How to Properly Wear a Sling on Your Shoulder

If you have suffered an injury to your shoulder, elbow, or wrist, you may be required to wear a sling on your arm to help protect it while things are healing. Wearing a sling keeps your arm against your body and prevents you from moving your arm too much as you heal after injury. Improperly wearing your sling may delay your healing or, worse, injure your arm further.

So what is the proper way to wear a sling on your arm? How do you put on your sling and make sure you are wearing it properly?

There are many instances where you may be required to wear your arm in a sling after injury. These include:

• After a fracture: A shoulder fracture, elbow fracture, or wrist fracture may require that you wear a sling. It is important after a fracture to immobilize your arm to ensure that the bones heal properly. The sling keeps your arm still and in place to be sure this occurs.
• After shoulder surgery: If you have had a surgical procedure on your shoulder, you may need a sling to prevent the muscles around your shoulder from contracting too hard and disrupting the healing process. After a rotator cuff surgery, a forceful contraction of your muscles can tear the repaired muscle. The sling prevents this from occurring.
• After a stroke: A stroke is a serious injury. It may cause paralysis in your arm, leg, or both. If your shoulder is not moving properly, it may become painful as it hangs at your side. A sling helps support your arm and prevents it from pulling uncomfortably at your shoulder.

Any injury or surgical procedure to your upper extremity may require that you wear a sling as things are healing. Make sure you follow your doctor's advice when wearing your sling.

If you are required to wear a sling, it is important that you wear it properly. This helps to prevent fluid and blood from accumulating in your hand and wrist. Proper sling usage can ensure that your arm heals the right way. You also want to be comfortable while wearing the sling, and putting it on properly can ensure maximum comfort.

Here’s how you put on the sling

1. Gently pull the sling over your arm and elbow. It should fit snugly and comfortably around your elbow. Your hand should come to the very end of the sling. Make sure the end of the sling doesn’t cut into your wrist or hand; if you hand hangs down at your wrist, your sling may be too small.
2. Reach around your neck and grab the strap that is attached to the sling behind your elbow. Pull the strap around the back of your neck and feed it through the loop in the sling that is near your hand. Pull the strap through and tighten it so that your hand and forearm are pulled up above the level of your elbow. This helps to prevent blood and fluid from pooling in your hand and wrist.
3. Fasten the strap with the Velcro fasteners. You may wish to put a small piece of terry cloth under the strap for comfort around your neck.
4. Some slings have a strap that goes around your back as well. This prevents you from lifting your elbow away from your body. If your sling has this strap, reach behind your back and grab it. (It is usually attached to the sling near your elbow.) Pull the strap around your back and fasten it to the sling near your hand. Make sure that the strap is not too tight. You should be able to fit two or three fingers between your body and the strap of the sling.

Your sling should fit comfortably and not feel binding or tight. It needs to offer support while allowing you to go about your day-to-day activities.

There are a few common mistakes that people make when wearing a shoulder sling. Avoiding these should be a priority; failure to wear your sling properly can result in discomfort or a possible delay in your healing process. Your physical therapist can help you avoid these pitfalls with your sling.

 Common mistakes when wearing a sling may include:

• Your sling is too loose. When wearing a sling, it needs to be supportive for your shoulder, elbow, and wrist. If your sling is too loose, it won't keep your arm in place, and you may be placing unnecessary stress and strain on the arm. Make sure that it supports your arm and forearm, and be sure your elbow is kept at a 90-degree angle. If your elbow is too straight, it may indicate that your sling is too loose and not doing what it should be doing.
• Your shoulder sling is too tight. When wearing your shoulder sling, you must ensure that it is not too tight. Wearing your sling too tight may restrict blood flow to and from your elbow and hand. Restricted blood flow may cause damage to your arm by depriving the tissues of oxygen and nutrients. If your sling is too tight, it may also prevent fluid in your elbow and hand from entering the venous return system. This may cause your hand, elbow, and forearm to look swollen and puffy. Signs that your sling may be too tight include swelling in your fingers, hand, forearm, or elbow, or numbness or tingling in your hand or fingers. Discoloration from bruising of your hand and fingers may also occur if your sling is too tight. If you suspect that you sling is too tight, visit with your doctor or physical therapist to have your sling properly adjusted.

When you are wearing the sling, your muscles around your shoulder, elbow, and wrist should be relaxed. Many doctors and physical therapists recommend removing the sling and doing pendulum exercises two to three times per day to help maintain gentle mobility in your arm as it heals. Speak with your doctor to see if this is appropriate for your condition.

The sling is designed to immobilize your arm. One of the detriments of immobilization is that it may cause decreased range of motion (ROM) and decreased strength in your arm. This could lead to loss of functional use of your arm. Once your injury has healed, you may need to consult with a physical therapist to learn exercises to help improve the ROM and strength in your arm. Improving your mobility can help you recover normal upper extremity function once you are fully healed.

Wearing a sling can cause a bit of anxiety with all of its straps and loops. With practice, you will be able to comfortably wear it to allow your arm to properly and safely heal. If you feel like you need more help with your sling, be sure to contact your local physical therapist for assistance.