April 17, 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+

Comments

  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.

      Dan

  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?

    Thanks,

    Ben

    • 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.

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