For those who think there’s not much that can go wrong when you are asleep, except for an occasional bad dream, we’re here to put that notion to rest. There are cases of spinal decompression reported every year while people sleep, and, if you think of the strange contortions that can occur in the sleeping mode, we’re also here to report cases of overextended knees, twisted elbows and wrists and even stiff and wrenched necks from elevated pillows. Many a chiropractor can attest to easing the pain and discomfort for all the above, but would you believe that venerable and muscled joint, the shoulder, is among the most vulnerable parts of the human body susceptible to injury from sleeping?
Think about it. If you sleep on your side, you’re putting full body weight on your shoulder, with the arm wrapped around the pillow or splaying out at odd angles. With constant body weight on your shoulder night after night, it is known to lead to injury to any of the rotator cuff’s four muscles. Some sleepers have been known to use their shoulder as a pillow, resting atop it over the course of thousands of hours throughout months and years of sleeping.
Aside from stretching and straining of any of those muscles, lying on your shoulder can result in an impingement on the rotator-cuff tendons and shoulder capsule. Again, it’s all about cumulative repetition and time— two factors that create load and intensity. An impingement is a pinching sensation limiting movement in the shoulder joint and drastically reduces range of motion.
Then there is the possibility of rotator cuff tendonitis, which is inflammation and swelling of both the bones and tendons. It may start out being stiff and sore. Then one day you realize you can barely lift your arm to shoulder level. Chiropractors can do a world of good in making that shoulder feel better, but physical therapy will not only alleviate the pain, but it can recover that mobility you slept away. Any of the rotator muscles that is injured, whether strained or torn to the extent of having to undergo surgery, typically results in physicians and surgeons prescribing physical therapy before and after surgery.
Physical therapy is the most recommended treatment — to the tune of some 3 million Americans a year— and often obviates the need for surgery.
Aging’s a Factor in This “Lifestyle Ailment”
Cumulative damage means something that occurs over an extended span of time, and that is why it is more common among the middle-aged and older and is considered a lifestyle ailment. Most rotator cuff injuries are the result of sudden impact, prevalent among youth and young adults playing sports, in accidents or physical activities otherwise healthy. For the older among us, accidents are the leading cause, and that includes falls and other household mishaps. The most common types of rotator cuff injuries are impingements, as they are when we sleep. And then there are tears of one of the muscles — the most serious of the rotator cuff injuries and the most likely to be repaired by surgery.
Pain when twisting the arm or raising it upward is a common symptom of injury to one or more of these stabilizing muscles between the arm and shoulder. Pay heed to shoulder pain and discomfort that disturbs your sleep. The frozen shoulder, which is pretty much what is sounds like, severely limiting shoulder mobility and reaching above shoulder level. The good news is that physical therapy does wonders for this debilitating condition. Exercises of elevation, often using a wall or frame of a doorway for support, are typical but should be supervised by a certified physical therapist.
If you do nothing, it is almost guaranteed to get worse with a dramatic decrease in strength and mobility.