Avoiding Running Injuries 103: Why the Way You Sleep Matters

Okay, okay, so maybe this one isn’t something you’re doing RIGHT NOW, but it’s still pretty dang important. Your ability to recover and capacity to work go WAY down if you’re sleep deprived, so if you’re not getting a good night’s sleep you’re setting yourself up for overtraining, injury, crappy times, and to top it all off, you’ll probably get sick.^,  Avoiding running injuries starts with sleep.

Now, I KNOW you know it’s essential to get good quality sleep for 7-9 hours a night. If you’re not, that’s definitely the place to start. Amount and quality of sleep are two HUGE factors that can impact your athletic and mental performance everyday. Harvard put out some of the best tips I’ve seen for getting a better night’s sleep. Make one small change at a time, these things can be overwhelming if you try to do a complete overhaul all at once, but I guarantee you’ll notice a difference in your sleeping AND performance as you implement these.

Now, here’s something else I want you to consider. Think back to last night, what position did you go to sleep in? What position did you wake up in? Is this your go-to position that you’ve been sleeping in for decades? I have bad news for some of you, your sleep posture can be hurting your running.

Stomach Sleeping

There’s no good way to sleep on your stomach and have your spine in a good position. If you sleep on a massage table with a face hole, pillow under your stomach, and your arms down by your side, then carry on, otherwise—stop the stomach sleeping! As a runner, it tends to put your low back in an over-arched position which can contribute to pain and tightness. As a human, it’s terrible for your shoulders and neck because people tend to sleep with their arms up under their head (essentially in a shoulder impingement position), and with the neck torqued to one side. Try sleeping on your side, hug a pillow or your spouse to try to keep yourself from turning onto your stomach. I know it can be tough to transition, this is coming from a lifetime stomach sleeper, but your body will thank you when you make the change and wake up feeling refreshed!

Side Sleeping

This position can still sometimes be problematic for the neck and shoulders, so make sure you have a good pillow that supports your neck in a neutral alignment. Overall, a much better option than stomach sleeping, but there are still some things to be aware of! If you sleep in a running man pose (top leg bent up, bottom leg straight), put a pillow under your top leg—this keeps you from getting excess twisting through your low back and keeps your hip in better alignment. Same thing with you folks sleeping in the fetal position, put a pillow between your knees. I’ve seen many runners who struggle with hip, knee, or low back problems that don’t realize their sleep position is contributing to the problem!

Back Sleeping

Sleeping on your back allows for the most optimal spinal position, which means a healthier foundation for your runs. A key thing to think about is your pillow use. As Dr. Theresa Larson points out: “Ideally you should not need a pillow under your head, but we have grown accustomed to our head pillows, so just make sure the pillow is not so thick that it throws your neck into too much flexion.”³ A little trick I like is to use a somewhat flatter pillow and pull the bottom corners up around my neck and over my shoulders. This allows my head to be down in line with my shoulders, have the natural curve of my neck supported, and keeps my shoulders from resting in a forward “slouched” position on top of the pillow. Also, if you have low back pain when you try to sleep flat on your back, try putting a pillow under your knees—if your hip flexors are tight, lying flat pulls on your low back, so adding the pillow support takes that pressure off your low back. (Work on your hip mobility if this is a problem you have!)

If you feel like your performance has been suffering, consider your sleep and recovery before you start blaming your training. Similarly, if you’re waking up with any aches and pains that weren’t there when you went to bed, and that may carry on into your run, it’s worth considering that you sleep posture could be at fault. Try making some of these simple changes to your sleep position and implementing some of those Harvard tips for a better night’s sleep and you’ll be on the road kicking pavement better than ever!

Now, what’s on your feet?

Now, before you breeze over this, I’m not talking about the shoes you run in. Think about your last week’s of work wardrobe–what shoes did you wear every day? If you said anything other than flats, this section is for you! If you’re in heels, work boots, or men’s dress shoes 8+ hours for 5+ days, that’s a long  time to go not putting your foot flat on the ground, and chances are you’ve experienced some sort of low back, hip, knee, ankle or foot pain. Yep, your daily shoewear can impact all of that.

Csapo et al. found that chronic use of high heels induces functional shortening of the Achilles’ tendon. And yes, this still affects men, because your dress shoes and work boots have a 1″ or higher heel too! Why does that matter? When you have tight ankles, it affects all your joints up the chain. Generally, this means your body has to find some way to cheat to make sure you don’t trip with every step because you can’t pick your toes up high enough. Usually this is in the form of excess movement from another joint- excess stress on the knee, hip or low back- which leads to strain. Your body is a factory cranking out mile after mile on your runs, when one factory worker falls asleep on the job, the rest are going to have to pick up the slack, and eventually they’re going to get pissed about the extra work and go on strike.

“I mean, I wear those type shoes everyday, but how do I know if my ankles are too tight?” Don’t you worry, I have a test for that. Measure four inches away from a wall, take your shoes off and place your toe at the four-inch line. Push the knee forward while keeping the heel on the ground. If you cannot touch the wall with your knee, you lack optimal ROM in the ankle, and are at greater risk for injury.

What can you do?

TAKE OFF YOUR SHOES! Whenever able, spend more time barefoot. “But Megan, I have really flat feet and I’m not supposed to be barefoot.” Similar to progressing to standing more at work or using a flatter pillow for sleeping, it takes time, but the change CAN be made. You’ve been in heeled shoes for how many years of your life? You’re not going to comfortably transition to barefoot of flat shoes overnight, but work down to it. Start by taking your shoes off for 15-30 minutes when you’re sitting or standing at your work desk. Keep a lacrosse/tennis ball under your desk and you can roll your feet. Here is an AWESOME guide for transitioning to more minimalist shoes and barefoot life, including mobility and strengthening drills. I’m not necessarily advising running in minimalist shoes, but spending more time in the day letting your foot move the way that it was designed to is very important for your mobility and mechanics.

There are so many facets to training and performance, and these posts have only scratched the surface. I hope you’ve been able to take some tidbits away that will help you rock your next race or training run and stay running healthy for many years to come! Let me know what you think, does anything surprise you? What other running related questions can I help you with?

Click here to get access to my Head to Toe Mobility Guide for Runners for some other tips that can help get you on the right track to optimizing your running!