The pain of a muscle strain can make sleeping a challenge. Finding a comfortable position is one consideration, but it's even more important to avoid postures that may aggravate the injury or delay the recovery. Keeping a few simple concepts in mind can help ensure that the chosen sleep posture helps in healing.
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Keep It Neutral
The Mayo Clinic definition of a strain is "a stretching or tearing of muscle or tendon, a fibrous cord of tissue that connects muscles to bones." When a muscle or tendon is torn, the body undertakes a complex series of steps to repair the damage. Much of this repair work takes place during periods of sleep. Early in the course of recovery, the American Academy of Orthopedic Surgeons says, it is important to maintain the injured part in a neutral position to encourage the torn tissue to knit together along normal lines of orientation. At times, a brace may even be recommended to help maintain a neutral posture.
An old acronym for the treatment of sports injuries such as strains is R.I.C.E. This stands for rest, ice, compression and elevation. Depending on the body part, at least two of these can be accomplished while sleeping. Rest can be taken for granted in a sleep scenario. If the strain is to a muscle in an arm or leg, that part can be propped up with pillows to assist venous circulation flowing away from the injured area and back to the heart. This helps to minimize the swelling associated with an acute strain injury. Keeping the swelling down is important because excessive swelling can delay recovery.
As the recovery from a strain progresses, the injured muscle will remain tender and inflexible for some time. Restoring flexibility of the muscle and tendon becomes one of the primary goals of rehabilitation. The phases of healing from a strain, as described in a 1992 research article in the British Medical Bulletin, end with repair by "formation of granulation tissue and scarring." This scar tissue does not have the same elastic or contractile properties as normal muscle tissue. If the muscle is maintained in a shortened or contracted posture as this scar tissue is forming, restoring flexibility to the muscle later can be daunting. Sleeping with the injured part in a position that elongates the healing muscle will minimize the tendency for scar tissue to rob the muscle of flexibility. For example, if the hamstring is strained, sleep with the knee extended. If the right side of the neck is strained, do not sleep with the head tilted toward the right.