The purpose of a sling immediately following shoulder surgery is to provide immobilization and support for the recovering joint. The sling secures the arm and prevents unwanted movement, which protects the surgical repair and allows soft tissues to heal. Proper application ensures the shoulder remains in the correct anatomical position and optimizes the entire recovery process. Wearing the sling as directed by the surgeon, typically for several weeks, is essential for a successful outcome.
Preparing the Arm and Body for Application
Before applying the sling, sit upright in a comfortable and stable position, such as a chair with armrests. Support the operated arm on a pillow or stable surface, like a table, to reduce strain during the transition. Having a helper for the first few days after surgery is highly recommended, as manipulating the arm with one hand can be challenging and risky.
Lay out all components of the sling, including the arm pouch, shoulder strap, and any waist or abduction pillow attachments. Wear loose-fitting clothing that buttons or zips in the front to avoid pulling garments over your head. Preparing the area minimizes the need for sudden movements, protecting the surgical site from unnecessary stress.
Step-by-Step Sling Application
Gently place the operated arm into the sling pouch while keeping the shoulder relaxed. The elbow should be seated all the way into the back corner of the sling pocket to ensure the forearm is fully supported along its entire length. If the sling includes an abduction pillow, position the pillow against the torso on the operated side, then rest the forearm onto the pillow.
Next, secure the wrist and hand within the pouch, ensuring the arm is bent at approximately a 90-degree angle at the elbow joint. Fasten any separate strap or closure that secures the forearm to the pillow or pouch. The hand should be cradled so the material does not dig into the wrist, and the fingertips should be slightly visible at the end of the sling.
Thread the shoulder strap over the opposite, non-operated shoulder and buckle it at the front. Adjust the length until the arm is comfortably supported without the shoulder shrugging. For abduction slings, a waist strap wraps around the body and attaches to the pillow to hold the assembly firmly against the side, which should be buckled and tightened last. Use the non-operated hand to maneuver the straps and buckles, keeping the surgical shoulder completely passive.
Checking for Proper Fit and Alignment
Checking the fit after application prevents complications and ensures optimal healing. The hand and fingers should be positioned slightly higher than the elbow. This helps encourage venous return and reduces swelling in the hand. If the hand sags below the elbow, tighten the shoulder strap.
The elbow must remain fully seated in the deepest part of the sling to ensure the entire weight of the arm is borne by the device, not the shoulder muscles. A correct fit holds the arm close to the side in a neutral position, avoiding excessive rotation or movement away from the body. If a waist strap is used, ensure it is secure but not restrictive; two or three fingers should fit between the strap and your body.
The neck strap must support the arm’s weight without digging into the neck or causing discomfort. To enhance comfort, place a folded washcloth or pad underneath the strap where it rests on the neck. Regularly check the fingers for normal color, temperature, and sensation to confirm that circulation is not impeded by the sling or its straps.
Daily Management and Safety Precautions
The sling must be worn continuously, day and night, only being removed for specific exercises or personal hygiene as permitted by the surgeon. When sleeping, use a reclined position, such as a recliner chair or propped up in bed with pillows, as lying flat can increase discomfort and put pressure on the shoulder. Wearing the sling prevents unconscious movements that could compromise the surgical repair.
For bathing, you may be instructed to carefully remove the sling, but the arm must remain still and supported against the body or on a stable surface. When dressing, put clothing on the operated arm first and take it off last to minimize movement of the shoulder joint. Keep the sling clean through spot cleaning or by using a spare, based on the surgeon’s recommendation.
Watch for signs of complications: increased pain not managed by prescribed medication, severe or sudden swelling in the hand, or persistent numbness or tingling in the fingers. Monitor for skin irritation or breakdown under the straps. Any unexpected change in sensation, color, or temperature in the fingers warrants immediate contact with the healthcare provider.