After rotator cuff surgery, most people sleep best propped UP, not flat. Use a wedge pillow, a stack of pillows or a recliner, with a pillow under the operated elbow.
Keep the sling on at night unless your surgeon says otherwise, and don’t lie on the operated side for about six weeks.
The first six to eight weeks are the hardest. Sleep usually improves noticeably by three months, and keeps getting better up to a year.
The setup that works
- Propped up at about 30 degrees: a wedge pillow or three or four pillows behind your back. Many people find a recliner easiest for the first few weeks
- A pillow or rolled towel under the operated elbow. If the elbow drops back behind your body, the front of the shoulder stretches and it HURTS
- Sling on at night for as long as your surgeon wants it on during the day
- A pillow on the operated side to stop you rolling onto it in your sleep
- A glass of water, your phone and painkillers within reach of your good hand, so you don’t twist to get them
Support the elbow and the shoulder settles. Let the elbow drop and it won’t.
Positions
- Propped on your back: the best position for most people early on
- On your good side: possible for some after the first couple of weeks. Hug a pillow in front of you and rest the operated arm on it, sling still on
- On your operated side: not for about six weeks
- Flat on your back or on your stomach: usually uncomfortable for weeks. Don’t force it
Pain at night
- Take pain relief before bed, not when you wake up in pain. It’s easier to stay ahead of pain than to catch up with it
- Ice for 15 to 20 minutes before bed can help, with a cloth between the ice and your skin
- Getting out of bed: roll to the good side and push up with your GOOD arm only. Pushing up with the operated arm is one of the most common ways people strain the repair
- Nobody fully knows why shoulder pain is worse at night. It is real and very common, and it does ease
How long it lasts
- Weeks 0 to 6: the hardest stretch. Broken sleep is normal
- Weeks 6 to 12: sling off, sleep starts improving. Some people move back to bed from the recliner
- Months 3 to 6: most people sleep noticeably better
- Months 6 to 12: continued improvement, including lying on the operated side
For the full recovery timeline, see rotator cuff surgery recovery week by week.
Call your surgeon if
- Night pain is getting WORSE after the first few weeks instead of better
- Night pain comes back after it had settled
- You have a fever, feel unwell, or the wound is red, swollen or leaking
- You have new numbness or weakness in the arm or hand
- Your pain medication isn’t touching the pain
Propped up, elbow supported, good side only, and give it three months.