A broken shoulder, whether a fracture of the humerus, scapula, or clavicle, creates a significant challenge to achieving restorative sleep. The natural movements of turning over or lying flat can cause sharp pain and risk further injury. Finding a stable, comfortable position is necessary for the body to focus its energy on repair and recovery. A lack of proper sleep can increase perceived pain levels and delay the overall healing process. Establishing a carefully planned sleep environment and routine is the most practical step toward minimizing discomfort and preventing accidental re-injury during the night.
Recommended Sleeping Positions for Stability
Lying completely flat in a traditional bed is often not possible or safe immediately following a shoulder fracture. This supine position can cause the weight of the arm to pull on the injured joint, leading to discomfort and instability. The most recommended position for the initial weeks involves sleeping in a semi-reclined or upright posture. This elevated position reduces the strain on the fracture site and helps prevent the unconscious rolling movements.
Many people find the safest arrangement is sleeping in a recliner chair, where the torso is supported at a consistent angle. A wedge pillow system offers a similar benefit, allowing the individual to be propped up securely in bed.
When using a bed, the safest position is generally on the back, with the head and torso raised. If attempting to sleep on the side, it is imperative to lie only on the uninjured side. Sleeping directly on the fractured shoulder must be strictly avoided, as the direct pressure can displace bone fragments and significantly increase pain. Even when lying on the uninjured side, the injured arm must be supported and kept from hanging or falling forward to maintain immobilization.
Utilizing Supports and Customizing the Setup
Once the correct semi-reclined position is established, the next step involves using supports to achieve complete immobilization of the injured limb. Pillows are the primary tool for this customization and should be used generously.
Pillow Placement
- Place one or two pillows behind the back to help maintain the upright angle.
- Use a separate pillow to prop up the injured arm.
- Support the elbow and forearm fully to prevent the arm’s weight from pulling on the shoulder joint.
- A pillow underneath the forearm and hand keeps the arm neutral and slightly elevated.
- Tuck a smaller pillow or rolled towel against the injured shoulder and torso to act as a physical barrier against rolling onto the fracture.
The use of a sling or cast during sleep depends on the specific medical advice for the type of fracture. The sling supports the arm’s weight and prevents movement, and many healthcare providers recommend wearing it constantly, even while sleeping, for the first few weeks. If instructed to remove the sling, the arm must be snugly supported by the custom pillow arrangement to maintain stability.
When getting into or out of the supported sleeping setup, the “log-rolling” technique is recommended to keep the torso stable. This involves moving the entire body as a single unit, avoiding any twisting motion through the shoulders or core.
Pre-Sleep Routine and Pain Control
Managing pain and inflammation immediately before attempting to sleep is a proactive step that can significantly improve sleep quality. If prescribed pain medication, timing the dose to peak effectiveness during the night is important. Taking the medication approximately 30 to 45 minutes before lying down allows the analgesic to reach its maximum benefit right as sleep is being initiated.
Applying cold therapy can also help to numb the area and reduce inflammation before bed. An ice pack or cold compress can be applied to the shoulder for 15 to 20 minutes before getting into the sleep setup. Care must be taken to ensure the ice pack is wrapped in a thin towel to protect the skin and that it is placed in a position that does not require moving the injured shoulder.
Beyond physical comfort, establishing a relaxing routine helps combat the anxiety that often accompanies painful injuries and sleep disruption. Simple activities like dimming the lights, avoiding screens, or practicing deep breathing exercises can promote a calm state. Finally, ensure that necessary items, such as a phone, water bottle, or remote control, are placed within easy reach of the uninjured hand to eliminate the need to strain the shoulder during the night.