What the Experts Recommend  

“Our bodies are designed to move but also require balance. Just as too much standing or too much sitting can catch up with us throughout our waking hours, too much time spent in one sleeping position may cause issues as well,” says Terra Botha DC, ACP, Regional Clinical Supervisor at Airrosti Dominion.  
 
“Ideally, individuals should strive to lay on their back 50% of their sleep with a pillow under their knees, if needed to improve comfort. Next, 25% should be spent laying on the right side, and 25% on the left side, using pillow supports between the knees and elbows.” 

That may sound complicated; however, each sleep cycle lasts around 90 minutes, and our bodies naturally shift positions multiple times throughout the night. By being mindful of how you fall asleep and using supportive pillow placements, you can train your body to adopt better sleep habits over time.  

A balanced combination of back and side sleeping can help reduce pressure on the spine and joints, promote healthy circulation, and minimize the risk of waking up with stiffness or discomfort. Just like good posture during the day, balanced sleep posture plays a key role in maintaining long-term musculoskeletal health. 

Now, Let’s Have Some Pillow Talk 

We all have a comfort preference when our head hits the pillow, from soft and feathery to dense and firm, but your pillow impacts far more than just your head’s comfort. While sleeping positions greatly impact your body’s comfort and quality of sleep, their effectiveness begins with the right pillow. 

For every position, the neck should be aligned with the spine, ideally with the hips, shoulders, and ears in a line; however, pillows are not a one-size-fits-all solution. Here are a few tips to help you find the right pillow based on your sleeping position:

Back Sleepers: 

If you sleep on your back, it’s important that your pillow is not too high.  

• A pillow of medium height that supports the natural curvature of your neck is best – especially cervical/contour pillows. These pillows are designed with a roll under the neck which further supports the cervical spine. 

• Place the higher side under the neck with the lower side under the head to reduce strain of the neck and shoulders. 

• Medium firmness is ideal. Regularly check pillow firmness as it should be neither too hard nor too soft to provide proper support. 

• Memory foam is preferred, as it offers additional support by conforming to your natural shape

Side Sleepers: 

A thicker, taller pillow is most optimal for alignment if you sleep on your side. 

• A very firm pillow is ideal. 

• Avoid pillows that are too low or too high as heights can affect the curves of the spine. High pillows can elevate the head too much, causing strain to the neck. 

• Cervical/contour pillows are also recommended for support of the neck which further supports the cervical spine. A rolled-up hand towel placed under the neck is also an option to fill the space between the shoulders and head.  
• Memory foam is preferred, offering additional support by conforming to your natural shape

Stomach Sleepers: 

A very thin pillow or no pillow at all is the best option to avoid strain to the neck. 

• If using a pillow, a very soft pillow is ideal as twisting the neck puts pressure on your nerves. 

Regardless of your pillow type, be sure to monitor the wear and tear that occurs over time and replace it when appropriate. 

If you are experiencing muscle or joint pain as a result of uncomfortable sleep, schedule  an appointment with an Airrosti Provider. Our Providers seek to resolve injuries at the source to help bring fast, effective relief. In addition, Airrosti Providers supply the tools and resources needed to help you address problem areas as they appear so you can keep doing the things you love pain free. 

We offer in-clinic and telehealth appointments. Schedule below or call us at (800) 404-6050 for more information! 

It’s easy to overlook considering today’s countless footwear options, but your athletic shoes can determine how your body feels day by day. Footwear directly influences how your body absorbs impact, how efficiently you move, and how much stress affects your joints. A poorly structured or worn-out shoe is not only uncomfortable, but can also subtly shift your body’s mechanics, contributing to issues such as plantar fasciitis, knee pain, or even low back tension over time. 

Now, the right shoe won’t fix every problem, but as the primary foundation of support, shoes are vital to promote healthy movement. Proper shoes should support your natural movement, reduce unnecessary strain, and help your body move the way it was designed to move. When lower body discomfort appears, your shoes are one of the first places we recommend looking at as a potential cause. 

With so many athletic footwear styles available – minimalist, cushioned, zero-drop, stability, and many more – how do you know what best fits your feet and lifestyle?  

Three Key Considerations When Choosing Supportive Footwear 

1. Your Primary Activity Should Determine the Structure of Your Shoe 

Running: Look for shoes that offer shock absorption, responsive cushioning, and a secure fit around the midfoot. A proper heel-to-toe drop (typically 4–12mm) can also help maintain efficient running mechanics. 

Walking or standing all day: Choose shoes with firm arch support, a roomy toe box, and structured heel support to reduce fatigue and improve alignment. 

Strength training: A flatter, more stable base is the best option. Shoes with minimal cushioning and low heel drop help with balance and force transfer during lifts. 

Trail or outdoor use: Durable uppers (everything above the sole), deeper tread, and reinforced toe caps can protect against uneven terrain and tripping hazards. 

2. It’s Important to Identify Your Foot Shape and Gait Pattern Before Shopping 

People with flat feet or overpronation (where the foot rolls inward excessively) often benefit from stability or motion control shoes. 

Those with high arches may experience more stress upon impact and should look for extra cushioning to absorb shock. 

Pro Tip: Check your shoe’s inner lining and sole. If there’s uneven wear or spots where the cushioning is compressed, it can give you clues about your foot’s natural motion and where you might need extra support. 

3. Choose Fit and Comfort Over Design 

Fit matters much more than brand or design. Shoes should feel snug but not tight, with room to wiggle your toes, while avoiding slippage in the heel.  

Pro Tip: Try shoes on at the end of the day when your feet are slightly swollen to ensure they won’t feel tight during activity. 

Even With the Right Shoes, You May Still Have Questions… 

1. Do Shoe Inserts (Orthotics) Make a Difference? 

Orthotics, or shoe inserts, are commonly used to relieve pain and improve alignment. There are two main types: 

• Prefabricated orthotics are mass-produced and designed to address common issues like arch support, plantar fasciitis, or heel pain. 

• Custom orthotics are molded specifically to your feet and gait, usually prescribed by a podiatrist or specialist. 

While it’s reasonable to assume custom equals better, research suggests otherwise. This review published by the Canadian Agency for Drugs and Technologies in Health found that custom orthotics were no more effective than high-quality, over-the-counter alternatives in reducing pain or improving function over time.  

That doesn’t mean orthotics aren’t helpful. It just means orthotics are not a one-size-fits-all solution often portrayed in marketing. If you experience foot fatigue, arch pain, or recurring joint discomfort, trying a prefabricated insert may be a good first step.  

2. How Can I Tell When It’s Time to Replace My Shoes? 

Even the best shoes eventually wear out. Worn shoes no longer support your movement in healthy ways and can even increase pain and stress in your lower body. We recommend keeping tabs on the wear on your shoes and proactively replacing them before they begin to cause issues.  

Common Signs Your Shoes Need Replacement: 

• Mileage: Running or walking shoes typically last between 300–500 miles. For someone who runs 20 miles a week, that’s about 4–6 months. 

• Midsole breakdown: If the foam feels flat or unresponsive, or you notice new aches in your feet, knees, or back, it may be time to replace them. 

• Uneven tread: Worn down tread can alter your gait and increase your injury risk, so pay attention to the bottom of your sole. 

• Pain: If discomfort creeps in during or after activity, your footwear could be the culprit. 

Pro Tip: Rotate between multiple pairs of shoes. Giving shoes time to recover between usage extends their lifespan and improves performance. The variety also exposes your body to slightly different movement patterns, reducing repetitive stress. 

3. When Should I See a Professional? 

If pain continues despite good shoes and smart inserts, don’t wait!  

Sometimes, even the right shoe or insert isn’t enough. If you’re experiencing persistent pain in your foot, knee, hip, or back, even after changing footwear, it’s a sign something deeper may be going on. 

In the case of lower body pain, that might include tight calves contributing to plantar fasciitis, poor ankle mobility affecting your stride, or hip muscle imbalances leading to knee strain. 

Step into Comfort and Confidence  

While we all want our shoes to look great, the most important role they play is in supporting healthy movement. By aligning your footwear choice with your activities, foot shape, and desired fit, you’re setting the foundation for healthier, pain-free movement.  

Remember to listen to your body if your shoes are still leaving you with aches or soreness. The sooner you tackle the root cause of pain, the faster you’ll get back to feeling great and doing what you love. 

Flex, a new, comprehensive digital wellness program, puts the power of muscle and joint health in its user’s hands. As a first dollar coverage benefit, Flex can substantially reduce the costs of musculoskeletal (MSK) treatment – traditionally one of the most expensive healthcare categories – while expediting a return to normalcy and work.  

Launched in January from Airrosti – the national healthcare group that specializes in outcome-based MSK care – Flex equips users with customized, on-demand exercise programs designed to achieve wellness goals by enhancing mobility and reducing pain. The self-guided app allows users to employ their own MSK digital therapy anytime, anywhere (results can be achieved in just 10 minutes a day) through tailored, independent strategies easily followed on the Flex platform.