Shoulder replacement surgery, or arthroplasty, involves resurfacing or replacing damaged joint components to relieve pain and restore function. Immediately following this procedure, the arm is placed in a specialized sling or immobilizer for early recovery. The sling’s primary function is to enforce immobilization, protecting the integrity of the newly implanted joint and any associated soft tissue repairs, such as the rotator cuff tendons. Preventing accidental movement or strain on the surgical site is paramount, as unsupported motion could compromise the repair or risk dislocation. This mandatory period of rest allows surrounding muscles and tissues to begin healing in a stable, protected environment.
Step-by-Step Guide to Proper Sling Application
Applying the post-operative sling requires minimal movement of the operative arm, often needing assistance. Begin by gently sliding the forearm and hand into the fabric pouch, ensuring the elbow is seated as far back into the pocket as possible. The elbow must be fully cradled to ensure the device bears the arm’s full weight, relieving strain on the shoulder joint.
Next, secure the main body of the sling using the neck or shoulder strap, which passes over the opposite shoulder and connects to the front of the pouch. If the sling includes a waist strap or swathe, wrap it around the torso and secure it to prevent the arm from swinging away from the body. Finally, secure any smaller attachments, such as the thumb loop or wrist restraints, to keep the hand fixed and supported within the pouch.
Essential Positioning for Optimal Recovery
Proper alignment dictates the quality of protection for the repair site. The sling should be adjusted so the elbow is bent at approximately a 90-degree angle, keeping the forearm relatively parallel to the floor. The hand must be supported at or slightly above the elbow level to prevent gravity from pulling the arm down, which creates tension on the shoulder capsule.
A common component of post-arthroplasty slings is an abduction pillow, a firm cushion that fastens between the arm and the torso. This pillow holds the arm slightly away from the body, often in 10 to 15 degrees of abduction, minimizing tension on repaired rotator cuff tendons. Ensure the wrist is fully supported within the pouch and not drooping, which indicates incorrect positioning or a loose neck strap. If the neck strap causes chafing, placing a small towel or padding beneath the strap can prevent irritation without compromising support.
Navigating Daily Life With the Sling
The sling must be worn continuously, day and night, for the initial recovery phase, typically lasting four to six weeks, or as directed by the surgeon. Temporary removal is restricted to specific, prescribed physical therapy exercises and personal hygiene. Always ensure the operative arm is supported by the non-operative arm or a stable surface before removal, as the shoulder muscles cannot yet bear the arm’s weight.
Dressing
Dressing requires a specialized technique to avoid stressing the shoulder joint. Always dress the operated arm first, sliding the garment gently up the arm before pulling it over the head and feeding the non-operative arm through. When undressing, the sequence is reversed: remove the garment from the non-operative side first, then pull it over the head, and finally slide it off the operative arm.
Hygiene and Bathing
For bathing and hygiene, strip washing is recommended to keep the incision clean and dry, as full showers may be restricted. To wash under the armpit without moving the shoulder, gently lean forward and allow gravity to slightly open the space, facilitating cleansing with a washcloth or wipe.
Sleeping
It is often recommended to sleep in a semi-reclined position, such as in a recliner or propped up in bed, to prevent accidentally rolling onto the surgical site. When lying down, placing a small rolled towel or pillow under the upper arm or elbow helps maintain the correct, protected alignment and prevents the shoulder from internally rotating.