The use of a shoulder sling following surgery is a deliberate medical step to ensure the integrity of the repair site and facilitate optimal healing. The primary function of the sling is to maintain continuous, comfortable immobilization, which protects the surgical repair from accidental movement that could compromise the procedure’s success. The specific type of sling, such as a basic arm sling or an abduction pillow sling, is determined by your surgeon based on the nature of your operation. These instructions offer general guidance but must always be confirmed by the specific orders provided by your medical team.
Step-by-Step Guide to Donning the Sling
Putting on the sling can be a challenge initially, and having a helper present for the first few days is strongly advised. Begin by ensuring the arm is relaxed and fully supported by your non-operative hand or a stable surface, keeping the shoulder muscles completely passive. If using an abduction sling, first position the foam pillow component high on your ribcage, directly at your side.
Next, gently slide the elbow of your operative arm as far back as possible into the deepest corner of the fabric pouch. Seating the elbow is important for the sling to carry the weight of the forearm, preventing unnecessary strain on the shoulder joint. Once the elbow is seated, lay your forearm and wrist across the length of the sling, ensuring it is flat and well-cradled.
The final step involves securing the straps, starting with the main shoulder strap that loops over the opposite shoulder and clips into the front of the sling. Adjust this strap so the arm is held snugly against your body at the proper angle, usually with the elbow bent at approximately 90 degrees. If a waist strap is included, wrap it around your torso and secure it to the sling to limit arm movement away from the body. Secure any smaller straps, like the thumb or wrist loop, to prevent the hand from slipping out.
Ensuring Proper Fit and Alignment
Once the sling is on, proper alignment must be verified. The elbow must remain fully seated in the deepest part of the pouch so that the entire forearm is supported by the sling, not just the wrist. A common error is allowing the wrist or hand to hang below the level of the elbow, which indicates the neck strap is too loose and is pulling down on the shoulder joint.
The hand should be positioned at or slightly above the elbow, with the forearm generally parallel to the floor, to maintain the prescribed 90-degree elbow angle and prevent gravitational pull on the shoulder. For an abduction sling, the pillow must rest firmly against your side, maintaining the required angular separation of the arm from the body to protect the surgical site. The waist strap keeps the pillow securely in place.
Circulation and nerve function must be checked regularly to prevent complications from excessive strap tightness. Look for signs such as persistent tingling, numbness, a cold sensation, or a change in the color of your fingers (pale, blue, or dusky). If the shoulder strap causes discomfort or cuts into your neck, try using padding underneath it to distribute the pressure more evenly. Immediate adjustment or consultation with your medical provider is necessary if signs of compromised circulation persist.
Managing Daily Life: Hygiene and Sleep
The sling must be worn continuously unless your surgeon specifically instructs otherwise for physical therapy or approved hygiene routines. When bathing, you must keep the surgical incision site completely dry, often requiring sponge baths or showering with a waterproof wound dressing. If you are permitted to temporarily remove the sling for washing, keep the operative arm tucked securely against your torso, supporting it with your non-operative hand to prevent uncontrolled movement.
Skin care is important under the straps and pillow, as moisture or pressure can lead to irritation. Check the skin daily for signs of redness, chafing, or rash, and ensure the areas are clean and dry before re-donning the sling. Dressing requires a modified technique: always put the shirt on the operative arm first, followed by the non-operative arm. Undressing follows the opposite sequence, removing the garment from the uninjured arm first to minimize movement of the healing shoulder.
Sleeping comfortably with a sling requires modifying your position to ensure the arm remains supported and protected. The safest position is sleeping on your back, often with your upper body slightly elevated using a recliner or several pillows. Placing a small pillow beneath the sling or behind the elbow can further support the arm and prevent accidental shifting during the night. Avoid sleeping on the operative side entirely; if sleeping on your side, rest only on the non-operative side with a pillow placed under the arm for stabilization.