October 23, 2014

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. 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.

  2. 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.

  3. 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?

  4. 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 shoulderpainatnight.com. 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.

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