Pillows are a frequent topic brought up by clients who see me for myofascial release (MFR). They are often concerned if the pillow they are using is helping or hurting their bodies, specifically their neck. Most of my clients also report they have been on a never-ending quest for the perfect pillow that will relieve their stiffness and pain. They have tried endless pillows of varying thicknesses, fillings and price points. They often end up purchasing an expensive pillow with dips and curves that hold their head in perfect alignment. When it doesn’t relieve their discomfort, they are then concerned if they purchased it in the correct size. Should they have bought the small when they chose the medium??? I frequently hear they paid so much for it, they feel the need to keep using it anyway.
A quick search on Amazon of “pillows for sleeping” resulted in over 8000 results. The most expensive pillow I could find on amazon.com was $906.00. Don’t believe me? Do a search. The least expensive was on sale for $8.84. Pillows are big business.
There were many pillows with a full five-star review. There are pillows directed at all ages and many different problems from allergies to migraines. There was even a pillow for infants if you want to get started early on a stiff neck. Now, granted, I know there are some issues people have where a pillow can be very helpful and even necessary. So, I’m not saying everyone should toss their pillow. I’m not saying anyone should throw out their pillow. My goal with this post is to get you thinking about your neck, how stiff the muslces and fascia are in your neck, and what you are trying to accomplish with a pillow.
The goal of most people is to get a good night’s rest and to wake up ready to greet the day feeling great and full of energy. That is certainly mine. I will admit that I too have gone on the quest for the perfect pillow, but I never found it. I did find a pillow I really liked after I modified it by removing about a third of the stuffing. Even then, it didn’t take away the stiffness I often felt and the occasional headache I’d have in the morning. But, it was better than anything else I’d tried, so I stuck with it until…
I was listening to a podcast by one of my favorite author and podcaster, Katy Bowman. She mentioned that she had weaned herself off a pillow in 18 months. Katy is very into natural movement and also has no living room furniture. She explained how we didn’t evolve with pillows and not using one leads to more natural movements at night. Katy reported how she gradually went from a very thick pillow to a much thinner pillow then eventually a folded towel. At the time of the podcast, she was using an old t-shirt when she wanted something under her head. It sounded risky and uncomfortable, but I love Katy Bowman, so I thought I’d give it a try. It made sense to me from a natural movement perspective and a myofascial perspective. It took me two weeks.
What?! Two weeks?! How did you do it, Amy? Well, let me tell you. I have one of those 10” x 10” bean bags you can warm up in the microwave. I have been warming it up for years and taking it to bed with me. I find it very soothing regardless of the season. I will put it where I have a little ache or pain or just let it sit on my chest and soothe me to sleep. Occasionally I’ll put it under my neck if it feels stiff. When I decided to try not using my pillow, I put that under my neck curve while laying on my back and quickly fell asleep. The problem came when I rolled onto my side. That just wasn’t going to work. I had my regular pillow nearby and switched to it when I turned to my side. That pattern continued until one night I rolled to my side, switched to my regular pillow then moved back on my back with my regular pillow and then woke with a blazing headache. It felt like my regular pillow was pushing my head forward and it was. So, the next night I decided to stick with the bean bag when I rolled to my side. I wadded it up as much as I could and eventually fell asleep. When I turned to my back again, it was right there for my neck curve. 
I’m a very active sleeper and will sometimes roll to my stomach as well. Nothing works well now for that position so, I use nothing. …and it works well. I still use my little bean bag most nights, but many nights I prefer it on a shoulder or elbow if I have a little ache or pain, so I have nothing under my head or neck. And, it works just fine.
So, the big question… how is my neck? Is it less stiff? Do I have fewer headaches? The answer to both is yes. The reason I decided to try this experiment is that it made sense to me. I am a big believer that our bodies need to be both flexible and strong, and that includes the neck. For some reason, we are taught that our neck is so much more fragile than the rest of our body. We need to be super careful with it. Well it if is weak, tight and out of alignment, that is true. It is more likely to cause problems and be very painful when it is tight. If we are placing it carefully on a pillow for 6 to 8 hours each night, no matter how perfect the alignment we are creating an even stiffer neck. We are training it to prefer one position. That is not good. During the day many of us go to work and end up looking a screen much of the day again, keeping our necks in one primary position. Again, not good. The problem comes when we ask our neck to suddenly turn and look over our shoulder when we hear the dog tipping over the plant or our friendly co-worker sneaks up behind us with a surprise “boo.” We’re not flexible enough to handle these “extreme” motions. Extreme is in quotes because they are actually normal motions but not to a neck that is very stiff.
According to Katy Bowman, biomechanist, academic and author of Move Your DNA and Alignment Matters, when you laterally flex your neck or let your ear drop to your shoulder, they should touch. When I Googled the normal neck range of motion, I found 45 degrees to be the most common, but I did see 60 degrees. In our culture, it is so typical to lack range that we now expect less from our bodies. No, I can’t touch my ear to my shoulder unless I shrug my shoulder up. I’m working on it. The motion should be measured with the shoulder at rest and in its normal alignment. 
If you are not sure if your shoulders are in alignment, check your clavicles or collar bones. They should be level or parallel to the ground. If they aren’t or one is level, and one isn’t, you’ve got some tightness to work on.
Another common neck problem is the head forward position. If you stand most people next to a plumb line, the ear will not be in line with the ankle as it should. The ear will likely be much further forward. There are many reasons for this common posture, but one is our use of thick pillows. Big fluffy thick pillows are a symbol of luxury, and they look beautiful on the bed, but they are not great for our necks. 
They push the head forward and limit head movement at night. Again, our bodies need lots of movement and positions to be strong, flexible and healthy.
When sleeping with a tiny pillow or no pillow your head and neck will move more. They will not only move more, but they will also stay in different positions longer allowing the muscles, joints, and fascia to lengthen. In addition to lengthening, you also have gentle compression forces into your shoulders when you are sleeping on your side. Your tissues respond best to long slow stretches and why not get them when you are sleeping? When your neck tissues are suppler, they will have better blood and lymph flow to your neck, head, and brain. It will take more tension away from your thyroid, your vocal chords, your ears and your jaw.
It definitely takes time and effort to make lasting change in your body but making an effort to have greater neck flexibility and strength can make a huge difference in your health and well-being. This may be from changing your sleeping habits or changing your movement habits, either way, it is worth it. If you can’t seem to make the change, get some help. A neck that is chronically stiff may mean your fascia is tight. If you’ve tried regular massage and haven’t had lasting change, try myofascial release. The gentle sustained pressure will open the fascia, increase blood flow and make it easier to loosen the muscles. This combined with regular neck movement through its full range of motion both at night and during the day will keep your neck well. 
Sleep well!
Very interesting and informative article. Thank you.