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Preventing Injury and Enhancing Recovery Tips for Sleeping As a chiropractor, the most common question that I get asked is “what can I do to prevent or recover from an injury?” I tell patients that the most important thing you can do has to do with sleeping, sitting, and standing. Although lifting properly by using your legs and not slumping your back and holding objects you lift closer to your body is important, how and what you sleep or lie on, what you sit on, and what shoes and shoe supports you wear while standing are the most misunderstood and often overlooked aspects of preventing injuries and enhancing recovery from them. Why, you might ask? Well, there are three different postures that your body can be in with variations from these positions. You can be lying down, sitting down, or standing up. Yes, you can be propped up lying down, or reclined when sitting, or bending over when standing, but the point is the three primary positions are lying down, sitting down, or standing up. What you sleep on is just as important as the position that you sleep in. The first question I ask about lying down is what type of mattress do you have? Is the mattress new or old, firm or soft, water, springs, or memory foam? Many people tell me that they have a comfortable bed, which has much cushion and prevents them from having pressure points. What I tell patients is that a nice soft and cushy mattress often does more harm than good. The best type of mattress to lie on is one that is very firm and supportive. When I tell people this I get one of two responses. I love a firm mattress or a firm mattress is just too uncomfortable to me. The question you should be asking yourself at this point is, which person is right? Are they both right? Are they both wrong? The truth is a bed that is firm and stiff is actually better for your body. At this point, you are either agreeing with me or you are not. Either way you should learn why what I am saying is true. A firm mattress is better for your body because it offers the best support for your body. For those of you who own memory foam mattresses and waterbeds and swear by them, I do understand your personal confusion. How is it possible that the bed that you love could be bad for you when feel so well rested and are not having problems when you wake up? This happens, because the bed supports your body in a lousy position, and that position is not one that causes you to experience symptoms. However, after you get out of bed and get on with your day, it is then that your body starts noticing problems. Most people attribute the problems to something other than the bed, because the bed feels good to them. However, I often find that once I start correcting their body, that the bed starts to cause them problems because it places the corrected body in a lousy position. Regarding mattresses, I personally recommend Chirobedic mattresses, which are endorsed by the Michigan Chiropractic Society. Although, there are other reputable companies that produce good quality mattresses. When choosing a mattress, I typically recommend for the average person a mattress that supports a 300 lb person. This mattress is firm and more durable than a mattress for an average person. As such, it will be much more supportive and likely last much longer. If you are 300 lbs, it may be difficult for you to obtain a heavier duty mattress. However, some companies do make mattresses that are customized to your body weight. Chirobedic is a company that manufactures a customized mattress. Also, a Chirobedic mattress costs about the same as any other high quality mattress. When lying down to sleep, not only is the mattress important, the position you sleep in and the type of pillow you should sleep on, is important as well. The problem that you run into is that the advice you get is dependant upon whom you ask. Ask 10 doctors about the type of pillow or mattress you need and you are likely to get 10 different opinions. I don’t think it is possible for all of them to be right. So, who is right? The truth is most doctors’ recommendations are opinions based on their personal experience or what they have been taught through someone else’s research. In addition, as a consumer, you literally have hundreds of options to consider when looking for a pillow and a mattress for that matter. However, having personally tested patients and assessing the best sleeping position, pillow, and mattress, I can shed some light onto the subject. Our research has shown that the best position to sleep in is on your side and the second best position is lying on your back. Regarding side sleeping, patients often ask me is it better to sleep on my right or left side? In response, I ask them to tell me if they had to pick a side to sleep on, which would they pick? The patient immediately gives me an answer. You can do this yourself. If you had to pick a side, which side would you choose? Which one is it? Did you say right or did you say left. Well, the side you chose is the best side for you. The next thing to consider when lying down is what pillow should you use. The answer depends on whether you are sleeping on your side or on your back. Again it is best to sleep on your side. Regarding side sleeping, a pillow that is firm with a height that properly supports your head should be used. What is the proper height of a supporting pillow? A properly supportive pillow height is one that keeps your body comfortably on its side without effort and prevents your from rolling forward or backward. A pillow that is too small will cause your body to roll forward and result in you waking up on your stomach. A pillow that is too high will cause you to roll backward and result in you waking up on your back. The biggest problem with rolling forward is that it requires your head to rotate, which can injure your neck as well as affect your breathing. It can also cause hyperextension of your low back, which can cause lower back pain. The biggest problem with rolling on your back occurs if you end up with your head being propped up with the pillow behind your head. This can cause elongation the spine, which causes the spinal cord and nerves to become stressed, which can cause spinal pain in the neck, between the shoulders, and even in the low back. The best pillow height for side lying for the average adult is approximately 5 inches. To determine which height is best for you, lie down on your side with a pillow and observe what happens. If the pillow is too low you are going to have a tendency to roll forward and if the pillow is too high you are going to have a tendency to roll backward. As such, keep adjusting the height up or down until you no longer feel like you are going to roll forward or roll backward. Please keep in mind that the 5 inch pillow height recommendation, assumes that you are sleeping on a firm supportive bed. Picture a bed that is worn down causing you to sleep on a depressed surface. Not only will this put abnormal stress on your body, but also your shoulders and/or hips will slip into the mattress a bit deeper and will likely cause the 5 inch pillow to be too high. Regarding a side lying pillow, I recommend the Total Comfort Sleep System - Pillow designed by Dr. Jerry Porter out of Washington. The pillow has a unique design in that it is firm and supportive and you can adjust the height of the pillow to fit you. Another option if you don’t wish to invest in a pillow, is folding up bath towels and stack them up until you get the proper height. The bath towels work well, but don’t necessarily look as nice. Attached at the end of this article is information regarding the Total Comfort Sleep System Pillow. Instructions for side sleeping using towels is as follows: Directions for sleeping On Your Side With Towels: · If you sleep on your side (*optimal position for sleeping*): Start out with a towel pile that is too high and go lower. Start with the towel height approximately the same as your spread fingers, thumb tip to pinkie tip (approximately 4-5 inches). Lay on the floor with about four to five towels folded in a pile. If your body is falling forward, add another layer of towel. If your body is falling backward, eliminate a layer of towel. One layer could make the difference. When you have the correct height your eyes will close almost automatically and you will feel like falling asleep. FIND the height that’s right for you. The general rule: If the towel or pillow is too high you will roll on your back. If the towel or pillow is too low your will roll over on you stomach. Regarding sleeping on your back, I don’t recommend that a pillow be used at all. What we have found is that placing a pillow behind your head pulls your head forward and actually causes stress and strain on your spine (especially your neck and upper mid back). I realize that many companies sell pillows with the intention to have you sleep on your back, but these pillows are too high. The only people I have found that can tolerate a pillow behind their head when sleeping are those whom can’t lay their head flat on the bed when on their back. As such, they need the pillow there for the support. However, for these people I emphasize the need for them to sleep on their side. If you have to lie on your back, what I do recommend is three layers of a towel folded up behind the head and 5 layers folded up behind the neck. Instructions for back sleeping using a towel is as follows: Directions for sleeping On Your Back With Towels: If you sleep on your back (second best sleeping position): Use a hand towel. Fold one end 4 times. The fold is about 1 inch wide, makes 5 layers, and is placed under the neck. The towel under your neck is NOT a roll to push your neck up. You should not really notice that it is there. The other remaining end is folded 2 times. Each fold is about 6 inches wide, makes 3 layers and is placed under the head. It is recommended that you establish the height of the towels on the floor once before trying the bed. Because you will sink into the bed more than the floor, the towel height will change. The TOTAL COMFORT SLEEP SYSTEM - PILLOW is made with the edge that goes at the top of your head raised up a bit from the edge that your neck rests on. This is because your spine and skull need to be on the same plane, however, this plane is not supposed to be level. It is an incline plane. As in the picture, your spine is closer to the bed in the low back and further from the bed at the shoulders when lying on your side. It follows then that the top of your head should follow this same angle upward if your spine and skull are to remain on the same plane. This is the position that takes the tension off of the supportive spinal tissues and allows your body to relax. Available at Great Lakes Chiropractic.
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