Wearing a Shoulder Sling Properly

After an injury to your shoulder, elbow, or wrist, you might need to wear a sling on your arm to protect it while healing.

The shoulder sling keeps your arm against your body. It prevents you from moving your arm too much as you heal after an injury. If you wear it the wrong way, you might delay healing or injure your arm more.

This article goes over when you need a shoulder sling, how to wear it correctly, and mistakes to avoid.

Common Reasons for a Sling

There are many instances where you may need to keep your arm in a sling after an injury. These include:

• After a fracture: If you have a shoulder fracture, elbow fracture, or wrist fracture, it's important to limit your arm movements to help bones heal properly. The sling keeps your arm still and in place.
• After shoulder surgery: You may need a sling so the muscles around your shoulder don't contract too hard and disturb the healing process. After a rotator cuff surgery, using your muscles too vigorously can tear the repaired muscle. The sling prevents this from happening.
• After a stroke: A stroke is a serious injury and can cause paralysis in your arm, leg, or both. If your shoulder isn't moving correctly, it may become painful as it hangs at your side. A sling helps support your arm and doesn't let it pull uncomfortably at your shoulder.

Your healthcare provider might advise you to wear a sling as your body heals from other upper-body injuries or surgeries, too.

How to Wear Your Sling

If you must wear a sling, it's important to wear it the right way to prevent fluid and blood from pooling in your hand and wrist and make sure your arm heals well.

To put on a shoulder sling correctly:

1. Gently pull the sling over your arm and elbow. It should fit snugly around the elbow. Your hand should be at the very end of the sling. The end of the sling shouldn'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 push it through the loop near your hand.
3. Tighten the straps to keep your hand and forearm elevated above the level of your elbow. This keeps blood and fluid from pooling in your hand and wrist.
4. Attach the strap with the Velcro fasteners. You might want to put a small piece of soft cloth under the strap to make it more comfortable around your neck.
5. Some slings have a strap that goes around your back to keep the elbow close to the body. If yours has one, reach behind to pull the strap around your back and fasten it near your hand. Make sure the strap isn't too tight. You should be able to fit two or three fingers between your body and the strap of the sling.

Common Mistakes

There are common mistakes people make when wearing a shoulder sling. If you use it the wrong way, it can cause discomfort and slow down the healing process. Your healthcare provider or physical therapist can help you avoid these pitfalls.

Sling Is Too Loose

If the sling doesn't support your shoulder, elbow, and wrist, it won't keep your arm in place. This can put unnecessary stress and strain on your arm.

Make sure the sling supports your arm and forearm, and keep your elbow at a 90-degree angle. If your elbow is too straight, the sling may be too loose.

Sling Is Too Tight

A sling that's too tight may limit blood flow to and from your elbow and hand. This blocks oxygen from getting to your tissues and can damage your arm, hand, or fingers.

Ask your healthcare provider or physical therapist to adjust your sling if your arm, hand, or fingers:

• Feel numb
• Tingle
• Swell
• Feel cold
• Turn blue

Arm Is Hanging Too Low

When you wear your shoulder sling, your arm shouldn't hang too low. If it does, the weight of your arm may put more stress and strain on the healing arm and shoulder. Plus, your arm may suddenly fall out of the sling if it's hanging too low.

Keep your elbow bent at 90 degrees while you wear your sling. The sling should support your arm firmly against your body without lifting. Your shoulder should be in a stable and neutral position, not higher or lower than normal.

If you're not sure if the sling is on properly, ask your healthcare provider or physical therapist to adjust it.

You're Not Exercising Neighboring Muscles

The goal of your sling is to protect your shoulder and arm as it heals. But you should still use some of the muscles of your arm and hand during recovery.

The sling is designed to limit your shoulder mobility. Because of that, it can decrease your arm's range of motion (ROM) and strength — unless you take steps to avoid that.

During recovery, your healthcare provider might tell you to take off the sling and do no-impact pendulum circle exercises two to three times per day. This helps keep your joints mobile.

Also, handgrip exercises with therapy putty can provide resistance and help your wrist and forearm get stronger.