Sleeping Positions: Pillow Between the Thighs

sleeping positions can affect your back pain

If you have been reading this blog you know that I am very interested/obsessed with sleeping positions. While sleep might not cause injuries (though it might), it can definitely exacerbate them as the sleeping body can happily give in to misalignments and take on shapes that while comfortable, only increase our problems.

A classic example of that is sleeping on your side with one knee hiked up towards your chest. This accommodates the tight psoas on the hiked knee side but it also torques the pelvis for the duration of your sleep. No good can come from that.

That was me about five years ago. Since that time I have moved my knees together and actually straightened my legs, most of the way, while I sleep. I also have been sleeping with a pillow between my thighs for the past couple of years simply because it is recommended by a lot of people. Hey, I’m easy.

But lately I have been noticing that my left knee feels a bit tight when I wake up. The tightness dissipates fairly quickly but it is there every morning upon waking. In the back of my mind I have always been a little skeptical of the pillow between the legs as separating the legs throws off the natural alignment of the skeleton. Anatomical neutral when standing has the knees right next to each so the shin bones can move straight down to the feet in a parallel position.

Putting a pillow between your thighs separates the legs and I am wondering if it separates them too much. The IT band on the outer thigh tends to be tight in a great many people. If that is the case the pillow between the legs is a gift to that tightness because it allows the tight TI band to relax. But this might not be a good thing. It is just like accommodating the tight psoas with one knee higher than the other. It might actually make sleeping easier but it might also increase its tightness.

I’m not sure. It has been two night without a pillow and I’d like to think my knee feels different but I won’t know for a couple of weeks. Check out the way you sleep and how you feel when you wake up. Changing your sleeping positions, if necessary, is one of the best ways to help your body.

  1. I’m curious to know what you think about pillows in general. For a long time I’ve been using and happy with one of those curved foam pillows that support the neck. I still like it when lying on my side but on my back I feel like it’s too high and straining my neck and upper back (though my sinuses like it!). Last night I slept without a pillow to see how it would work and my neck and back feel great this morning, but my arms and elbows were hurting whenever I slept on my side.

    • Life is such a pain. And sleeping correctly requires precision that isn’t necessarily available when the lights are out. You have the right ideas. Technically, when yoa re on your back you shouldn’t use a pillow because it throws off the alignment of the neck (though I love that it helps your sinuses). And not to be too neurotic, but on your side the pillow or pillows should be as thick as the exact distance between the bed and your ear with the both sides of the neck at even length.
      ps.I checked out your blog and like it a lot. Also I’d be curious to know what you think of Broads book when you read it.

  2. I have now for some time been sleeping without a pillow between my legs and I think I am now suffering from it.I regularly have tight hamstrings and inner hip tightness-you name it-I have got it.All because I am sure that what a wonderful physiotherapist told me years ago, I think is true.After sleeping with a leg pillow, I felt so much better!Over the years I have become lazy and not bothered with it and now am paying the price.I suddenly remembered this technique this morning and wish I had been doing it every single night!Oh well it is amazing how much one can throw your body off especially in the hips and legs.Tonight The pillow will go back between the legs!

  3. I have had sever right ankle pain as if the ankle is sprained or even if the achilles is damaged.
    This pain I believe was caused from my hips & lower back. (the doctors did not think it was, but I know how my body feels and what takes away the pain) My hips and buttock muscles were very tight and I had lower back pain, my muscles down the outside of my right leg are tight. I cramp in my hip muscles and also would get pins and needles in my foot depending on my body position.
    I know I sleep with my knees high up towards my chest or scissor type position sepperated and twisted. Perhaps this is why I have had the problems I have had, mixed in with other stresses I put on my lower back and side due to my heavy one sided work & exercise like running up hills etc. Treatments I have had have been chiropractic, physio, accupuncture, massage, podiatry, stretching, cupping and I have seen a sports medicine doctor, I have had a lower back cat scan and had my ankle ultrasounded. The back scan showed nothing of note, the ankle showed inflamation. I was given exercise to stretch the achilles, Whilst some of these treatments helped alivate some discomfort the issue did not go away. I had to stop my accupuncture & chiropractic due to costs. These treatments I was having at least once a week, they did give me some relief but I have not had treatment now for a month. This is also when I saw something a month ago on youtube that said put a pillow between your legs to sleep in a better position and aleviate back pain and thought I would give it a go as nothing else seemed to be working too well.
    This is the only thing I have been doing differently and my pain has definatly decreased in both my hips and lower back plus my ankle does not have the pain or discomfort or movement restricitons it has had for well over 2 years. I am hoping this keeps improving,it is only early days & i still have some discomfort but no where near what I have had. Some people my say all the medical treatments may have helped but until I used the pillow between my legs I had no relief. It has taken just over a month…amazing! I am booked in to see an ankle knee/specialist soon which I think will be a waste of money this was booked in over 3 months ago and I may cancel this or move it in the next week if things continue to improve? I am going to go back to accupuncture and chiro to see if things improve further along with the pillow between the legs and will report back. Give the pillow a go its a free easy treatment! PLus I will read this blog in more detail to see what else I might learn as all I read was these few posts re pillow wich I found in a search engine. :)

  4. I find it particularly helpful for people to have something between thighs AND ankles. Especially those with piriformis issues. With that foot hanging down, like in the picture above, it pulls and irritates.

  5. I can only sleep on my side. I’ve tried to sleep on my back, but I can’t. I developed knee pain and back pain. I tried a big pillow between my knees, but it made it hard to turn over, and woke me up. I tried a small pillow, but when I turned over, I lost it.

    So, I developed a pillow that is the perfect size, and stays put all night.

  6. I have only just become educated after 20 years of sleeping on my front that it is the cause of my long term neck pains… It is only because I av recently developed lower back pain aswel that I av started to evaluate why… I av now started to sleep on my back with my legs slightly raised (after months of struggling to do so) with no pillow….The problem now is that I’ve started to feel slight numbness in my glutes and i randomly feel a warmth in my anterior ankles, is this something I should be worried about (I’m the sort of person that just lives with things without complaint )

    • I am not a doctor, so I can’t answer that question. Have you considered trying to sleep on your side with a knee pillow? It couldn’t hurt to try another sleeping position to see how that effects you.

    • If you sleep on your back it is good to sleep without a pillow. If you sleep on your side you want to have a pillow that allows both sides of the neck to be equally long.

    • I just wrote a post the other day about sleeping with or without pillows. But I never heard about it making someone more flexible. But even if it doesn’t it is a safe thing to try.

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