What To Do When Your Shoulder Hurts When You Sleep On It

There are 2 problem areas that come up the most, knees and shoulders. In my 10+ years of personal training if I take a tally, I will have to say shoulder pain edges knees in the complaint department. You would be surprised on how many potential clients would meet with me that couldn’t lift their arms up in the air without pain or hitch. I’m not talking about 50 or 60 year olds either. Clients in their 20s and 30s who you wouldn’t even think that would be an issue. People who just live with it final draw tends to be when their sleep starts to suffer. Not only are they in pain but exhausted from being woken up multiple times a night.

A shoulder that wakes you is a shoulder worth building the rest of your training around.

Just because sleeping on your shoulder is when you notice it, that doesn’t mean that is what’s causing the issue. When you’re a side sleeper your bodyweight is putting a lot of pressure on your shoulders. While you’re sleeping none of the other muscles around the joint engages to help carry that load. A properly functioning shoulder can handle that load without any issues. When a shoulder that has been getting stiffer and losing range of motion tries to carry that load for an extended amount of time like sleeping it can’t handle it. So just stop sleeping on it and its fine, easy fix, right? Not quite that easy. Just because sleeping is when your shoulder really acts up that doesn’t make it the cause of the problem. The reason why your shoulder screams at you while sleeping is because sleeping is the only time you hold one position long enough to notice.

You move arms all day long but usually in the same direction Most of the day you use your arms for hundreds of tasks. The problem is its usually in the same position as reaching forward when driving when your hands are on the steering wheel, typing at work, texting on your phone, drinking a cup of water, and opening a door. Sometimes injuries and pain are not caused by what you did to a specific area, but what you haven’t done to/for a specific area. Most people don’t rotate their shoulders out and back on a regular basis throughout the day. Your rotator cuff is the small set of muscles that holds the ball of your shoulder centered in the socket while the big muscles push. It doesn’t get stronger by pressing, it needs to be rotating to build strength.

What can you do about it? You need to get more shoulder rotation. It can be something just that simple. Since your day-to-day activity doesn’t get enough of it you need to add an exercise to your workout program. Add band external rotations. Using a small resistance band, loop the band around both wrists and bend your elbows 90 degrees while keeping them pinned against your ribs. With your forearms pointing straight ahead rotate both forearms out against the band, as far as they go without your elbows leaving your ribs, then come back slowly. Do a 3 to 4 sets of 10—12 reps.

Make sure you keep your elbows connected to those ribs. When the band starts to feel heavy your elbows will start to want to move away from your body to make the exercise easier to do. When that happens, it makes your torso start to help by twisting. Then your shoulder exercise becomes an oblique exercise instead. Keep the elbows glued and use a band light enough that it feels almost too easy and go slow enough to feel the back of the shoulder engaged. This is not a rehab exercise you have to do for 6 weeks and forget about. Your shoulder is never going to stop pushing forward most of the day, so this needs to stay in the rotation. It doesn't need to be everyday but 2-3x a week would be ideal.

Here are some things to do when you go to sleep. First, stop sleeping with your arm overhead or tucked under your head. The reason we want to cut out this position is because it pins the shoulder down and holds it there for hours. Try hugging a pillow instead, with your top arm being supported in front of your chest instead of it being dragging across while pulling the shoulder forward. Most people go to sleep on the same side every night. Try to start on the other one if you can. I know for some that’s a big ask but your shoulder just needs the load to spread around some.

As far as training changes we need to take inventory of how much pushing and pulling exercise you are doing. First count how many pressing sets and pulling sets for one week. Do 2 pulling sets for every pressing set. Anything like rows, face pulls, and band pull aparts are great. You need to engage your shoulder blades. Also for any overhead press cut your range of motion for a few weeks. Don’t go above your head so we can keep that shoulder out of the movements. If you’re bench pressing, move to a narrower grip to keep elbows from flaring out and lower the load between 70 to 80% of normal for the time being. We need to do less of what’s irritating your shoulder and more of what’s not getting enough attention. Your shoulder is carrying a load it shouldn’t be doing on its own.

Your shoulder doesn’t operate in a bubble. You want to get on top of the root cause of your problem before other issues arise. For instance, rotator cuff issues, or a tight chest that starts pulling other muscles into imbalances as well. What does not work is working out around it. That’s the same as just ignoring it. Also, you need to take a look at what you’re doing in the gym. If your program has you pressing 3 times a week, and your shoulder has been giving you issues for months, the program is just compounding the problem. You have to adjust and need a plan that can do that for you.

I will be releasing a shoulder pdf for in the upcoming weeks for people who need to work on their range of motion and strengthen the muscles around the shoulder. Subscribe and keep an eye out for when that drops if you or someone you know is in need of some help. It will have everything laid out for you with instructions, pictures and videos of each exercise.