December 21, 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. 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.

  2. 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?

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