Following a shoulder dislocation and joint realignment, the immediate recovery period focuses on protection and initial healing. The most direct answer to whether you should sleep with a sling on is yes, for the initial phase of recovery as directed by a healthcare professional. Wearing the sling at night is a protective measure that significantly reduces the risk of re-injury while the joint’s supporting structures begin to heal.
The Necessity of Nighttime Immobilization
The shoulder joint is the most mobile joint in the human body, making it inherently unstable following a dislocation. When the humerus is forced out of the socket, surrounding soft tissues, including the labrum, ligaments, and joint capsule, are stretched or torn. Immobilization is required to allow these damaged structures to heal without strain.
The primary reason to wear a sling while sleeping is to provide passive stability to the newly reduced joint. While awake, you can actively protect the shoulder from sudden movements, but sleep introduces unpredictable elements. Unconscious movements, such as rolling over, can place rotational forces on the healing joint capsule, potentially leading to a re-dislocation.
The sling acts as a restraint, preventing the arm from moving into positions of instability, particularly external rotation and abduction. Immobilization for the first one to three weeks is recommended to encourage the initial formation of scar tissue and allow the joint capsule to tighten. Studies indicate that unprotected sleep could expose the joint to movements that disrupt the early healing process of the injured soft tissues.
Optimal Sleeping Positions for Comfort and Safety
Finding a comfortable position for sleep remains a challenge after a shoulder dislocation, even with the sling providing stability. The most recommended position for the initial recovery phase is to sleep semi-reclined, as this minimizes pressure and prevents rolling onto the injured side. Sleeping in a recliner chair or propped up in bed with a wedge pillow or several pillows is advised.
An incline of approximately 45 degrees helps keep the shoulder elevated and in a neutral, protected position throughout the night. It is safest to sleep on your back, but if side sleeping is necessary, always position yourself on the uninjured side. Place a pillow lengthwise along your back to create a barrier that physically prevents you from rolling over onto the affected shoulder.
Using additional pillows can enhance comfort and protection. A small pillow placed beneath the injured elbow or forearm helps support the weight of the limb and prevents the shoulder from rotating inward or outward within the sling. This focused support ensures the arm remains slightly elevated and in the prescribed position, which can also help manage swelling and pain.
Knowing When to Stop Using the Sling
The duration for which you must wear the sling depends on the severity of the injury and the specific instructions of your treating physician. For a first-time anterior shoulder dislocation, continuous immobilization typically lasts between one to three weeks to allow for early capsular healing. Younger patients, who have a higher risk of recurrent dislocation, might be advised to maintain sling use for a longer period.
The transition away from the sling must be gradual and supervised after the initial immobilization phase. Your doctor or physical therapist will determine readiness based on reduced pain, the start of passive range-of-motion exercises, and evidence of initial tissue healing. You should never remove the sling for sleep until you have received explicit clearance from your healthcare provider.
The weaning process usually involves removing the sling during the day for prescribed exercises while still wearing it at night for protective function. This nighttime protection may continue for several weeks after daytime use has stopped, as it guards against unpredictable movements during deep sleep. A structured rehabilitation program focusing on strengthening the rotator cuff and stabilizing the scapula follows the immobilization period and is the long-term solution for restoring joint stability.