Has the shine come off your rise and... because of low back, neck or shoulder pain? Do you keep exacerbating an existing structural problem by simply filling your very human need for sleep? Changing the position you sleep in could be key to healing. Here's why:

The shapes we make make our shape

Did your mom ever say don't make that face 'cuz it'll get stuck like that? It turns out she was right! Well... kind of.

The main tissue of structure is fascia. The terms
"connective tissue" and "fascia" are interchangeable. We will use both in this and subsequent blogs. Fascia is made by a cell called a fibroblast. Fibroblasts secrete the protein collagen. Collagen is the predominant protein in fascia.

Collagen proteins are arranged into strings and fibers. They move in and are coated with a watery mixture of sugar and amino acids. This watery stuff is called ground substance. It
allows collagen fibers to slide along each other and quickly change into any shape that could be useful to you. As a whole, fascia gives your body structure. Without it, all
the water in your body would end up in your feet. You can think of it as biological fabric.

Fibroblasts are like snails leaving a slimy trail of collagen

When you maintain a shape for any length of time, fibroblasts begin laying down tiny strings of collagen to support you. They are like traveling snails leaving a slimy supportive string as they go. When you come out of whatever shape you’re in, some of those tiny “strings” are dissolved.

If you repeat the same shape over and over again, fibroblasts lay down strings of collagen over and over again. It's as if they say; "She must like this shape. Let's support her!" When you habitually repeat a shape, fewer and fewer strings are dissolved or stretched out. [1]

Sleep as close to "neutral" as possible

So the shapes you practice are written into your structure. So why don’t we walk around looking like the shapes we use in our nightly mattress interactions?

Thought you’d never ask! As it turns out, just the act of getting out of bed stretches out and organizes some of those collagenous relationships that have formed over night. * And, In our waking life, we have ample opportunity to really stretch out all that “knitting.” You could actually sleep in just about any position with no negative consequences. [2] However, there is a very important “IF” that has to be tacked on here. You could actually sleep in just about any position with no negative consequences IF your waking hours included lots of movement variation and interaction with a wide variety of loads and surfaces.

Unfortunately, just because we have the opportunity to organize our fascia when we are awake does not mean we will take it. How many times have you said it? Or heard a friend say it? “I need to stretch more!” Sometimes what we are sensing is the lack of variety in our movement practice. If you sleep, "on the regula'" in a position that mimics a structural problem, AND you don’t engage in proprioceptively rich and vector variant movements during your day, you will have (or continue to have) a structural problem. Your body will literally continue to knit you into that posture!

What do we mean by "structural problem?" When your hips, rib cage, shoulders or head are held out of what is a neutral position for you, it causes pain. This is because your body likes to have a good relationship with gravity. If a body part is held far from the center line of gravity that falls through the middle of you, your body will let you know you are wasting energy and asking other parts of you to work too hard. That's where the "ouch" in back pain, neck pain, shoulder pain etc. comes from. By the way, if you're confused about how to find your "neutral," come see us
here at Structural Elements. It's what we do!

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Common structural "problems" show up in the way your major weights (hips, rib cage, shoulders and head) behave in space.

If you are dealing with an injury or structural problem you will benefit from sleeping in a position that closely mimics the most organized way for you to be in gravity. If your waking life does not include a variety of movement and interactions with a variety of loads and surfaces, you will
also benefit from looking at your sleeping position. As structural integrators and movement teachers we help you find your “neutral.” The position you sleep could be especially important if you are in that kind of process with us.

Possible sleeping position do's and dont's

Please keep reading because we will qualify all of this.

We can't be dogmatic about which sleeping position is best for you. But in our experience the following positions cause or exacerbate structural problems because they mimic, well... structural problems. So these positions are on our don't list (and, seriously, keep reading beyond these lists because we would not be giving you the whole picture by saying don’t sleep in this or that position):

Don't (or try not to):

sleep on you stomach.
sleep on your stomach with one leg "cocked" up and to the side.
sleep with one arm extended up under your pillow, as if your'e raising your hand in class.
sleep with your arm trapped under your partner. (We're not against cuddling! Just try not to spend eight hours like this).
sleep on your side with one leg straight and the other pulled toward your chest.
sleep on your back with your head turned to one side.
sleep on your back with your arm raised over head.
sleep on your back with one leg cocked up and to the side.
sleep in a creative combination of any of these configurations!

These positions closely mimic neutral and seem to do bodies good. They are on our "do" list:

Do (or try to):

sleep on your side with your head on a pillow that helps you mimic what is neutral for your head; both knees slightly bent so that they are mirroring each other; a very large pillow between your knees and feet; hugging another large pillow in front of you.
sleep on your back with a small pillow or bolster under your knees; both legs in neutral (in other words, don't pull one leg up and out to the side), arms at rest by your side. If you have neck problems, you likely need to abandon this position and try the first "do" position.

If we are not good movers in our waking life, staying in any position for hours on end can cause us to get stuck or locked up. But, in our experience, these "do" sleeping postures cause the fewest problems. They help a body closely mimic "neutral" and don't place your hips, rib cage,
shoulders or head in a position that looks like a structural problem. If you are not used to sleeping in one of these "do" postures it may take a while for your mind/body to allow you to feel restful as you practice them. Don't give up! Keep trying! It may take a couple months for the posture to become habit. At first, and for a while, in the AM you may find that you have unconsciously thrown your pillows on the ground or across the room. Be patient.

Try to spend at least the initial part of your night in one of these positions. If you wake up and you are back to your stomach or in some other confounded configuration, don't fret! Gently reposition.

If you are suffering with low back pain, shoulder pain, hip pain, neck pain or any other structural problem, book a free consultation with us! Click here to book an appointment.

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But, but, but…

...the title of this blog is “Why the position you sleep in matters but really shouldn’t.” We’ve said a little about the “really shouldn’t” part but we will explain more in part in part two of this blog. Click here to find out why you really should be able to sleep in any position and why you may not be able to.

* hydrogen bonds or cross links that hold collagen fibrils and fibers together are loosened when the extra cellular matrix reads “stretch” and fibroblasts are subsequently stimulated to release collegenase which in turn could lead to the degradation of collagen fibers. Movement and stretch also hydrate and reorganize less transitory fibers. [1]

[1] Stecco, Carla, et al. Functional Atlas of the Human Fascial System. Churchill Livingstone Elsevier, 2015.
[2] Bowman, Katy. Move Your DNA: Restore Your Health through Natural Movement. Propriometrics Press, 2017.

Why the Position You Sleep in May Matter But Really Shouldn’t (Part One 5 minute read)