclined position rather than lying flat on your back. There are two ways to do this. You can either bolster yourself from behind with pillows, or more preferably, sleep in a reclining “Lazy Boy” type of chair. It is also worth noting that as your sleeping comfort improves, it is worth slowly lowering your body down over time until you are back to a horizontal position. Many patients will have to sleep in a semi-reclined position for up to six weeks or longer following surgery. It is worth your while to plan ahead of time and borrow a recliner if you know that you will be having shoulder surgery.

2. Pharmaceuticals can be extremely helpful after shoulder surgery. What some patients do not realize is that different people react in different ways to different medications. If you are not getting any sleep secondary to pain with your current medication, ask your doctor if there are other options.

3. Many healthcare practitioners who deal with post-surgical shoulder rehab agree that placing a single pillow under the elbow and hand places the shoulder in a position that allows maximal blood flow to the rotator cuff tendons during sleep. The picture above shows such a position. It is even possible to do this while you are wearing your physician-prescribed shoulder sling.

4. Ask your doctor if it is acceptable to spend some time out of your shoulder sling every day. Shoulder slings are a necessary evil: they do indeed protect the shoulder from trauma while the patient is walking and performing daily tasks. The downside of the shoulder sling, however, is that it places the shoulder in an undesirable forward position that does not help with restoring normal mechanics. The longer a shoulder is kept forward in a sling, the harder it is to get the shoulder to rest in a normal position. This is yet another example of “form following function.” As soon as your doctor allows you to stop using your shoulder sling, burn it.

About Dan Baumstark, MSPT, CHT

Dan is a physical therapist who specializes in sports medicine & upper extremity rehabilitation. He is certified by the American Society of Hand Therapists, and he has extensive continuing education in manual therapy from the Michigan State University School of Osteopathic Medicine. Google+


  1. michael wolfman says:

    had severe rotator cuff damages…4 reattachments
    in sling and cannot find position to sleep except almost completely upright,,,impossible
    i have been told that i will be in sling for a month

    q – is this just something i have to accept and get thru? what is the usual discomfort time until i can recline

    thank you!

    • Michael

      It may be a month or two before the sleeping comfort improves, especially with the level of involvement of your surgery. Try propping pillows under the elbow and arm to see if you can find a better position. If you have a reclining chair / lazy-boy that will usually help as well.


  2. Nicholas porter says:

    I had labrum surgery for my shoulder three weeks ago but it feels fine sleeping without my brace and walking around my house without it on…. Is it okay that I’m only wearing it when I go out in public?

    • Nicholas

      The labral anchors really need a good month to heal in a stable position. Be very careful about taking the sling off in certain situations. I would certainly say that you need to wear it in public and while you sleep. It is probably fine to take it off in the house and when you are sitting quietly etc.., but you of course need to run the idea by your doctor.

      Better to be mildly inconvenienced short term in order to have a stable recovery.

  3. I had 4 reattachments this afternoon. Having pains In lower right ribs in every breath. Is there a reason for this and since the surgery was on my right shoulder can I sleep on my left side and not worry about hurting my shoulder?



    • Ben

      The rib pain probably has to do with your positioning during the surgery. Keep an eye on it, if it doesn’t go away or if it gets worse see the doctor. I would say that you could probably sleep on the left side without doing any damage to the right shoulder, but it may be a bit clumsy especially if the doctor wants you to wear a sling.


  5. Sally gonzales says:

    I am fixing to have right shouder replacement is their certain pillows I need to get?? I have a big recliner thanks

  6. I had rotator cuff surgery February 10, 2014 and have been sleeping in my recliner up until two weeks ago. I transitioned to my bed. I sleep okay in my bed but I wake up every morning with excruciating pain in my back and my neck. Did I transition too soon from my recliner to my bed and should I have done it not 8 hours all at once? I am considering going to a chiropractor. I am going back to my recliner until I can see my surgeon again.

    • I am guessing that your back is now accustomed to the reclined position rather than the supine position that your bed provides. Seeing a chiro may not be a bad idea. I would also work on strengthening your back.

      Is there any way that you can gradually decrease the angle on the recliner? That might also be a good idea.

  7. Why was my question deleted that I posted several days ago?

  8. I just had a distal clavicle excision 5 days ago. I’ve been sleeping on my reclining couch and tried tonight to sleep on my bed. Felt like my shoulder was pulling and my incision started to burn, will I just have to “work out” the stiffness? Or do I need more time on the couch reclining? Thanks!

  9. Izzy Badjio says:

    I had rotated cuff surgery a month ago, still in the sling. I was shifting my car from park to drive when I felt the most excruciating pain. It’s been over 4 hours and I am still in a lot of pain. Even uusing my fingers to type hurts, how do I know if I messed up my injury.? Any advice would be helpful.

    • You probably just strained it. Ice it for a few days and let it rest. I would also avoid any pulling or pushing with the arm until you get the “okay” from the doctor. It is a bit early to be shifting car gears with the arm. It generally takes 4-6 weeks for the anchors that the doctor used to adequately heal into place.

      If the pain doesn’t get any better in a few days talk to the doc about it.

  10. lAWANDA says:

    I had a hold shoulder replacement on the 26 of June. I can’t sleep at night the pain is in my elbow an wrist what can i do about that.?I’m still sleeping in my recliner i can go to sleep thin then i woke up from the pain is that something i should be going to the doctor for?

  11. I had rotor cuff surgery done on June19! For a week now I have been accident sleep on my shoulder! Is that harming my shoulder in any way?

  12. Sally Rumph says:

    I had massive rotator cuff repair surgery on July 10. I am married to my sling for a minimum
    of 8 weeks. i am experiencing sleep disabling pain in my forearm and hand. I usually get about
    2 hours and the pain will waken me. I will adjust position and ice, to no avail. I am guessing this is
    a circulation (lack thereof) issue. Any suggestions? Thank you.

    • Sally is there any way to adjust the sling so that your elbow is less bent?? You may be getting irritation of the nerves as they pass through the elbow. A sustained flexion of the elbow will sometimes cause trouble like that.

  13. Raelene says:

    I had these procedure done
    1: synovectomy, debridement of Lalbrum, tenotomy of the bicep tendon, acromloplasty, cop landing of the clavicle of my right shoulder on July 15 and how long should I sleep in a recliner and wear the sling?

    • Raelene says:

      Of the clavicle

      • Raelene it sounds like you had a lot done on the shoulder. You may find it necessary to use the recliner for a month or two for sleeping comfort. Don’t worry about it if you have to go even longer than that.

        In terms of the sling, ask the surgeon. He or she may want you to wean off of it slowly.

  14. jose jimenez says:

    Just had shoulder surgery, can’t sleep? Hard to do #2, need help.

    • Can you recline rather than lying down? I would also try to place a pillow under your elbow and arm like in the blog picture. As far as toileting goes, you are probably going to have to figure out how to use the other arm for the short term.

      The doc should also be able to prescribe you something short term for sleeping comfort. Ask him if there are any options.

  15. jose jimenez says:

    Presciptions don’t seem to b working, can’t go anywhere long. Holiday weekend, need to wash myself, how?

    • I would see the doc this week to see if you can get something else for the pain. In terms of hygiene, can you sit in a bath tub and use a shower attachment with your good hand with your surgical shoulder resting on something? Is there anyone else around to help you out?

  16. I had a total shoulder replacement approximately 3 mos. ago due to severe arthritis being one of the problems. I’m still having sleeping issues. I have sleep apnea, more noticeable when lying on my back. I’m a side sleeper and I’m now having problems with other shoulder pain. . I’ve been looking at the pillow on to help take stress off sleeping on my side; any suggestions would be greatly appreciated. Thank you in advance for any suggestions.

    • Hattye I would recommend sleeping in a partially reclined position. A “Lazy Boy” type reclining chair might place you in a more comfortable position.

      Some people with sleep apnea do indeed have a very difficult time sleeping flat. If you don’t have access to a reclining chair, it might be possible to prop yourself up with a bunch of pillows placed behind you.

  17. i just had labrum repair done, arthritis repaired, ac bone snipped? its been 20 days now, diff sleeping #1, can i leave my arm out of my sling if im not doing anything other than sitting, or just general moving about the day? i have some moderate pain, only once in a ahwile .ty ps. how much movement does it take to disrupt the 5 anchors that are installed? i heard the drs do a good job @ them, so it would take a mod blunt force to hurt/disrupt them?

  18. I just finished speaking to a woman whose husband has to sleep in a recliner. She’s been looking for a pillow that keeps his neck and head from rolling around and found my website. It’s a pillow specifically designed for a recliner. If you’d like to take a look the website is

    Hope you’re able to find a way to be comfortable!

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