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Diana Remaley, LMT
Diana@RemaleyMassage.com
(203)292-5362
19 Compo Road South
Westport, CT

Sleeping Positions, Part 2

Consider that the way to sleep may be causing your pain

In the first entry of these series, we explored how sleeping positions can affect pain our shoulders, hands and forearms. In this post, we'll discuss pain in the hips, calves and feet.

Consider that how you sleep may be contributing to your waking pain. And keep an open mind as you try to modify some of these patterns that have likely been entrenched for years, if not your entire life. It's not easy to change them, but it's absolutely worth it. Ask yourself if you have pain in any of these areas, and, just for fun, see if you sleep in any of the mentioned positions.

The muscles we'll be discussing relative to these sleeping positions are the Glutes, posterior hip rotators (Piriformis is the most commonly known) and the Calves (comprised of the Soleus and Gastrocnemius). One or more of these muscles might be implicated in pain; if you can't determine which with these articles, it might be time to make a massage therapy appointment.

Anatomy Lesson:

Broadly, the three glute muscles attach from the pelvis to the upper thigh, and move the leg backward. There are six hip rotators, which attach from the sacrum to the upper thigh as well. The hip rotators, as their name suggests, rotate the leg out to the side.

Sleeping Position:

Many people sleep with one of their legs kicked out to the side. But glancing at the images shows the level to which that stresses out the posterior hip muscles - it's terrible for them! If the Piriformis muscle is too tense for too long, it can cause numbness and tingling down the leg, mimicking sciatica. Unlike true sciatica, though, which involves bones, Piriformis Syndrome can absolutely be alleviated with massage therapy, stretching and exercise. If you ever have pain, numbness and tingling down the backs of your legs, check that you're not sleeping (or even sitting!) with a leg bowed out. It's a very simple change that will make a huge impact on hip pain!

 

Anatomy Lesson:

There are two main "calf" muscles: Gastrocnemius and Soleus. They attach from the back of the knee to the heel.

Sleeping Position:

The calves are tight on almost everyone; they carry us around during the day and are usually active even when we're sitting. Pointing the toes activates them; keeping those toes pointed for a long time, like when we're sleeping, stresses out the calves quite a bit. In fact, this overuse of the calf muscles can lead to stress in the connective tissue of the foot, inflammation of which is Plantar Fasciitis. Anyone who's experienced that is likely desperate to get rid of the pain.Training yourself to sleep with your feet at 90 degrees is a very simple way to try to take pressure off the calves. In fact, when diagnosed with plantar fasciitis, most patients are given the "boot", which is meant to be worn only while sleeping or sitting, and which keeps the foot at about an 85 degree angle. This will help stretch the calves a bit. If you're experiencing Plantar Fasciitis, it's an easy change to make to wear the boot as often as you can while sitting and/or sleeping. (There's also a plantar fasciitis sock that performs a similar function but isn't nearly as bulky. Many people say they can't deal with how huge the boot is; the sock can be a good substitute.)

If you notice your toes are pointed while sleeping, make a conscious effort to keep them at 90 degrees. If you wake up with them pointed again, and are experiencing calf and foot pain, the special boot or sock might help train your muscles to stay soft and neutral. (A special note: If you sleep on your stomach, it's pretty certain that your toes will be too pointed. Stomach sleeping is actually bad for a number of reasons, too varied to go into in this post.)

Short personal story: I had plantar fasciitis in my left foot a few years ago. The pain was at it's most intense for a few months over the summer. I saw a podiatrist, and bought the big boot. I couldn't deal with wearing it while I slept, so I wore it every moment I wasn't standing at home; while watching Netflix, reading, etc. I took it off right before bed after having put in a few hours with it on. This helped me at least THINK about keeping my foot at 90 degrees while I slept. In fact, I often propped it up with my right foot until it learned to relax and stay at 90 degrees. NOW, after doing that for about three years, my RIGHT foot and calf are acting up a bit. By hooking my left foot in to my right, I was keeping my left foot in a good position, but straightening and aggravating my right. I got away with it for a few years, but now I notice the added tension. So I've got to make my right foot as happy as my left!

These small changes likely won't completely eliminate pain, but they can help mitigate it. Keeping our muscles in neutral positions while we sleep helps create positive muscle memory, meaning it will be easier to keep them neutral while we're awake. Who doesn't want more muscular control, right?

Consider trying to sleep in the suggested positions for a few nights if you notice pain in the hips, calves or feet. If you notice a little pain relief, then you know you're on the right track. And to get the rest of the pain under control, feel free to contact me for a massage therapy appointment. I'll see you in my Westport office!

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Sleeping Positions, Part 1

Consider that the way to sleep may be causing your pain

Many clients come in to my office with pain with no discernible causation. While it is true that sometimes pain just occurs randomly or due to emotional factors, it's also true that we may be unwittingly putting our bodies in compromising positions. We tend to recognize this when we're sitting at a desk all day; 9-5 pain tends to be pretty pronounced. Less pronounced, however, are patterns we may develop while we're sleeping. Sure, we may wake up with a sore neck or back, and these are acute pains usually from a weird position over the course of a single night. Negative muscular patterns, though, develop over time.

In the next two posts, I'll explore common sleeping positions that can lead to muscular dysfunction and pain. Consider that how you sleep may be contributing to your waking pain. And keep an open mind as you try to modify some of these patterns that have likely been entrenched for years, if not your entire life. It's not easy to change them, but it's absolutely worth it.

This first entry will explore pain in the shoulders, pecs, hands and forearms. The second entry will explore hip, calf and foot pain. Ask yourself if you have pain in any of these areas, and, just for fun, see if you sleep in any of the mentioned positions.

Anatomy Lesson:

The muscles we'll be discussing relative to these sleeping positions are the Pectoralis Major and Minor, the Deltoid and the Wrist Extensor Group. One or more of these muscles might be implicated in pain; if you can't determine which with these articles, it might be time to make a massage therapy appointment.

The Pecs attach from roughly the sternum to underneath the arm. When we put our arm up above our head, we're using our pecs. The deltoid is a large "cuff" that covers our entire upper arm. Again, moving the arm up above the heat will use it.

Sleeping Position:

Now that we know where the above muscles attach, we can deduce that sleeping with our arm above our head activates the Pecs Major and Minor and the Deltoid. It's incredibly common for this sleeping position to cause "Pec Minor Syndrome", which causes pain in the underarm and numbness and tingling in the hand. In fact, this syndrome is remarkably similar in symptoms to Carpal Tunnel Syndrome, but is far more common. If you notice tingling in your hands and fingers and sleep with your arm above your head, do yourself and favor and keep that arm down. In this position, the Pecs and deltoid are relaxed and neutral.

Anatomy Lesson:

This one's super easy: The wrist Extensors are a group of nine muscles on the back of the forearm that attach from the elbow, through the wrist, to the fingertips. If you hold your fingers on the back of your arm and wiggle your fingers, you'll feel them activate.

 

Sleeping Position:

It's extremely common for us to wake up with our fingers balled in to a fist. The wrist Extensors naturally curl our fingers a little bit, but when they stay curled over night, especially for a prolonged period, they can lead to pain in the forearm and fingers. There's an incredibly simple solution to this: Keep your fingers straightened under a pillow. It's nearly impossible to keep your fingers straight on their own, but locking them under a pillow or under the edge of your blanket will keep the forearm muscles neutral and soft. You'll certainly notice this reduces pain in the fingers themselves, and it may even reduce pain in the forearms also.

 

These small changes likely won't completely eliminate pain, but they can help mitigate it. Keeping our muscles in neutral positions while we sleep helps create positive muscle memory, meaning it will be easier to keep them neutral while we're awake. Who doesn't want more muscular control, right?

Consider trying to sleep in the suggested positions for a few nights if you notice pain in the shoulders, hands or forearms. If you notice a little pain relief, then you know you're on the right track. And to get the rest of the pain under control, feel free to contact me for a massage therapy appointment. I'll see you in my Westport office!

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A Modified Pec Stretch

Are your shoulders and chest feeling tight? Give this stretch a try

 I've written about a number of pec stretches before, but this one is one of my favorites. It stretches not only the front of the shoulder, but also gives the feeling of stretching the back of the shoulderblades, which I think are less than mobile on most of us. Give this a try during the day if you're stuck at a desk, or even first thing in the morning to wake up your upper body. I love it!

Anatomy Lesson:

Primarily this stretch will affect your Pectoralis Minor and Pectoralis Major muscles. Secondarily, it will move your scapula (shoulderblade) in a way it doesn't normally move, which provides a feeling of release.

The Pec Major attaches from the sternum and clavicle to the upper arm (humerus). It's the huge muscle we think of when talking about the "Pecs". It's the first one you'll feel when you massage the area (Pec Minor is actually beneath it).

 

Importantly, the Pec Minor attaches from the third to fifth ribs and the scapula (shoulderblade), meaning we move it FAR more than Pec Major with this motion. Since it's also attached in a more vertical direction, moving the arm up at the elbow is what pulls it and stretches it more fully. Although smaller, the Pec Minor is often implicated more in pain than Pec Major. It's closer to the nerve and can also therefore cause numbness and tingling down the arm if it's hypertonic. That's why keeping it loose and soft is so critical.

The Stretch:

Bend your elbow at the level of your shoulder, with your palm near your ear.

 

 

 

 

 

 

Place your elbow in a door jamb (or on some other fixed object) and take a step forward, keeping your hand near your ear.

 

 

 

 

 

 

 

 

 

Let your shoulderblade bend backward and your elbow "fall" behind you.

 

 

 

 

 

 

This should feel fantastic on both the front and back of the shoulder. Don't bounce; just let the weight of your body move you toward the floor. Hold for at least 20 seconds, or longer if you feel tight still. Repeat as often as you feel you need it!

The shoulder is probably the most complicated joint in the body; so if you're still feeling that it needs to move more freely, it's probably time for a massage therapy appointment. I'll see you in my Westport office!

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Diana Remaley, LMT
Diana@RemaleyMassage.com
(203)292-5362
19 Compo Road South
Westport, CT