A shoulder labral tear involves damage to the labrum, which is a ring of specialized cartilage surrounding the shoulder socket. This structure deepens the socket, providing stability and acting as an attachment point for ligaments and the biceps tendon. When torn, the joint can become unstable, causing persistent pain, clicking, popping, and a reduced range of motion, often worsened by lying down. Nighttime pain is a common and frustrating symptom because pressure or an unstable position exacerbates discomfort. Finding a stable, neutral position for the injured joint is the most important step in managing pain throughout the night.
Recommended Sleeping Positions
The safest and most recommended orientation for sleeping with a shoulder labral tear is the supine position, or lying flat on your back. This position naturally distributes body weight evenly, preventing direct compression or pressure on the injured joint. The arm on the affected side should be kept in a neutral position, resting comfortably along your side.
A slight elevation of the injured arm can help prevent the downward pull of gravity, which can otherwise strain the tear. Sleeping with the upper body slightly inclined, such as in a recliner or with a wedge pillow, provides additional comfort and stability. This elevated position can also help reduce inflammation that often intensifies when lying flat.
Sleeping on the unaffected side is a secondary option, requiring careful positioning to protect the injured shoulder. The primary goal is preventing accidental rolling onto the painful side and avoiding movement that takes the joint out of its neutral alignment.
To maintain neutral alignment, place a supportive pillow between the knees. Ensure the injured arm is positioned comfortably in front of the chest, minimizing the risk of internal rotation. Achieving and maintaining joint neutrality is key to both positions.
Using Pillows and Supports
Strategic use of pillows and specialized supports helps maintain recommended sleeping positions and prevents unwanted movement. When lying on your back, place a small pillow or folded towel under the elbow and forearm of the injured arm. This simple elevation prevents the upper arm bone from hanging down, keeping the shoulder joint stable and supported.
If sleeping on your unaffected side, place a large body pillow or stack of firm pillows in front of your chest and abdomen. The injured arm should rest on top of this support, preventing the shoulder from dropping forward and internally rotating. This setup stabilizes the shoulder and acts as a physical barrier against rolling onto the painful side.
To deter rolling, place a firm, rolled-up blanket or pillow snugly behind the back. Specialized shoulder relief wedge systems can also relieve pressure when side-sleeping. If a soft sling or brace is recommended for nighttime use by a healthcare provider, ensure it is worn correctly to maintain the shoulder’s position, but never use one without professional guidance.
Nighttime Pain Reduction Strategies
Preparing the body before bed minimizes nocturnal pain and improves sleep quality. If approved by your healthcare provider, time the dose of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Take these medications about one hour before bedtime so their pain-relieving and anti-inflammatory effects peak during the initial hours of sleep.
Applying cold therapy helps calm inflammation before lying down. Place an ice pack wrapped in a thin towel on the painful area for 15 to 20 minutes before settling into position. Conversely, moist heat, such as a heating pad, can help relax muscle stiffness accumulated throughout the day.
Gentle, physician-approved range-of-motion exercises can be performed earlier in the evening to reduce joint stiffness. These movements should focus on non-strenuous, pain-free range, such as light pendulum swings or passive stretching. This promotes blood flow without aggravating the tear, making the joint less prone to sudden pain when resting.
Movements That Aggravate the Tear
Understanding and avoiding specific movements is fundamental to protecting a torn labrum while sleeping and transitioning out of bed. Any movement that involves reaching overhead or across the body while lying down must be consciously avoided. This can place significant rotational or shearing stress on the unstable labrum, causing the joint to catch or click, resulting in a sharp spike of pain.
Movements During Sleep
Extreme external rotation (where the arm falls outward and back) and internal rotation (such as tucking the injured arm under the body or head) are particularly damaging. These end-range movements pull on the torn cartilage, potentially worsening the injury or causing a painful subluxation (partial dislocation). Sleeping directly on the injured side is the highest risk position, as body weight compresses the joint and pushes the head of the humerus against the torn labrum.
Transitioning Out of Bed
When waking up, avoid the urge to push yourself up using the injured arm, as this places immediate, heavy strain on the shoulder. Instead, roll onto your unaffected side first. Use the strength of your uninjured arm and legs to push your body up to a seated position. Maintaining awareness and moving slowly during these transitions significantly reduces the risk of sudden aggravation of the tear.