Tuesday, February 19, 2008

Injured... While Sleeping?

Every once in a while you wake up and your neck hurts. Sometimes it’s so bad that you feel you can’t even turn your head one way or the other. It feels stuck, achy and completely uncomfortable all day so you take some Ibuprophen, rub it here and there and try to stretch it as often as you can as the day goes on. But what happened? You can’t remember doing anything the day before that would have caused your neck to be sore. You don’t recall heading a ball in soccer or getting in a little fender bender or even banging your head against your office wall after you got of the phone with your controller. Still your neck is sore, the muscles are tight and it hurts to move. What you probably did - or didn’t do - is get what I’ll call a “sleep injury”. Exactly as it sounds, a sleep injury is a mild injury you probably incurred while sleeping. Not that you fell off the bed or managed to kick the dresser in the middle of the night, but your body ended up positioned in such a way as to force some part of you to be over-stretched or over-contracted.

Sleep injuries can most commonly happen in the neck, back, shoulders, knees, hips and under some circumstances even the feet. Do you see a trend here? Almost any joint can be the site for a sleep injury and it mostly depends upon what position you slept in that night. Each type of injury is similar in that the height of pain is early in the morning - when you get up and try to move the afflicted body part. Also, this injury can affect other activities. A hip or knees sleep injury can bother you while running or walking whereas the neck and back injury makes it hard to turn around or even sit up. Sleep injuries usually work themselves out because your body eventually recognizes that it is in the wrong position and will correct the situation in the next night or two. Some like knee and shoulder injuries could last a little longer, however. The important thing to remember about a sleep injury is to recognize it as such and try to avert the problem in the future. Each type of sleep injury has a particular cause and it’s own simple method for alleviating the pain in the future.

Physiologists have figured out that the anatomically correct position to sleep in would be lying on one’s back with their head elevated about 4 to six inches and their knees bent upward about 8 inches. Physiologists are silly - no one sleeps like this. We sleep on our backs with our arms over our head, or on our side in some sort of fetal position or totally on our stomach with our head turned to one side or any other number of awkward and sometimes alcohol induced positions. Under normal circumstances these positions should have no affect on the physical structures of your body if you are comfortable when you fall asleep. However, if your body is unable to obtain a restful sleep position because of stress or discomfort it may try to alter your position slightly in adverse directions for your joints. Identifying the type and likely cause of a sleep injury is the best way to avert the problem the next night.

Each injury has its own cause(s) and, therefore has its own simple treatment. Remember, any sleep injury will induce the most pain in the morning. It may even take you a few moments before you can get out of bed at all. Sometimes these injuries may be associated with mild numbness of the extremities as well. I’ll go through each common type of sleep injury and simple ways to alleviate the pain but if you try these methods and pain persists, consider talking to your doctor or accepting the possibility that you don’t have a sleep injury at all but rather the pain is caused by some other means.

Neck Injury: I’ve already described a typical neck injury in the first paragraph. This is one of the more common sleep injuries and, fortunately, often one that manages to handle itself within a few days without any changes made by the sufferer. Neck injuries are usually caused when your head gets in an awkward position relative to your torso. This can happen if you sleep on unnatural surfaces like on a chair or couch or in a car for instance or if your head happens to be in an odd position in bed. If your head is elevated too far from your shoulder in any direction or if it is turned too far from center relative to the natural flexibility of your body, this over-stretched position could cause pain if the position is maintained over time (like several hours of sleep). Neck injuries in bed could be caused by a new pillow or a pillow that is too low or high in the first place. Or, if you sleep on your stomach, it could be the result of just turning your head too far to the side. In any case, try adjusting the size or number of pillows under your head and if you sleep on your stomach, try putting a pillow under the arm and should which lie on the same side as your face.

Shoulder Injury: A sleep shoulder injury will usually cause pain in the back or top of the shoulder joint and sometimes slightly down the back of your arm. This can come from one of two probable reasons. First, if you have a tendency to sleep on your back, and your arm ends up over your head for the night, this could cause compression in the joint capsule between a couple bones. If you were to hold this position for a few minutes, it may not feel like much but after several hours, your shoulder will have had enough and it will tell you in the morning. Another position which can cause shoulder injury is lying on either your side or your stomach with your arm turned over in front of your body such that the shoulder capsule is stretched rather than pinched. Both result in a similar pain, however, and the important thing to remember is that these tissues have likely been over-stretched so don’t try to stretch them more when you get up in the morning. Rather, try moving the arms up and down and out to the side slowly to allow the arm to warm up then add a little weight to the movement with cans of food or rocks or weights - anything slightly heavy. If the weight hurts, stop moving that way. To avoid the same situation try hugging a pillow when you go to sleep. This should keep you from rolling onto your arm in the first place.

Back Injury: A back injury will usually happen if your whole body is somehow twisted. If by some odd movement your torso faces one way and your legs face another, your back muscles will try to stabilize your spine and they will get tired by the time the night is over. This, of course, is painful. If you have a back sleep injury, you can attempt to stretch it mildly but it would be helpful to warm-up a bit first. To avoid the back injury, hug a pillow like you might for a shoulder injury but to keep your legs from flailing, try putting a pillow down under or between your legs as well. This should keep you from twisting into the odd position again.

Hip Injury: Hip sleep injuries are most common in women for anatomical reasons. Adult women have wider hips than men and their hips, therefore, create greater angles relative to the position of their legs in many situations. If you sleep on your side - particularly the same side every night - you may find yourself with some hip pain the next morning. The pain you would feel is again an over-stretching of tissues on the outer portion of the hip, so don’t try to stretch these. Rather get up and walk around for a bit then try to balance for a few seconds at a time on alternate legs. This should help to work it out some. You get to use the pillow trick again for hip pain, but in this case, you want to put the pillow between your knees while you lie on your side so that your top leg is slightly elevated. This will help to align your leg more properly with your hip.

Knee Injury: The knee injury is tricky. Mostly because there are so many ways to hurt the knee that it is hard to identify a sleep injury of the knee. Again, pay attention to the time of day that the pain occurs most often and with the greatest intensity. If it is early in the morning when you first try to get out of bed, the culprit may be your sleeping position. Knee sleep injuries occur when your thigh is somehow braced and your lower leg hangs limp in a direction other than the natural bend of the knee. This can happen if you sleep on your side and one leg sits atop the other with the bottom leg bent or if you sleep on your stomach and one leg ends up extending off the side or end of the bed. The result will be a general ache in the sides or back of the knee again from over-stretching. Try to walk around a little until the pain goes away and to avoid this problem the next night, try using the same pillow trick you would with hip pain, or just make sure that both knees sit on the bed at about the same height.

Fortunately your body is usually pretty good at avoiding injury while you are asleep. If you are in an awkward position, you may just wake up or your body will move itself to avoid the continued stretch. If you are particularly exhausted for some reason or if you fall asleep under the influence of depressants (alcohol) your body may not be aware enough to adjust your positioning. And as some of us know, you can potentially sleep in any number of awkward situations when severely under the influence. Most sleep injuries wont last more than a few days and will go away on their own, but if your positioning continues, the injury may become more chronic and cause continued pain during other activities. In these cases the various pillow and positioning remedies I have given should help alleviate the problem. But, if the pain still wont go away - of course, see your doctor.


fiona said...

hi, its very informative, Neck Injury , thanks

Kristin said...

Thank you so much. I woke up this morning with what feels like a sprained knee. I have not injured myself so I know it must have happened while I was asleep. I will try your suggestions. I can barely walk today.

6148ef86-1901-11e2-ae5b-000bcdcb471e said...

After breaking 2 ribs and having difficulty sleep on the injured side, I now have an ache/pain in my hip. Thank you for the information

Erin said...

Also woke with severe burning pain in the left side of my knee, and heard a pop when I tried to move and get up. It REALLY hurts, and feels crazy that I injured it while sleeping because the symptoms are those associated with a ligament tear

Erin said...

Also woke with severe burning pain in the left side of my knee, and heard a pop when I tried to move and get up. It REALLY hurts, and feels crazy that I injured it while sleeping because the symptoms are those associated with a ligament tear

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Dahlia said...

Thank you for this information. It sounds ridiculous (to me), that I injured my knee while sleeping--but that's exactly what happened! Your article assured me that, yes--this really does happen and I'm not delusional!!! (lol)

scott said...

Hi there, i am a restless sleeper and its causing an old knee injury to have trouble healing. Any thoughts on using a lockable knee brace of some kind? Does that do more harm than good?

Alex said...

Thanks for sharing your work. I now need to add some interactivity to the offline map, so that a user can get info after clicking on a point.
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