A shoulder sling with a pillow, often called an abduction pillow sling, is a specialized orthopedic device prescribed after shoulder surgeries or severe injuries. Its primary function is to immobilize the arm and shoulder joint, preventing movement that could disrupt healing. The integrated pillow holds the upper arm away from the body, typically at a 10 to 45-degree angle of abduction. This position minimizes tension on repaired soft tissues, such as the rotator cuff, helping maintain the shoulder capsule in a relaxed state during recovery.
Identifying the Components and Setup
Before applying the device, identify its main components and check the sizing. The system consists of the forearm envelope (the soft pouch for the arm) and the abduction pillow (a firm foam wedge that sits against the torso). These parts are usually connected by hook-and-loop fasteners, allowing for minor adjustments.
The device is secured by two primary straps: the shoulder strap, which loops over the neck and opposite shoulder, and the waist strap, which wraps around the back and clips to the pillow. Many slings also include a thumb loop or wrist strap to stabilize the hand and prevent the arm from sliding out. To ensure the correct fit, measure the length from the elbow crease to the base of the index finger, as this measurement often corresponds to the sling size.
Detailed Steps for Applying the Sling and Pillow
The application process begins by correctly positioning the pillow against the torso on the injured side. The curved side of the pillow should fit snugly against the waistline, projecting forward. Next, carefully slide the injured forearm into the envelope, ensuring the elbow is seated deeply into the back corner of the sling pocket.
Once the arm is resting comfortably, secure the waist strap by wrapping it around the back and clipping the buckle at the front of the pillow. This strap immobilizes the pillow and the shoulder joint against the body.
Bring the shoulder strap over the unaffected shoulder and attach it to the front of the sling. Adjust the strap length so the forearm is level or slightly elevated relative to the elbow. The elbow should be bent at a 90-degree angle to take stress off the shoulder joint and promote a neutral arm position.
Finally, if your sling includes one, secure the thumb loop or wrist strap to keep the hand stable. This ensures the arm is fully supported before the straps are tightened to maintain the prescribed abduction angle.
Ensuring Proper Fit and Comfort
After application, several checks ensure the sling is fitted correctly for healing and comfort. Verify the arm is held at the angle prescribed by your physician, typically between 10 and 45 degrees of abduction, with the elbow bent to 90 degrees. A poorly adjusted shoulder strap can cause the hand to hang too low, leading to swelling or discomfort in the wrist and fingers.
Regularly check circulation in the injured arm. Signs of poor circulation include numbness, tingling, or a change in the color or temperature of the fingers. If these occur, the straps may be too tight and should be loosened slightly. To relieve neck strain, ensure the padded section of the shoulder strap is positioned over the collarbone and neck area.
The waist strap must be snug enough to prevent the pillow from shifting but should not restrict breathing or cause discomfort around the ribs. The goal is a fit that securely immobilizes the shoulder without creating pressure points or cutting off blood flow. Small adjustments help achieve the balance between therapeutic immobility and prolonged comfort.
Removing the Sling and Maintaining Hygiene
The sling should only be removed for hygiene, dressing, or prescribed exercises, and only with the approval of a medical professional. The safest removal technique involves releasing the straps in order while supporting the injured arm with the unaffected hand.
Removal Steps
- Begin by unfastening the thumb loop or wrist strap.
- Unbuckle the shoulder strap.
- Next, unbuckle the waist strap that secures the pillow around the torso.
- While continuing to support the injured arm, gently slide the arm out of the forearm envelope.
Supporting the arm throughout the removal process is important to prevent sudden, uncontrolled movement that could compromise the surgical repair.
Maintaining Hygiene
The fabric components of the sling should be cleaned regularly, as prolonged wear can lead to moisture buildup. Manufacturers recommend hand-washing components, such as the forearm envelope, using a mild detergent and cold or lukewarm water. Rinse thoroughly to remove all soap residue and allow them to air dry completely. Machine-washing, bleaching, or using a dryer is not advised, as it can damage the materials and compromise the device’s structural integrity.