How to Wear a Shoulder Sling

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.

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. 

To apply a shoulder sling correctly:

1. Gently pull the sling over your arm and elbow. It should fit snugly around the 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 your hand hangs at your wrist, your sling may be too small.
2. Reach around your neck and grab the strap behind your elbow. Pull the strap around the back of your neck and feed it through the loop near your hand.
3. Tighten the straps so your hand and forearm are elevated above the level of your elbow. This helps to prevent blood and fluid from pooling in your hand and wrist.
4. 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.
5. Some slings have a strap that goes around your back to keep the elbow close to the body. If it has one, reach behind and pull the strap around your back, fastening it near the hand. Make sure 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.

There are common mistakes people make when wearing a shoulder sling. If used incorrectly, a shoulder sling can cause discomfort and delay the healing process. Your physical therapist can help you avoid these pitfalls:

• The sling is too loose. If it's not supportive of your shoulder, elbow, and wrist, the sling won't keep your arm in place, and you may place unnecessary stress and strain on the arm. Make sure the sling supports your arm and forearm, and be sure your elbow is kept at a 90-degree angle. If your elbow is too straight, the sling may be too loose.

• The sling is too tight. This may restrict blood flow to and from your elbow and hand, depriving tissues of oxygen and damaging your arm, hand, and/or fingers. If you experience numbness, tingling, or swelling, or your hands and fingers feel cold or turn blue, see your doctor or physical therapist for an adjustment.

• Your arm is hanging too low. When wearing your shoulder sling, your arm should not hang too low. If it does, the weight of your arm may place increased stress and strain on your healing arm and shoulder. Plus, your arm may simply and suddenly fall out of the sling if it's hanging too low. Your elbow should be bent 90 degrees while you're wearing your sling, and the sling should support your arm firmly against your body without lifting. The shoulder shouldn't be lifted or dropped. If you aren't sure the sling is on properly, have your physical therapist make necessary adjustments.

• You're not exercising neighboring muscles. The goal of wearing your sling is to protect your shoulder and arm as it heals. This doesn't mean you shouldn't use some of the muscles of your arm and hand during recovery. Because the sling is designed to immobilize the shoulder, it can cause a decreased range of motion (ROM) and strength of your arm unless steps are taken to avoid it. During recovery, doctors will typically advise you to remove the sling and do no-impact pendulum circle exercises two to three times per day to maintain joint mobility. Handgrip exercises using therapy putty to create resistance can improve strength in your wrist and forearm.

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 a physical therapist for assistance.

Once the 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 return you the condition you were in prior to the injury.