The recovery process following a rotator cuff repair requires careful protection of the surgically repaired tendons, and the specialized sling provided after the procedure serves this purpose. Proper use of the sling is paramount because it limits specific movements that could re-injure the delicate repair site during the initial healing phase. Understanding how the sling functions, how to wear it correctly, and how to manage daily life while immobilized are all necessary steps to ensure a successful outcome. The guidelines for using the sling are designed to reduce tension on the newly secured tendons, allowing them to integrate fully with the bone.
Understanding Your Post-Surgery Sling
The type of sling used after rotator cuff surgery is chosen by your surgeon to minimize strain on the repaired tissue. The most common type is an abduction pillow sling, which is more advanced than a standard arm sling. This immobilizer includes a firm foam pillow that rests against the patient’s waist, holding the arm slightly away from the body, typically at a 10 to 15-degree angle of abduction.
This abduction position relaxes the supraspinatus tendon, often involved in rotator cuff tears, by taking pressure off the suture line. The sling’s primary function is to restrict movement, particularly internal rotation and extension, which could pull on the healing tendon. For patients with larger or more complex tears, the abduction pillow prevents the arm from falling into a harmful position that might compromise the repair.
Applying and Adjusting the Sling Correctly
Putting on and adjusting the post-surgical sling correctly often requires assistance, especially in the first few days. First, ensure the elbow is seated snugly into the corner pocket at the back of the sling to maintain the proper arm angle. The forearm should rest comfortably within the main pouch, with the wrist and hand secured by the appropriate straps. The thumb loop prevents the hand from sliding out, though some patients may remove this for comfort when permitted.
The neck strap must be adjusted so the hand is level with or slightly higher than the elbow, which helps prevent swelling in the forearm and fingers. A strap that is too loose is a common error, as it allows the arm to hang and puts unnecessary strain on the shoulder. For abduction slings, the waist strap must be secured tightly around the torso to hold the pillow firmly against the body without causing discomfort. This prevents the arm from rotating inward or moving away from the body, maintaining the immobilizer’s protective function.
Daily Management While Wearing the Sling
Navigating daily activities while wearing a sling requires modification of movement and careful technique to protect the shoulder. When dressing, always put the sleeve on the surgical arm first, using the non-operative arm to gently guide it. The reverse technique is used for undressing, where the unaffected arm is removed from the sleeve first. It is beneficial to wear loose-fitting clothing that buttons or zips in the front to simplify this process.
Maintaining hygiene requires careful planning. Patients are typically instructed to strip-wash or take a shower while keeping the surgical site dry. When showering, the sling is removed only while the arm is supported and kept close to the body, avoiding any lifting or reaching movements.
To manage comfort, patients should regularly check the skin under the straps for irritation or pressure points and can use a thin towel under the neck strap for padding. It is also important to perform gentle exercises for the elbow, wrist, and fingers several times a day, removing the arm from the sling briefly to prevent stiffness in these joints, as directed by the surgeon.
Sleeping can be challenging, but wearing the sling at night is required to ensure the arm remains immobile. Most patients find the most comfortable position is semi-reclined, either in a recliner chair or propped up in bed with several pillows. Using a pillow to support the operative arm slightly away from the body can help reduce pain and improve rest. During the initial phase, all lifting, pushing, or pulling motions with the operative arm must be avoided, even for light objects.
Timeline for Sling Use and Removal
The total duration of sling use is specific to the individual patient and depends on the size and complexity of the rotator cuff tear that was repaired. Generally, the sling is worn continuously for a period ranging from four to six weeks following the procedure. Patients with larger or more extensive repairs may require the sling for the longer duration to ensure the tendon has sufficient time to heal and securely attach to the bone.
During the initial phase, the sling is worn at all times, including while sleeping, and is only removed briefly for hygiene and specific prescribed exercises. The transition to partial sling use begins only after clearance from the surgical team, typically around four to six weeks post-surgery. At this point, the sling may be discontinued while at home for gentle activities, but it is often still recommended for use when leaving the house or in crowded areas. The gradual removal of the sling and the progression of movement are strictly governed by the physical therapy protocol.