Rotator cuff surgery is often performed to help relieve shoulder pain and improve function. However, the recovery period, particularly the challenge of finding comfortable sleep, can be daunting for many patients. In this post, we’ll delve into what rotator cuff surgery entails, when it’s recommended, and provide practical, actionable tips to help you achieve restful sleep during your recovery.

• Rotator cuff surgery involves reattaching or repairing torn tendons, typically recommended when conservative treatments fail or for traumatic or severe tears.
• Adequate rest may support tissue repair, pain management, and overall healing after surgery.
• Sleep strategies such as taking a reclined position, positioning pillows strategically, and setting up an ideal sleep environment can help with sleep during recovery.

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, providing stability and enabling a wide range of motion. Tears in these tendons are common, often resulting from acute injuries (like a fall) or degenerative changes over time due to repetitive overhead activities. When conservative treatments such as rest and physical therapy fail to alleviate shoulder pain or other symptoms, rotator cuff surgery may be recommended.

Rotator cuff surgery often involves reattaching tendons to the head of the humerus (upper arm bone). The procedure can be performed using different techniques:

• Arthroscopic Repair: This minimally invasive technique involves making small incisions and inserting a tiny camera (arthroscope) and specialized instruments to repair the tear. It typically results in less pain and a faster initial recovery compared to open surgery.
• Open Repair: Nowadays bigger incisions to directly access the tendon are much less common, but rarely can be done if necessary to gain better access to the torn tendon.

The decision to undergo surgery is made after a thorough evaluation, considering the patient’s age, activity level, tear size, and overall health. An experienced shoulder specialist can evaluate the injury and recommend the best treatment strategy for you.

One of the most common challenges for patients recovering from rotator cuff surgery is difficulty sleeping. There are several reasons for this:

• Pain: Post-operative pain, even with medication, can make it difficult to find a comfortable position and stay asleep. This is especially true after shoulder surgery.
• Immobilization: The need to wear a sling, often for several weeks, restricts movement and can feel cumbersome, especially at night.
• Fear of Re-injury: Patients may worry about accidentally moving their arm or rolling onto the surgical side, which can lead to anxiety and disrupt sleep.
• Discomfort from Swelling: Swelling in the shoulder area can add to the general discomfort.

Adequate sleep is not just about comfort; it’s an important component of the healing process. Addressing sleep challenges proactively supports a successful recovery.

Navigating sleep after rotator cuff surgery requires strategy and patience. In the next subsections, we’ll review some strategies to help you get the rest you need.

For many patients, sleeping in a reclined position is the most comfortable and safest option for the first few weeks or even months after surgery. This position helps to keep your arm elevated and prevents you from rolling onto your surgical side. You have a few options for achieving this:

• Recliner Chair: A comfortable recliner allows you to adjust the recline angle to find what feels best and provides firm support.
• Pillows in Bed: If a recliner isn’t an option, you can create a similar setup in your bed using a wedge pillow or several regular pillows. Stack pillows to elevate your upper body to a 45-degree angle. Ensure your head, neck, and shoulders are well-supported.

Pillows can provide support, elevation, and act as barriers to prevent unwanted movement. Consider placing a small pillow or rolled towel under your elbow or forearm to keep your surgical arm slightly elevated and supported.

If sleeping on your non-operative side, placing a pillow behind your back can prevent you from rolling onto the surgical side during the night. Additionally, wedge pillows are specifically designed to provide incline and support, making them ideal for post-shoulder surgery sleep. They can be used alone or in conjunction with other pillows.

There are specific pillows made for sleeping after shoulder surgery as well. An example of this is the Shoulder Sleeper. This pillow is designed to conform to your body and make sleeping at night more comfortable. If you choose to use the Shoulder Sleeper, use code KOHANMD at checkout for a discount.

Your surgeon will provide specific instructions regarding sling wear. In most cases, you will need to wear your sling while sleeping for a prescribed period. The sling is important for immobilizing your shoulder and protecting the repair. Ensure it is fitted correctly and comfortably, even when lying down.

Applying ice to your shoulder before bed can help reduce pain and swelling, making it easier to fall asleep. Consider applying an ice pack (or a bag of frozen peas wrapped in a thin towel) for 15-20 minutes.

Coordinate with your doctor to time any pain medications to take effect before you go to sleep. If you are still struggling to sleep despite pain management and positional adjustments, discuss over-the-counter sleep aids with your doctor.

Optimize your bedroom for sleep:

• Darkness: Ensure your room is as dark as possible. Use blackout curtains if necessary.
• Quiet: Minimize noise distractions. Earplugs or a white noise machine can be helpful.
• Cool Temperature: Keep your bedroom cool.
• Comfortable Bedding: Use breathable sheets and blankets.

Sleeping comfortably after rotator cuff surgery can be a significant challenge in the recovery process. However, by implementing strategic solutions, you can help improve your chances of getting the restorative sleep your body needs to heal. Strategies include prioritizing the reclined position, utilizing pillows for optimal support, adhering to your sling instructions, managing pain effectively, and cultivating a calming sleep environment.

Generally, patients are advised to sleep in a reclined position or with significant pillow support for 4 to 6 weeks after rotator cuff surgery. However, this can vary based on the extent of your surgery, your surgeon’s specific instructions, and your comfort level.

In some cases, sleeping directly on the operated side can put pressure on the healing repair. If you are a side sleeper, you may be able to sleep on your non-operated side, but ensure your surgical arm is well-supported with pillows in front of you to prevent rolling onto it.

It’s a common concern, but try not to panic. The sling helps protect your shoulder. If you wake up having rolled onto your surgical side, gently reposition yourself. If you experience new or increased pain, or suspect you may have re-injured your shoulder, consider contacting your surgeon’s office.

Yes, many patients find wedge pillows to be very helpful for maintaining an inclined sleeping position. Specialized post-shoulder surgery pillows, such as the Shoulder Sleeper, are also available that are designed to support the arm and shoulder in a protective position.

If sleep difficulties persist, it’s important to communicate this with your surgeon and your physical therapist. They can assess if there are underlying issues, such as inadequate pain control, or offer additional strategies. Remember, good sleep supports your recovery, so don’t hesitate to seek help.