
Sleeping comfortably after rotator cuff surgery can be challenging, especially in the first few days, due to pain and the need to keep the shoulder immobilized for proper healing. Getting sufficient rest is crucial, as it helps the body heal faster. Here are some strategies to improve sleep after rotator cuff surgery:
| Characteristics | Values |
|---|---|
| Sleeping position | Sleep on an incline for 4-6 weeks after surgery |
| Sleeping aids | Use a recliner, angled wedge pillow, or stack of pillows to keep your upper body sloped at about 45 degrees |
| Sling | Wear a sling or rotator cuff brace to keep your arm immobilized and prevent further injury |
| Pillow usage | Place a pillow under the back of the affected arm to help keep it aligned correctly; use a pillow between your torso to prevent the sling from rubbing against your neck or shoulder |
| Medication | Take prescription pain relievers or over-the-counter anti-inflammatory medications as directed to minimize discomfort; time your medication intake so that you take a dose shortly before sleep |
| Ice packs | Apply an ice pack or a cryocuff/iceman (specialized ice pack) shortly before bedtime to control pain and reduce inflammation |
| Therapy and exercises | Perform therapy or exercises earlier in the day and stretch your elbow or shoulder before bed to help loosen your arm and reduce cramping |
| Clothing | Wear thin shirts, tank tops, or no shirt to bed to prevent the sling from rubbing against your skin and causing discomfort |
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What You'll Learn

Sleep on an incline
Sleeping on an incline is generally recommended for 4 to 6 weeks after rotator cuff surgery. This helps to keep your upper body sloped at an angle of around 45 degrees, which is the most comfortable position for healing. For the first few days, you may find it most comfortable to sleep upright on a recliner.
Once you return to your bed, use an angled wedge pillow to achieve the correct angle. You can also stack a few pillows to create a similar effect. Place another pillow under the back of the affected arm to help keep it aligned correctly. It is important to ensure that your arm and shoulder have enough support at all times to prevent discomfort and abrupt movements that can cause harm.
If you are an active sleeper who tends to move around a lot, sleeping on a recliner is a safer option. This will help you avoid rolling onto your affected arm or into a position that could damage your shoulder. You can also sleep with your sling on to keep your arms in position and protect your shoulder from sudden movements while asleep.
Sleeping on your back is not recommended after shoulder surgery. It is important to find the right position to sleep in as the site heals, especially in the first few days after surgery when you may still be experiencing pain.
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Wear your sling
While it may be annoying and uncomfortable, wearing your sling is crucial after rotator cuff surgery. The sling immobilizes your shoulder, preventing you from rolling onto your affected side and damaging your shoulder while you sleep. It also prevents the repair from slowly loosening, which can occur when performing everyday activities. Even a millimetre of displacement can prevent the repair from healing, so it is important to keep your shoulder as still as possible.
Your surgeon will likely recommend wearing the sling for about six weeks after surgery, which is the minimum time it takes for the tendon to heal reasonably well. During this time, you should avoid any daily activities that involve moving your shoulder, such as putting dishes away, taking things out of the refrigerator, or driving. By immobilizing your shoulder, the sling helps to keep the repair intact and prevents the tendon from tearing out of the stitches.
However, it is important to note that early immobilization can have negative effects, including muscle atrophy, increased pain, and decreased function. Some studies have found that not wearing a sling and engaging in early motion of the shoulder after surgery leads to faster recovery, greater range of motion, less pain, and better overall patient ratings. This is especially true for patients with small to medium-sized tears. Therefore, while wearing your sling is important in the initial stages of recovery, it may be beneficial to start physical therapy and gentle movement as soon as possible to prevent stiffness and improve the strength of the healed tendon.
It is always best to follow the specific instructions provided by your surgeon, as the recovery process may vary depending on the individual case. Additionally, proper positioning while sleeping is crucial for the first four to six weeks after surgery. It is recommended to sleep on an incline, rather than flat on your back. Using an angled wedge pillow or stacking a few pillows can help keep your upper body sloped at about 45 degrees.
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Take medication before bed
Sleep is crucial after rotator cuff surgery as it helps the body heal. However, many people who have just undergone shoulder surgery struggle to fall asleep or stay asleep due to increased nighttime pain. Taking prescription pain relievers or over-the-counter anti-inflammatory medications as directed helps minimise discomfort after shoulder surgery. For best results, time your medication intake so that you take a dose shortly before you go to bed. This will allow you to space out the dosages wider, enabling you to sleep for longer without waking up for the next dosage. Taking pain medication a few minutes before bed will numb the pain and let you rest peacefully.
It is recommended that you wear your sling or rotator cuff brace to bed during the day and night to keep your arm in the correct position and protect your shoulder from sudden movements while you sleep. You should only remove your sling when dressing or bathing. If you are having issues wearing a sling while sleeping, consult your doctor, as they may have some tips or tricks.
If you are taking medication for pain relief, it is important to follow the instructions carefully and take the correct dosage at the right time. You can also apply an ice pack shortly before bedtime to control pain and reduce inflammation. Wrap the ice in a towel and place it on your shoulder for about 15 minutes. Alternatively, you can use a cryocuff or iceman, which are like special ice packs for your shoulder, providing numbing pain relief.
In addition to medication, it is important to consider your sleeping position after rotator cuff surgery. Sleeping on your back is not recommended, as this can put pressure on your shoulders. Instead, try sleeping on an incline for around 4 to 6 weeks after the surgery. You can use an angled wedge pillow to keep your upper body sloped at about a 45-degree angle, or stack a few pillows to create a similar effect. For the first few days or weeks, you may find it more comfortable to sleep in a recliner.
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Use ice packs
Sleeping comfortably after rotator cuff surgery can be challenging as you try to find a position that does not put pressure on your shoulder. To help with pain management and to get a good night's rest, you can use ice packs.
Ice packs are a great way to reduce inflammation and control pain. They can be easily made at home by placing ice and a bit of water in a plastic bag, then wrapping it with a washcloth. You can also use gel-based ice packs purchased from a drug store or online. Never apply ice directly to your skin, as this can cause frostbite. A safer alternative is to wrap the ice in a towel, as recommended by Dr. K. Mathew Warnock, an orthopedic surgeon.
Applying an ice pack for 15 to 20 minutes shortly before bedtime can help manage pain and reduce inflammation. This can be repeated with 20-minute breaks in between. A bag of frozen peas is another convenient option as they do not get as cold as ice.
For more advanced solutions, there are cryotherapy units that circulate cold water through a pad placed on the affected area. These can be especially useful for targeting specific areas impacted by the surgery.
Remember to always follow your doctor's post-operative instructions and take any prescribed medications as directed to aid in your recovery and improve your sleep.
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Stretch before bed
Stretching before bed can help you sleep better after rotator cuff surgery. However, it is important to ensure that the swelling has gone down and that your arm is no longer painful to move before attempting any stretches.
One stretch you can try before bed involves standing in an open doorway and spreading your arms out to the side. Grip the sides of the doorway with each hand at or below shoulder height, then lean forward through the doorway. Continue leaning until you feel a light stretch, but be careful not to overstretch. Hold this stretch for 15 to 30 seconds and repeat three times.
Another stretch that can be done before bed is a variation of the previous stretch. This time, instead of standing in a doorway, you will be lying down on the side opposite your injured arm. Bend the elbow of your injured arm to 90 degrees and rest your forearm across your abdomen. Hold a light dumbbell in the injured hand and, keeping your elbow against your side, slowly raise the weight towards the ceiling. If you do not have a light dumbbell, you can use a can of soup or a resistance band. Stop rotating your arm if you feel any strain. Hold the weight up for a few seconds, then slowly return to the starting position. Repeat this stretch three times, with each set consisting of 10 repetitions. Once you can easily complete 10 repetitions, increase to 15.
It is important to listen to your body and not push yourself too far, especially if you are still experiencing pain or swelling. If you are concerned about your recovery or the severity of your injury, consult your doctor.
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Frequently asked questions
It is recommended to sleep on an incline for 4 to 6 weeks after the surgery. You can use a 45-degree wedge pillow or stack a few pillows to create a similar effect.
Taking prescription pain relievers or over-the-counter anti-inflammatory medications as directed can help minimise discomfort. For best results, take the medication shortly before you go to sleep. Applying an ice pack or using a cryocuff or iceman, which are readily available online, can also help control pain.
It is recommended to wear a thin t-shirt, a tank top, or no shirt to bed so that the sling doesn't pull around your neck or shoulder and cause discomfort.
It will take 4-6 months before you can go back to sleeping however you want.
If you are an active sleeper, consider sleeping in a recliner chair, especially during the first few days after surgery. This will prevent you from rolling onto your affected arm. You can also use a pillow to prop up your arm and ensure enough oxygen reaches your shoulder, which is crucial for collagen growth and infection management.











































