Saturday, December 8, 2007

Sleeping and Postural Adaptations

You always hear Coaches and Trainers talking about posture with their athletes and clients. You here them cueing to keep your chest up during a squat, pull the shoulder blades back during a row or to stand up tall during the day. It is well known what slouching and being in a seated position can do to your overall posture. But an area that is often looked past is the positions we put ourselves into during a night of sleep. How can this lead to postural distortions, muscle imbalances, pain and discomfort, and even repetitive stress injuries? In Shirley Sahrmann’s book, “Diagnosis and Treatment of Movement Impairment Syndromes,” she states that the body will adapt to a position that is held for over an hour. Depending on how sound a person sleeps through the night, these positions can be held for up to 10 hours! Let’s take a look at some common sleeping positions and some solutions that can help:

Common Sleeping Positions:

Sleeping on your side
This will cause the top leg to go into adduction, flexion and internal rotation, and the bottom shoulder to be flexed and externally rotated. This is usually accompanied by mild trunk flexion and plantar flexion of the ankles. This position can lead to a shortening of the hip internal rotators, the TFL, and the abdominals. Long term effects can include hip impingement syndromes, back pain, and injury due to movement compensation. Also, if you do not have a pillow to support a neutral neck, you will tend to use your arm for support. This can lead to shoulder problems

Solution: Sleep on your side with your legs drawn up slightly toward your chest and a pillow between your legs. Use a full-length body pillow if you prefer. This position may be particularly helpful if you have osteoarthritis in the spine, spinal stenosis — a narrowing in the spine — or hip pain.

Sleeping on your abdomen
Sleeping on your abdomen can be hard on your back. This puts your hips in an excessive anterior pelvic tilt, leading to excessive stress at the lumbar spine and shortening of the abdominals, hip flexors and erector spinae. Experts recommend to try and sleep another way.

Solution: If you can't sleep any other way, reduce the strain on your back by placing a pillow under your pelvis and lower abdomen. Use a pillow under your head if it doesn't place too much strain on your back. If it does cause strain, try sleeping without a pillow under your head.

Sleeping on your back
Again this can be hard to maintain the normal curve of the low back.

Solution: If you sleep on your back, place a pillow under your knees to help maintain the normal curve of your lower back. You might try a small, rolled towel under the small of your back for additional support. Support your neck with a pillow. This position may be helpful if you have low back pain. This position may be helpful if you have degenerative disease or a herniated disk in the central portion of your spine.

Choose a sleeping position that feels most comfortable to you, and it would be wise to select a mattress, reclining chair or adjustable bed that supports you. Note that I am not a sleep expert and there are many other sleep positions, strategies and tools that can help.