Pillows. In our culture, they’re viewed as necessary bed-time equipment. Along with sheets and blankets, pillows are so strongly associated with sleep that the idea of foregoing one seems unrefined or ‘strange’ to many people.
This post is intended to raise awareness about how pillow use-habits can contribute to neck pain, shoulder pain, back pain, tension, etc., and offer some DIY solutions.
We all want to move better, feel better, and get injured less easily, right? Well, looking at how you sleep might make a difference in how you’re moving and feeling the rest of the time.
How might a pillow cause problems?
The positions you practice matter — and the positions you spend the most time in, you master.
MOST people have mastered hunching, chin thrusting, rib thrusting, shoulder elevating, and inwardly rotating the upper arms. This position states, “I sit a lot”. It’s the chair-bound screen-oriented position.
Sadly, Doctor Ken Pole Ninja photo extraordinaire is not around so we are working with my shoddy screenshots.
There’s nothing inherently wrong with the positions listed above, we’re able to do them for a reason. But when you’re nearly always hunched and you can no longer move into and out of these positions with ease, you have a habitual mechanical issue. In simplified terms, you’re stuck in not-so-great, stiff, and often painful, place.
This isn’t something you can’t just exercise your way out of it. You need your lifestyle, *including your sleep*, to reinforce better positioning.
Pillows are one of those quiet, unassuming things that may be doing root-level damage. (Rarely appreciated facts: soft and fluffy things can, in fact, f* you up. And sleeping, the most restful activity one can do, can leave you injured, depending on how you do it. )
But aren’t pillows for comfort?
Theoretically, yes. Pillows do have plenty of great body-bolstering uses. But when you sleep on your back with a pillow under your head, you’re reinforcing hunching and/or chin thrusting habits for however many hours a night you sleep.*
Pillow habit-breaking is something that needs to be done gradually. If you remove your pillow and your chin is jutting forward (if the front of your neck is lengthened, and the back of your neck is shortened), you’re in neck extension. This could negatively alter your breathing and increase snoring. Pillow use can lead to neck strain—but being too aggressive about removing the pillow can also lead to neck strain.
Most people ARE uncomfortable when they lay flat because their upper-spine has taken on some ‘turtle-like’ characteristics. The more ‘neutralized’ position of laying flat is too extreme for them to be comfortable. They need a pillow. But they weren’t born that way, their bodies have adapted so well to sitting and pillow use that they’re in pain without it.
I can’t sleep on my back, what about other sleeping positions?
If you sleep on your side, using a pillow helps neutralize the neck. But, always sleeping on one shoulder may lead to problematic changes in your shoulders.
When you sleep face down with a pillow, you’re likely stuck in neck extension and rotation throughout the night. Even without a pillow, extended periods of time in this position commonly lead to neck issues and the old “crick/kink/crook in the neck” . (Yes, people say all of those things and they all describe an uncomfortable injury technically called spasmodic pseudotorticollis).
Disclaimer:
Before abruptly diving into my suggestions, please understand that like minimal footwear or a new training program, if you dive deep into a new mechanical habit, the injury/pain risk is REAL. You need to take your time to safely adapt.
Here’s what I’ve found…
Through much experimentation and re-training, my joints feel best after sleeping flat on my back (without a pillow) on a sturdy but slightly squishy surface (mattress properties will have to be another post). Maybe it’s just me, but when my head is free to roll side to side, I’m all over the place. I’m tangled, twisted, and numb. The positions I settle in usually put my arm to sleep or irritate my neck.
My safer-supine-sleeping-solution is…the “Head Hole."
The Head Hole is a different type of head wrap. It offers head support from the sides; it’s like a skull-bra. Besides the mechanical benefits, I find it very calming, especially when I wear it in conjunction with support under the neck (not skull) and a long buckwheat (weighted) tube-pillow over my eyes or forehead.
This is similar to what I’m using on my eyes:
It’s intended as a neck weight, but I love that it wraps my face and offers side support. I also use it as an under neck support or head-hole replacement. I affectionately call it my Snake:
How to Quickly Make a Head-Hole:
Step 1:
Fold a towel in half so that it is more square (not a long rectangle).
Step 2:
Get a piece of elastic that is longer than the short end of towel.
Step 3:
Roll the elastic inside the towel.
Step 4:
Tie the ends of the elastic to make a circle and tuck the knot into the towel and tuck the knot into the towel.
Step 5:
Lay down, wedge your head in and OM, Ahhhh, or ZZzzzzzzz.
The awesome thing is, you can travel with a piece of elastic (and your own towel if you like) and make “Head Hole” pillows wherever you go. Head-Holes on the road! Head-Holes for Hell Holes! ok, ok.
You can also make more permanent versions of this with some basic sewing skills. Get a soft material and fill it with some organic buckwheat, cotton, and lavender. Sew some ties onto it. It should be the right length to frame your skull, and full enough to keep you from rolling. If you have a head-hole crafting party, please invite me.
How to Use the Head Hole:
Please start by layering folded towels under your head to a height that is just a little bit less than what you’re used to.
Once you have the right height, lay down, wedge your head in and OM, Ahhhh, or ZZzzzzzzz.
“Laying on my back is still uncomfortable”:
If being on your back hurts other body parts, say, the back of your knees, or your lower back, consider rolling up some towels for under those areas too. You can buy all sorts of small pillows, but towels and blankets are good way to figure out what works before committing to a purchase. If your mattress is too soft, it can also lead to discomfort. When you sink in, your lower back rounds, your hips close, your shoulders drift forwards and you’re again practicing anterior (forward) head positioning.
To sleep on your side, and gradually work towards supine, try semi-side sleeping.This may place less pressure on the shoulder than usual. Wedge several pillows behind you so that you are less side-lying, and more supported from behind.
If you insist on sleeping face down, try to do it with less extreme neck positioning. Placing a super-thick pillow or two under your chest and pelvis so that the back of your neck is lengthened. Use a small buckwheat-type neck pillow to support your forehead and the side of your face. *Note that sleeping face down is one leading causes of spasmodic pseduotorticollis, or ‘frozen neck’. Weaning yourself off of this position is recommended.
If you start supine and you’re still tempted to roll over, you can place pillows all around your pelvis and legs. Build a pillow trench of sorts. As mentioned, your mattress will highly impact your sleep choices, so take that into consideration as well. Essentially, experiment with props that help you sleep as close to neutral as your body is ready for.
To be clear, stillness is NOT what are looking for, you’re not a corpse. You also don’t need to sleep in perfect alignment. Movement is good, even when sleeping. For the vast majority of human history, we did not sleep on flat surfaces, and our sleep environment frequently changed. It would be common for your body to have to conform to lumpy earthen materials along with some other humans and animals. Switching up how and where you sleep can be quite beneficial, especially if it involves more air from the outdoors and less artificial light. If you really want to maximize the benefits of your sleepy time, find ways to cuddle up with nature more often. (http://time.com/4656550/camping-sleep-insomnia/)
If you use these tips for even part of the night, that’s less time in a position that my be harming you. The goal is to gradually transform your sleep environment into one that creates better movement habits, and to not NEED any special props to feel at home in your body.
Long-term flat-surface sleep goal: Being able to comfortably lay flat without the ribs jutting out and the neck neutral.
Ok! That’s it! I hope this helps somehow. May your sleep be restorative and your movement be free.
*In technical terms, you’re practicing thoracic hyper-kyphosis and hyper-extension in the upper cervical vertebra.
Thank you Meredith Greisman for your help making this visually presentable and Kenneth Kao of Vital Balance Chiropractic for expert consulting and editing.