How to Wear a Shoulder Sling After Surgery or Injury

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To wear a shoulder sling properly, bend the elbow to about 90 degrees and tuck it fully into the back of the pouch. Rest the forearm across your body with the wrist and hand slightly higher than the elbow, and the hand supported to the end of the pouch. The strap should sit on the side of the neck with padding, and the shoulder should rest level, not hitched up or dragged down. Your surgeon’s or doctor’s instructions come first, especially after surgery.

After surgery a sling protects the repair; after an injury it mainly eases pain. If yours has a small pillow that holds the arm away from the body, wear it the way your surgical team showed you.

Key takeaways

  • Elbow: bent to about 90 degrees and tucked into the back of the pouch.
  • Hand and wrist: slightly higher than the elbow and supported, which helps limit swelling in the hand.
  • Strap: padded where it crosses the side of the neck, adjusted so the shoulder rests level.
  • Checks: look at the hand’s color, warmth and swelling several times a day, especially in the first 48 hours.
  • Keep moving: fingers, wrist and usually the elbow need regular movement unless you have been told otherwise.
  • Surgeon first: how long, when to take it off and which movements are allowed vary with the operation.

Setting it up

  • Sit down first: sit in a chair with the forearm resting on a pillow on your lap, so the arm is supported throughout.
  • Slide the pouch on: ease the pouch under the forearm from the hand end, then bring the elbow fully into the back corner.
  • Bring the strap around: pass the strap behind your neck and fasten it with your good hand, keeping the sore arm relaxed.
  • Set the height: adjust the strap until the elbow sits at about 90 degrees and the hand is about 2 to 5 cm (1 to 2 inches) higher than the elbow.
  • Pad the neck: place the strap pad, or a folded soft cloth, where the strap meets the side of the neck. It should not press on the bony point at the back of the neck.
  • Check in a mirror: both shoulders should look level, and the wrist should not bend over the edge of the pouch.
  • Waist strap: if your sling has one, fasten it snugly enough to stop the arm swinging, loose enough to slide a flat hand underneath.

Taking it off is the same in reverse: sit, support the forearm on the pillow, undo the strap, then slide the pouch away.

Daily checks

  • Color and warmth: compare the hand with the other hand. Both should be a similar color and temperature.
  • Nail check: press a fingernail until it turns pale, then let go. The color should return within about 2 seconds.
  • Swelling: some swelling of the hand is common in the first days. Remove rings before surgery or as soon as possible after an injury.
  • Skin: check under the strap and in the armpit once a day. A thin, dry cloth in the armpit absorbs sweat.

Dressing, showering and sleeping

  • Dressing: loose, button-front tops are easiest. Put the sore arm in first and take it out last, without lifting it. Some people wear a loose top over the sling at first.
  • Showering: many surgeons allow the sling off in the shower with the arm kept by your side. Keep the wound dressing dry as your surgical team advises, and sit on a shower chair if you feel unsteady.
  • Sleeping: many people sleep propped up for the first weeks, with the sling on in bed if the surgeon advises it and a pillow behind the elbow. See how to sleep with shoulder pain for positions.
  • Keeping the rest of the arm moving: open and close the hand about 10 times, and bend and straighten the wrist, several times a day. Straighten the elbow out of the sling a few times a day if you have been told you can.

The sling holds the arm so the shoulder does not have to. Your fingers, wrist and elbow still need to move.

Common mistakes

  • Wrist hanging over the edge: the hand drops, swelling collects, and the wrist aches.
  • Strap too long: the arm sits low, the elbow slips out of the back, and the neck takes the weight.
  • Strap too short: the shoulder hitches up toward the ear and the neck muscles tire within hours.
  • Using the arm too early after a repair: reaching for a cup or pushing up from a chair with the operated arm can strain a repair that is not yet healed.
  • Wearing it longer than advised after a minor injury: extra weeks in a sling usually add stiffness rather than safety.

How long you wear it

This varies with the reason. Typical ranges, with your surgeon’s or doctor’s advice taking priority:

Most people find the first 2 to 3 days the most awkward. One-handed tasks usually get easier within about a week.

Where else this could be coming from

  • Neck ache from the strap: the neck and upper shoulder muscles carry the strap all day. Padding and a level setup usually help. See neck muscle strain and knots.
  • Stiffness after the sling comes off: some stiffness is expected. Movement that stops improving needs review. See stiff shoulder after surgery.
  • Tingling in the fingers: a strap pressing in the wrong place, a swollen hand, or a nerve block wearing off. Loosen and reset the sling first.

Get it checked if

  • Emergency: call your local emergency number if the hand turns cold, pale or blue and does not recover when you loosen and reset the sling, or after surgery if you have calf swelling or sudden breathlessness.
  • Today: contact your surgeon or doctor today if numbness or tingling is spreading or not easing after loosening the sling, if pain is not controlled by your prescribed pain relief, or if the wound is red, leaking or you have a fever.
  • Soon: get it checked if the hand stays very swollen after the first week, the skin under the strap breaks down, or the elbow or fingers are getting stiffer.

More on this area: surgery recovery guides.

Elbow at about 90 degrees, hand a little higher, strap padded and level, and the hand checked often in the first days.

Written by Louise Yow, Neck & Shoulder Physio.