by Kelly Treviño, MS, LAT, ATC

You’re asleep. Your muscles are off-duty and nothing’s in motion. At least, that’s the idea. But while you’re out cold, your body might be stuck in patterns that keep tension alive, like twisted hips, tilted shoulders, and a spine shaped like a question mark. At Work Right, we talk a lot about alignment in movement, but alignment in the stillness matters just as much. Because if your body spends eight hours in the wrong shape, it doesn’t matter how well you lift the next day. You may already be starting behind.

The Best Position For Sleep

We spend about a third of our lives lying down. Ideally, this time helps restore alignment and neutrality to our bodies. But, if our sleeping position works against that, we’re reinforcing misalignment night after night.

According to the Sleep Foundation, side sleeping is the most common position, but without proper support, it can contribute to low back pain. Stomach sleeping (prone) has the highest prevalence of discomfort due to spinal overextension. The best positions for alignment? Sleeping on your back with a pillow under the knees, or on your side with a pillow between the knees and adequate head support. Both promote a neutral spine and reduce strain across the shoulders, hips, and lower back.

Poorly Positioned For Work

Sometimes, though, we are doing a task that requires repetitive transitioning back and forth between two areas, or maybe between our task and our tools. In that case, we want to apply the same Align principle. As we turn, we want to pick up the leading foot and make sure our leading foot/hip/shoulder move as a unit, rather than keeping our foot planted and twisting your knee and low back. This is especially important if you are holding something heavy: our bodies were not designed for repetitive compression and rotation, and our knees and backs suffer the consequences of such motions.

Prevention Favors The Prepared

Sleep is personal. There’s no single “right” position for everyone. But there are better habits that support musculoskeletal alignment and help your body recover overnight. The use of pillows, mattress firmness, and body awareness all play a role.

A 2023 study in Musculoskeletal Science and Practice found that sleep posture is a contributing factor in chronic low back pain. And, research published in Ergonomics suggests that mattress sagging can disrupt spinal alignment and worsen discomfort, especially for side and stomach sleepers.

As we focus this month on Aligning Our Shoulders, Hips, and Toes, remember, how we sleep is just as important as how you move. You don’t need a perfect setup. You just need to give your body the chance to rest in a position that helps it recover, not unravel.

Sleep Alignment Checklist

• Pillow supports my neck (not just my head)
• Side sleeper: pillow between knees
• Back sleeper: pillow under knees
• Stomach sleeping? Avoid or shift to side/back
• Mattress isn’t sagging beneath hips or shoulders
• Sleeping position supports spine alignment
• Bonus: side sleeping reduces heartburn & snoring
• Bonus: back sleeping helps with nasal congestion

Kelly Treviño, MS, LAT, ATC || Kelly has been practicing athletic training since 2018. She currently lives in Rio Rancho, NM with her wife, Shelby, and two dogs, Harvey and Storm. In her free time she enjoys Legos, working out, and going for rides on her motorcycle.

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Be sure to check out our other blogs for further injury prevention education and tips for the industrial athlete from Work Right NW!