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Diet Detective: Interview with physical therapist reveals best sleep position and how to loosen joints in the morning

Friday, August 29, 2014 - 12:05 pm

Recently, I was able to catch up with an expert in physical therapy and dance, Colorado-based Mieke Scripps. She studied dance and kinesiology at the University of Wisconsin while performing in the modern dance troop Li Chiao-Ping Dance. After her dance career, she received her doctorate in physical therapy from Northwestern University and then worked as a physical therapist for the New York City Ballet, the School of American Ballet, the Miami City Ballet, the Juilliard School, the Colorado Ballet Academy and on many Broadway shows. I was able to do an extensive three-part email interview with Dr. Scripps.

Diet Detective: What's the best sleep position?

Mieke Scripps: It is a difficult thing to train yourself to sleep in the proper position, but once accomplished you will feel refreshed and wake up without so many aches and pains. Try to fall asleep in the appropriate position. If you wake up in another position just reposition yourself and try to fall asleep again in the appropriate position.

1. Stomach: Don't even think of sleeping on your stomach. The rule is to maintain the spine in neutral alignment. It is impossible to maintain neutral alignment through your neck in this position. It also puts the lower back in an exaggerated curve. Try to slowly train yourself to sleep in another position.

2. Back: This is a good choice, but remember to accommodate the curve in your neck. Keep only a small amount of pillow under your head (to avoid pushing your head excessively forward). The hollow in your neck is where you need the most support. Here are some pillow options: Take a larger, malleable pillow and bunch it so there is more under your neck and less under your head. Another option is to use a small, soft pillow or rolled towel for the neck. You may also wish to place a pillow under the knees. This allows the soft tissues that run from your neck all the way to your toes to be relaxed and supported, decreasing back discomfort.

3. Side: This is when pillows become important. Use three of them ­ that's right three pillows. Pillow No. 1 should be placed under your head to lift it to a position centered on your shoulders (be sure to put more pillow under the neck than the head, so that the neck is fully supported). Pillow No. 2 should be hugged with your arm to decrease the strain on your shoulder, upper back and neck muscles. Finally, pillow No. 3 should be placed between the knees to decrease the strain on the hip and low-back muscles.

DD: What about reading or using the computer in bed­ does that contribute to back pain?

MS: Yes, when you use your bed for reading, watching television, using your computer, etc., you probably get comfortable by propping yourself up with pillows. This often violates the rule of maintaining a neutral spinal alignment. What happens is that the hollow in your lower back is now reversed into rounding; the roundness of your upper back is more accentuated; your shoulders are hunched forward; and your head is significantly in front of your shoulders (probably pushed forward by the pillows). If bad positioning is maintained over an extended period of time, it puts strain on your muscles, ligaments and joints. Strain can develop into inflammation, pain and permanent changes.

DD: So what can you do if you enjoy reading, working and watching TV in bed?

MS: You can moderate the damage by getting up every 20 minutes and frequently rearranging your pillows. Finally, improve the ergonomics of your setup:

Your back should be on a gradual incline. Your lower-back hollow should be maintained with a lumbar pillow. Put a pillow under your knees to keep them bent. Your head should rest back on a pillow so it can fall back past your shoulders and allow the neck to maintain its natural hollows. Basically, try to maintain the natural spinal curvature.

DD: Why do we feel tight in the morning?

MS: During those hours of sleep, the body's core temperature has fallen, and viscosity of the joints has decreased. Also, the discs in the back fill with water to rejuvenate, which stretches the muscles and ligaments around them. When you pop out of bed, it compresses the discs and surrounding structures giving your back a bit of a jolt. Try the following process to get your day off to a great start:

Lying in Bed: While still lying in bed, turn onto your side or back and bend your legs. Gently rock your pelvis up and down. As you do this motion, you should feel your lower back change from arching to flattening. Start with a small motion, and gradually increase the range. After you do this for a minute or so, roll onto your back. Once on your back, alternately pull one knee to the chest while straightening the other leg. Remember, move gently, you are just waking up.

Sitting up in Bed: Now it's time to rise and shine, but we want to minimize the strain on the body. This means we do not sit straight up in bed. Instead, roll to your side, bend your legs and use your hands to push up from the bed while lowering your legs down over the side. This saves your back, because you avoid twisting and bending your spine before the blood is flowing and the tissues are ready for it.

Getting on your Feet: Finally, to get from sitting to standing, try this method. Scoot to the edge of your bed; push your feet into the floor. As you lift your bottom off the surface, make sure to keep your head up and push your feet into the ground, engaging your leg muscles. By doing this, you use your bigger leg and buttock muscles and avoid straining the back.

To finish things off, take a nice hot shower.

Charles Stuart Platkin is a nutrition and public health advocate and founder of DietDetective.com.