When you wake up with stiff shoulders, the real issue is often your muscles rather than how you sleep.
Stiffness and pain in your shoulders and neck when you wake up in the morning happen because your muscles are not flexible enough to shift into the posture your body needs for sleep.
When you sit, your muscles adjust to the length needed for sitting. In the same way, when you lie down to sleep, muscles throughout your body adjust their length so you can settle into a sleeping posture. But if that adjustment does not happen before you get into bed, pain and discomfort can appear.
Stiffness and pain in your shoulders and neck when you wake up in the morning happen because your muscles are not flexible enough to shift into the posture your body needs for sleep.
The illustration on the right shows how a gap can form between the shoulder and the mattress. The space between the right shoulder and the floor is noticeably larger.
When you sit, your muscles adjust to the length needed for sitting. In the same way, when you lie down to sleep, muscles throughout your body adjust their length so you can settle into a sleeping posture. But if that adjustment does not happen before you get into bed, pain and discomfort can appear.
If you fall asleep before your body has adjusted, you cannot fully rest your weight on the pillow or bed, so tension remains. When your shoulders or neck feel dull and heavy, there may be a gap between your shoulder and the bed, but the root cause is the posture your body has become fixed in during everyday life.
Flexible muscles help your body shift into a sleeping posture that is different from the posture you use while standing or sitting during the day.
Many people wake up with painful or stiff shoulders and necks, or feel discomfort in the neck as soon as they lie down, and end up not knowing how they should sleep.
You may also have tried sleeping on your side or stomach, changing your pillow or mattress, stretching before bed, or warming your body in the bath.
If none of that has truly cleared things up, it is because your body has not yet regained the suppleness it had when you were a child. If your body could change posture flexibly even while you sleep, pain would not occur. To solve shoulder and neck stiffness during sleep, you need to identify the type of distortion in your body and stretch the muscles that are creating it.
- Changed their bed or pillow, but saw no improvement.
- Tried stretching before bed.
- Regularly do exercise such as running or yoga.
- Have received treatments such as massage.
The key to solving this is understanding your body's habits.
This illustration shows part of an examination. Because the hands are not at the same height, we can suspect that there may be a problem with how the shoulder blades are moving.
No one has a body with no distortion at all. One shoulder may be higher than the other, or one leg may appear longer than the other. This happens because each person has their own habits in how they use their body.
People constantly and rationally choose the ways of moving that feel easiest. Muscles that are hard to use tend to be used less, gradually weaken, and eventually show up as distortion.
We use examinations to find these distortions. Having distortion does not automatically mean you will have pain. However, in many cases, pain disappears when the distortion is corrected.
That is why, when you have discomfort such as stiff shoulders, the key to solving the problem is to identify the distortion and understand the habits in how you use your body.
Treatment record
Let’s look at a case record to see the steps through which persistent shoulder and neck stiffness can improve.
- Symptoms: Dull pain in the neck and shoulders both while working and while sleeping. Still feels fatigued even after waking up in the morning.
- Age: In their 40s
- Work: Mainly computer work
- What they had tried: Chiropractic, acupuncture, changing pillows and mattresses, running, stretching
If we put the course of events in chronological order, it looks like this:
- Was told the cause was skeletal distortion.
- Was told that prolonged sitting posture was causing the distortion.
- Started stretching and running.
- Improved somewhat with exercise and stretching, but the condition remained unstable.
- Tried changing the bedding, but it did not help.
- Became even less sure what the real cause was.
In addition to trying different kinds of treatment, this person also kept experimenting with approaches such as adding exercise.
We carry out various examinations to identify the cause. Each part of the body has its own normal range of motion. For example, if you can tilt your head back until your face is nearly parallel with the ceiling when looking upward, we can judge that neck movement is normal.
If a movement cannot be performed as it should, or if moving up and down or side to side is difficult on one side, that limitation can be identified as a cause of pain.
Test results
Problems were found in the length of the toes and the position of the shoulder blades.
Comparing the big toes on both feet, the big toe on the left side appears longer.
A longer big toe indicates that the arch of the foot, the hollow on the sole, has dropped. One of the main reasons is that the muscles of the thighs and buttocks are being used differently on the left and right sides of the body.
In this way, problems around the waist, which is the center of the body, can show up in the extremities.
Although the patient complains of pain in the neck and shoulders, I do not touch the neck or shoulders at the start. There are two reasons for this.
① It can worsen inflammation and increase the number of visits needed
Massaging the shoulders briefly improves circulation, so it feels good for a moment. However, the muscles causing pain are inflamed, and pressing on them can make that inflammation worse. If that happens, the pain continues all the time, and during treatment it becomes impossible to tell whether the symptoms are improving or not.
When that happens, you cannot tell on the spot whether the symptoms have improved, so the session ends with something like, “That’s all for today. Please see how it goes for a while,” which leads to more visits. Increasing the burden on the client is not desirable.
② The cause is often not where the pain is felt
For example, when there is shoulder pain, the cause is often hidden somewhere farther away, such as the lower back or legs. Massaging the shoulders may feel good, but it does not lead to fundamental improvement.
In some cases, the painful muscles are muscles that should not be loosened. If so, the more they are treated directly, the worse the condition can become.
For these two reasons, even when a patient complains of pain in the neck or shoulders, I do not begin by touching the neck or shoulders.
Treatment details
Here, I will introduce a treatment method that is unique to seitai.
When many people’s spines are viewed from behind, they form a curve like the letter C or S. When the curve is large, it is diagnosed as scoliosis. Mild scoliosis is common and does not necessarily cause problems in daily life.
However, scoliosis reflects habitual patterns in how the body is used. In other words, it is the result of repeatedly using the body in the wrong way. If you can relearn how to use your body so that the scoliosis pattern decreases, the strain on the neck and shoulders also decreases, and the pain goes away.
The illustration shows exercise guidance aimed at straightening the spine. By exercising with appropriate resistance, we switch on muscles that are usually dormant and retrain them to perform their proper function.
We again tried the movements that had caused pain during the examination before treatment. The patient confirmed that there were no problems with any of those movements. The discomfort running from the neck to the shoulders while lying on the back had also disappeared, so waking up should no longer be a problem.
I explained that we would not know for sure whether the symptoms had truly improved until a few nights had passed, so if waking up was still difficult, I asked the patient to come back for another visit.
Because sleep is something we do every day, we receive many questions about it. How can you sleep comfortably and wake up feeling refreshed?
We recommend sleeping on your back, as this is the easiest position for breathing.
When you lie on your side or stomach, the framework surrounding your lungs (the rib cage) cannot move properly, which causes shallow breathing.
Unlike the heart and intestines, the lungs cannot move by themselves. They expand and contract when the rib cage moves. The bones surrounding the chest, such as the ribs, each have joints, so they can move the rib cage in the same way as moving your hands and fingers. It is these bone movements that allow us to breathe.
Since you'll be tossing and turning in your sleep, it's difficult to always maintain the ideal posture, but lying on your back when you get into bed is recommended. If you have flexible muscles that can smoothly adjust to different positions when you turn over in your sleep, you'll be able to wake up feeling refreshed in the morning.
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This is because you are sleeping with your body stiff.
The posture you assume when you are active during the day is different from the posture you assume when you sleep. When you get into bed, your muscles move to help you assume a sleeping position. However, if your muscles cannot move freely, you may fall asleep without preparing your sleeping position.
For example, if you sit for a long time, certain muscles become less mobile and are unable to stretch or contract freely. Stretching is said to be good for stiff shoulders because it helps restore flexibility to the muscles.
When you fall asleep with your muscles moving awkwardly, like a robot, even the unevenness of the pillow or bed that your body was able to adapt to when you first bought it no longer suits you. When this happens, no matter how many times you change your pillow or bed, your neck hurts so much that you feel like there's nowhere to put your head or neck.
However, this is only possible if your bed is not too soft and your pillow is not too high.
Steps to solve the problem through seitai
The way you use your body today has been shaped by many experiences since childhood, including play, sports, accidents, and childbirth.
If you are in pain, it is simply your body’s way of telling you that there has been a problem in how you have been using it up to now.
The first stage of solving the problem is to stop the pain. Once the cause has been identified through examination and treatment is given, the pain can be reduced. Only after the pain has eased are you ready to learn the correct way to use your body.
The second stage is to learn proper body use. This changes both the body and the brain so that you do not return to your old state.
Because physical pain is often caused by daily habits, stretching and exercise become necessary. Just like brushing your teeth, steady repetition is important.
If you want to solve pain, the first step is to stop it. Stretching and exercise come after that.
