Shoulder Surgery: When Can I Get Rid of My Shoulder Sling?

Rotator cuff repairs, shoulder labral repairs, acromioplasty, humeral fractures, and other shoulder surgeries inevitably require the usage of a shoulder sling as a means of protecting the surgeon’s work and allowing early healing of the involved tissue. I have yet to meet a surgeon who does not prescribe the usage of a shoulder sling immediately following a shoulder surgery.

shoulder slingA shoulder sling will protect the involved arm from sudden jarring motions that the patient might consciously or unconsciously attempt to perform. For example, if a patient momentarily loses his or her balance while walking or while ascending stairs, using the post-surgical shoulder to grab a bannister can easily ruin the surgery.

I have also spoken with patients who have damaged shoulder surgeries during sleep. Although this may at first sound implausible, some people will actually damage a rotator cuff repair as the result of flailing the involved arm during a bad dream. (Pain medication will at times lead to “animated” dreams.) Rolling on to the involved shoulder during sleep will also place undo stress on a surgical recovery.

For these reasons it is a good idea to wear a prescribed sling during the early phases of healing a rehabilitation.

Shoulder sling immobilization comes at a cost

Slings have the potential to pitch the shoulder into an unnatural forward position. Muscles, tendons, and ligaments tend to accommodate to the position that they are placed in, even if they are forced into a position for relatively short periods of time. A forward position of the shoulder tightens the pectoral muscles, tips the shoulder blade into an awkward position, and increases stress on the rotator cuff tendons and ligaments with movements of the arm.

The shoulder also needs to experience the normal, rhythmic swinging movements associated with walking. When we halt this motion for too long, the spine and even the legs can be affected by this forced asymmetry in our motion.

As disturbing as this may seem, wearing a shoulder sling for too long will inevitably place stress on the very structures the sling was initially meant to protect.

Practical tips in regards to shoulder sling usage

1. Ask your doctor what his or her specific protocol is for wearing a shoulder sling. You should also ask your doctor when is the earliest time possible to begin scaling down the amount of time spent in your sling. Do not go against your physician’s orders! I have found, however, that too many patients simply never find out the appropriate time frames and end up wearing the sling for too long.

2. Try to spend some time out of your sling every day in a controlled environment free of obstacles or potential hazards. Allow your shoulder to rest in as normal a position as possible. Use the position of your non-surgical arm as a reference.

3. Realize that there is a psychological hurdle that you must get over in regards to using your arm again. A sling represents protection: It is easy to fall into the trap of wearing it for too long because of the fear of painful and restricted motion.

4. Work on strengthening the muscles that have become weakened from sling usage as soon as your doctor and physical therapist permit such. It is also a good idea to encourage limited and comfortable swinging of the arm with walking. Lying flat on the floor with your shoulders relaxed and your hands folded on your stomach is a great way to gently and passively stretch your chest, spine, and shoulders into a more ideal position.

5. It is not a good idea to stop using your sling “cold turkey.” Gradually wean yourself off the sling. Some people find that removing the sling at home and at the office is a good place to start. The last days of wearing your sling should involve only wearing it in crowds and in public.

6. It is very common to experience neck pain as the result of wearing a sling, even if only for a few weeks. If you are experiencing neck pain, discuss it with your doctor or physical therapist in order to have it addressed.

Discussion

    • says

      Ugh that is a tough one. Check the internet and see if there are any types of slings that are more mesh than solid material. I would also ask the doc if you can spend some time out of the sling every day to let things “air out”.

  1. Chris says

    Approximately 3 weeks ago I had labrum surgery which involved having 8 anchors installed to repair my labrum. I am following doctors orders as part of my recovery, I am curious to know if I do anything to harm my surgery or damage the repair- will I know it? I’m scared that I will screw this recovery up and not know it for along time to come. Thank you

    • says

      Chris you would normally have to do something very abrupt to the shoulder, like fall and try to catch yourself with the surgical side. Anchor tears usually feel like sharp, disproportionate, constant pain.

      Having said that, we see TONS of physical therapy patients here in DC who are post-op that have varying levels of pain that I would consider normal.

      • Lewis melina says

        Hi dan could u give me some advice!

        I had anchour points put in my shoulder think in the front! I didnt really get told what was happening as he wasnt sure what the damage was but he told me he had done something when i woke up but then wentam nearly 3 weeks post op.
        But when in my sling and im walking about i get the odd jolts! And get constant aches! But when i dont wear it i dont get nothing! Which i thought it would be the other way round!
        They told me to start doing pendulum excercises after 2 weeks
        Which i can do well
        My arm and were they went in is still slightly bruised.

        Is this NORMAL!!?
        Would i still feel the odd jolts!
        I wear my sling every night when i sleeps also! And sleep on my back.

        Many thanks lewis

        • says

          Lewis having jolts like that are common after a surgery like that. I would wear the sling according to your doctor’s instructions. Ask the doc if you can gradually decrease the amount of time you are wearing the sling. Hopefully you won’t have to wear it for much longer.

          The bruising is probably normal as long at it is going away.

          • Lewis melina says

            Thanks dan!
            I also keep getting a lot of clicking now im getting more movement from my pendulum excersises!
            But im also guessing thats normal too cheers!

  2. Lance says

    I’m having labrum repair surgery this Monday. The pain that is usually over the top of my shoulder and down the front has also started to travel up the right side of my neck and down the back of my arm. Thanks in advance

    • says

      Lance the repair should ultimately help with much of that pain, but I am wondering if the neck pain is more of a postural compensation that you are having because of the shoulder issue. Once this is all said and done, you should have your PT check your posture and spinal alignment to make sure that everything looks good.

  3. Rhys says

    Hi Dan Baumstark

    On the 22nd of January I had a arthroscopic right shoulder labrum repair, 3 nearly 4 weeks ago to this day.
    Everything was fine in regards to pain and retaining my movement as of two days ago, when I subconsciously without my sling supported myself to sit down on a bus rail (pole)… whilst resting my shoulder from wearing the sling all day…

    As a result I’m feeling a slight uncomfortable pain, not excruciating but apparent.

    Do you reckon I have damaged the shoulder procedure or just irritated it?

    I would appreciate if you could give me some advise

    Thanks

    Rhys

    • says

      Most likely just irritation. It usually takes more of an abrupt, hard jerking motion to pull anchors. You may feel it for a week or two though. I would back off of the PT exercises for a few days to allow some healing. You can of course always talk to the doc about what happened if you feel that things aren’t going in the right direction.

  4. Simkhe says

    Hi,
    I had arthroscopic rotator cuff repair six weeks ago tomorrow. I had a surpraspinitus tear sewn up and a biceps tendonesis plus some cleaning up of the labrum. Recovery has been going well and I started passive PT last week, with all feeling good. Then yesterday — while wearing the sling — I reflexively pulled my operative arm back after touching something burning hot. It was definitely a jerking motion and I have been sore since then. I’m heartsick to think I might have re-torn something or dislodged anchors. I am feeling a bit of burning sensation. I have another PT appointment tomorrow. Should I lay off for a bit? Please tell me it just needs a little rest and some ice . . .
    Thanks.

    • says

      Tell the PT what happened. At six weeks that repairs are probably fine. The most likely scenario is that you inflamed the tissue a bit from the sudden motion. I would take it easy for a few more days and if it is not getting better I would talk to the doc about it.

  5. Kasey says

    Hello I had labrum surgery 2 weeks and 3 days ago it is feeling pretty good and already have a lot of motion back. Do you think it would be safe to sleep without the sling. I’ve slept In a recliner all but two days since surgery and when i try to sleep in my bed I just can’t get comfy with this awful sling on.

  6. Marie says

    I had labrum repair surgery on February 20, about 16 days ago. I had a tear from about 3 PM to 9 PM, requiring about six anchors. I took two weeks off work, meaning I didn’t go into the office, however I did work from home on my laptop. By day 12 post-op, I took the sling off only when I was lying propped up in bed on the computer. By 14 days post-op, I’ve been keeping it off pretty much all the time because I can’t stand it and it gives me a rash and hurts my neck. I mostly try not to use my right arm, but have accidentally done so a few times causing some pretty jarring pain, but it usually goes away within 10 minutes. I went in 10 days postop and surgeon said I did not have to wear the sling all the time but that I should wear it “walking around and when standing” to support the shoulder, and that I only needed to use it for about two more weeks. The shoulder feels fine if I just keep my hand in a hoodie pocket and don’t use it. My question is how do I know if I’ve re-injured it? For example, my elbow hit the knob in the shower making the water really hot, and by instinct I shot out my right arm to turn it down and then felt like it was going to fall off. It throbbed for about an hour after that but got better after I iced it. I’ve done something similar a few times since then, causing acute pain that usually went away within the hour. I can’t reach behind me at all, or have my arm reach out to the side, but sometimes I forget and then my shoulder reminds me. Am I causing damage? Should I suck up the rash and the neck pain and just wear the sling?

    • says

      Usually when an anchor has pulled, there is disproportionate pain that is constant in nature. They things that you described do not sound like they would dislodge an anchor, although it certainly can increase the overall inflammation of the shoulder.

      If the doc said that it is okay to ditch the sling, then it is up to you. If you feel that wearing the sling prevents sudden movements of the arm then it might be of use to you.

  7. steven says

    Hello. I had labrum surgery on my left shoulder, 4 anchors. At 2 weeks post op i fell with my sling on. I know im being paranoid thinking i have damaged something. I didnt have any pain when i fell and i still dont have any pain from the fall. I guess my question is, if i were to have damaged my surgery wouldnt i be in a pretty good amount of pain? I wouldnt think i could wreck the surgery without having a intense amount of pain. thanks and sorry for the paranomia,

  8. Mike says

    I just had rotator cuff surgery a little over 5 weeks ago. My doc says its ok to have my sling off off and on during the day. Well I had my sling off an accidentally picked up a small cereal sized bowl with my repaired arm and then I quickly realized what I was doing and put it down. I didn’t feel any pain at all, but I am worried I could have ruined the surgery. Am i just being paranoid?

    • Mike says

      I also wanted to add that when I have been sleeping my shoulder has twitched/shivered/spasmed and it popped and one time it actually woke me up cause it hurt. Should i be worried about that or is that normal?

  9. dustin says

    I had labrum repair 3 weeks ago. The other night I was getting ready for bed and rolled to far over onto my slinged arm. It felt like a rubber band breaking and the next day was followed with pain that i have not felt since the surgery. Is this something I should worry about or just irritation?

  10. Cathy says

    I had a bicep tenodesis seven days ago. I have a sling to wear. I was scheduled to go back to the dr 5-7 days after surgery but it turns out he is on vacation and I won’t see him until 15 days after surgery. Do I need to stay in a sling until the first visit or can I ween off of it sooner.

  11. Laila says

    The dr at urgent care thinks that I tore my rotator cuff and put me in a sling. He doesn’t want to order a MRI unless it doesn’t get better within 3-5 days. How long would you suggest I continue to wear my sling for? Also, I’m wearing it to bed, is that ok?

    Thank you,
    Laila

  12. Tanya says

    How long after surgery for a complete rotator cuff tear with anchors should I avoid pulling myself up three steps onto a bus for?

  13. Bob Waskiewicz says

    Four weeks ago, I had pretty extensive arthroscopic surgery to repair full thickness tears of the supraspinatus and subscapularis tendons, a partial thickness tear of the infraspinatus tendon and a tear of the anterior superior labrum. Many anchors were used during surgery. From Day 1 after surgery, my biggest problem has been sleeping. Naturally, I’ve been sleeping with the sling on, mostly in a recliner. I only seem to have been able to sleep for short periods, waking up in pain or discomfort. I roam the house throughout the night trying my bed, couch, other chairs…to no avail. It’s been a month of sporadic sleep of 4 to 6 hours a night. Today I was allowed to remove the sling all together – this coinciding with my first day of PT which was only compiling info and previewing my therapy plan. My therapist had some thoughts on sleeping, suggesting sleeping in bed with a body pillow to support the injured shoulder or continuing in the recliner keeping my arm hanging at my side as best as possible. I am sending this to you at 2;30 AM, so obviously none of the suggestions are working. It is even more painful than trying to sleep in the sling. Any suggestion? Should I go back to the sling just to sleep, as my arm feels more secure sleeping in it, even though the strong pulling on the neck is uncomfortable? HELP!

    • says

      Bob you certainly had a lot of work done, and it does sound as if you have been doing the right things in terms of positioning.

      Some people can get over this initial distress of disrupted sleep through pharmaceuticals. This falls entirely in to the realm of your doctor. I would talk to him or her and see if you can have something prescribed to help you sleep more comfortably.

  14. Vicki says

    Back in August I had Arthroscopic surgery for a severe rotator tear from a horseback riding incident. I remained in a immobilizing sling for 4 weeks then did 8 weeks of physical therapy with no improvement. The Dr. and I decided he should scope it again and as suspected the sutures to the anchors were all undone,so he did a second repair.This time the tendons had retracted back even more so he was unable to get them to pull into the last position so he anchored them in a different spot. I was in the sling for 6 weeks this time and after 4 weeks of physical therapy with no progress he decided I possibly had frozen shoulder. I went in and had manipulation under anesthesia done and then 4 weeks of deep tissue massage therapy. Still with no progress,so back in for another surgery.This time it was arthroscopic also but when he say it was detached again he went in surgically. He made the repairs along with breaking up all the scar tissue. After 3 and a half weeks in the immobilizing sling he told me I didn’t need to wear it and I was scheduled in 2 weeks to start therapy again. I’m concerned that he took me out of the sling awful soon this time and I’m wondering if something in the therapy or something I’m doing is causing the repairs to undo.I never feel the excruciating pain or anything abnormal when they do come apart.

    • says

      Hard to say what is causing the anchors to dislodge. I would take this route super, super conservatively. Keep all of your movements very basic and do not do any aggressive stretching. I would make sure that you are seeing the best PT around, someone with tons of experience.

      I would also get a consult from another surgeon if things don’t happen to go well this time around.

  15. ren renzel says

    I’m a 77 year old with torn rotator cuff who wants to continue playing golf. If I have surgery, wear the sling and have p.t.; or, dont have surgery, wear the sling, for the same length of time and have p.t. what is your guess as to he outcomes after, say three months?

    • says

      Ren the last person that I saw who was your age took a year to get a decent recovery from RC surgery. She did not get back full active range, but certainly enough range to swing a golf club.

      I would opt for the PT first to see what type of outcome you get. You may recover enough to be able to play some golf. It does depend on how much of the rotator cuff is intact. If you do PT alone I would assess your range after about 2-3 months and see what kind of range and strength you have.

  16. Peter T says

    I fractured my humerus in 3 places at the top 22 days ago, two follow up xrays show it is healing very, very well. My concern is it feels better out of the sling and i have a constant desire every 20 secs to move my lower arm or rotate my arm to relieve the stiffness, I dont want to wreck things by going too early as I am 49 as its still brused and its my right arm.

    I have been walking and putting the fins on and doing a 1km or so in the pool with the spare sling on , water feels so nice and supportive.

  17. Greg Feeney says

    I had arthroscopic labrum repair surgery one week ago today on my right shoulder. I am in sling with no pain sitting still. However my shoulder has occasional twitching/spasms during the day. Five days post op, late at night I had a mental lapse and used my right hand (in sling) to plug in my ice therapy machine and applied some pressure with my right forearm, which was still in the sling. If any anchors dislodged would I be in more pain or felt anything. How much pressure to dislodge labrum anchor? I am really paranoid. What does anchor dislodging feel like?

  18. says

    Hi.Had arthoscopy on rt shoulder last Wed to repair tear and remove bone. No probs w/surgery. Was home about 10 hours when I got up and fainted. Stayed I’m Hosp for 36 hours..
    Dr said I fainted due to.extreme pain. No cardiac issues. Etc. I’vre been home for 4 days. I have developed a very bad friction rash under my surgical arm (in arm pit area), as well as on my torso, under my breasts. Is this heat rash or From combo of wearing this sling and heat rash. Been taking oxy 5/325 (2) every 4 hours. I temp stopped in case it was a reaction to the oxys. I have taken my arm out of sling while sitting and watching TV to air my skin out a bit. Having issues sleeping w/ it on,as it is not comfortable. My Dr apt is on Fri, 1+ 1/2/days from now. I’m guessing I should put the sling back on after a couple hours, since it’s been just 7 days since the surgery. Tear was 5 cm. So not big. Any thoughts? Thankyou

    • says

      Sorry to hear about that Tracey. A small percentage of people do tend to get rashes from the sling and / or from the constant contact of the arm against the side of the body.

      Ask the doc about getting out of that sling when you are sitting quietly. If you can convince him it might be a good idea. Some docs will also allow patients to start with “pendulum” exercises early on. That might also be of use to you, but again ask him about it when you see him.

  19. Will says

    Hi Dan. I had arthroscopic shoulder surgery last Tuesday (14th April) to repair a SLAP tear. Only one anchor was placed during the surgery. I have experienced very little pain since the operation and have mainly been sitting on the sofa for most of the days. I have been performing the prescribed rehab exercises each day.

    My issue, however, is that last night, my operated arm jerked/flailed quite forcefully during a dream. The pain woke me up, but I was able to fall back to sleep fairly quickly with no pain medication. I was wearing my sling at the time; however, the sling I was given is very basic (no waist strap, side cushion, etc.). From what I can remember from my dreamy state, my arm attempted to extend at the elbow (almost like a tricep pushdown or karate chop), but happened in a jerky manner (I must note that my forearm wasn’t able to extend because it was abruptly stopped by the sling, but still jerked with enough force to cause pain). I cannot be certain that it didn’t externally rotate. I have experienced an increased amount of pain today, yet still haven’t felt the need to take pain medication. I have little to no pain when resting my arm on a cushion whilst sat on the sofa. My rehab exercises are slightly more uncomfortable/painful today, but I am still able to complete them.

    I am quite worried that I may have ruined the repair/dislodged the anchor. I have tried calling my surgeon, but haven’t been able to get through to him. I am not due to see him for another two weeks. I’d really appreciate your opinion on this.

    Many thanks,

    Will

    • says

      If the shoulder is just a bit sore I wouldn’t be too worried about it. A jerky movement like the one you described would certainly make the shoulder hurt, but it doesn’t sound like that would be enough to dislodge.

      Your shoulder will probably be sore for a week or so.

  20. Caroline manganoni says

    Hi I had a mini open rotator cuff repair on 17th April. I have two questions firstly is the sling I’m wearing to stop me from using the arm or sudden movements that would damage the repair rather than comfort and secondly is it ok to take my arm out the sling if I’m sitting in a chair and if so should I support it on pillows. It’s still painful enough that I’m having to take naproxen and codeine and I’m worried that I may have done something’s of the repair when taking my arm out the sling for showering.

    Many thanks

    Caroline

    • says

      Caroline

      The sling is mostly there to keep you from using your arm with sudden movements, as you may have guessed it is not used for comfort (most people hate the sling).

      In terms of taking the sling off, get the docs permission. I for one would not have a problem with you out of the sling when you are sitting quietly, but it really is the doctor’s call. Pillow positioning would also help if you do in fact get out of the sling.

  21. Dawn Coultas says

    I had open surgery GA and nerve block on 14th March 2015.
    Full thickness Supraspinitus tear, Amacromial decompression, ? bursur removal, torn bicep and repair to deltiod muscle.
    Due to reaction to Morphine I was given other painkillers. Sling 24/7.
    Pain was unbearable and had to return to Hospital.
    Problem 6+ weeks is bicep pain on movement/exercises.
    Physio exercises painful but some areas of shoulder seem to be improving, albeit slowly.
    I feel as I’m experiencing pain in my bicep what’s going on ?

    • says

      What is going on is that you had a huge amount of work done.

      You are likely going to have a fair amount of pain for a few months to come. The thing to look at here is whether or not you are making a little bit of progress from week to week (not necessarily day to day). The biceps is likely very weak right now as is the supraspinatus. They attach to the shoulder very close to one another, so pain in that area is to be expected.

      Stick to the doc’s protocol in the mean time.

      • Dawn Coultas says

        Thank you for your reply.
        I’m at a loss with the physiotherapists here telling me to wait and ask my Consultant on 10 June what he has done. Yes they have had a letter from him to plan my exercises but here in the UK it is not their job to say anything to enlightening the patient of their operation.
        I’m afraid I must be very patient with my recovery.

  22. Andy says

    Hello, I have just gotten my arthroscopic shoulder surgery done today. I had no serious pain before on my shoulder, just minor soreness. I took a MRI and the doctor said my ligament on my shoulder was keep on getting contact with my bone, so it might be getting damaged when time passes by. My surgical dressing states I may remove dressing Saturday, shower, pat dry, cover with bandaids, and leave steri-strip intact. But it doesn’t state I should have my sling on. The doctor told me I can remove the steri-strip after 3 days but never told me when to remove my sling. Can I stop using the sling after the first day?

  23. Rose says

    Hi Oct 31,2014 I had soreness between my arm pit and my shoulder after an MRI I was first I was told I had a rotator cuff capsule sprain. I’ve been I physical therapy for the last 6 month. I still have the pain on top of new pain that’s now in my shoulder capsule and in the back of my arm. I just got an MRA the results is I have labarum and cartilage tear. Did physical therapy made my condition worse. I was using stretch bands and weights for my physical therapy. Pls help me.

    • says

      I doubt that strengthening had a bad effect on the shoulder. I would however hold off on any more strengthening until the soreness calms down a bit. I would ask the doc what the next step should be. You may benefit from an injection given that PT does not appear to have helped.

  24. Symone Jackson says

    I Just Had Surgery On My Right Shoulder Rotacut Tair On 4/27/15! I Just Got Out My SlingA Couple Day’s Ago On 5/18/15 He Told Me To Follow Up With Therapy But I HaVe To Wait Awhile Because Of My Insurance Even Tho I’m Out My Sling I Can Not Lift My Right Shoulder At All Why Is That??

    • says

      Symone your shoulder muscles are totally weak right now. It is going to be many weeks before you are able to lift the arm. The doctor or the physical therapist will usually give you a guideline in terms of what exercises to do, and when to do them.

      Normally patients will not be allowed to try active lifting of the arm until at least 8 weeks after the surgery.

  25. Deb says

    3 1/2 weeks after rotator cuff surgery I lost my balance but grabbed the towel rack with my good arm to keep from falling. Although my arm was in my sling I still jerked my injured shoulder which did give me a sharp pain. My doctor said to wait and see if I pulled out my anchor. It has been 5 weeks since my surgery and I am still in a lot of pain when my physical therapist has me extend my arm out very far. Is this normal? I do not see my doctor for 3 more weeks. When I had my MRI initially, the sleeve they put me in made my pain 10 times worse, and the pain never got better before my surgery. Can an ultrasound show if the anchor is out or do I have do do the MRI?

    • says

      I am not sure if an ultrasound will definitively tell if the anchor has pulled. It does not really sound like you did enough to pull an anchor based on what you said. Most people will just have an increase in pain for a few weeks after jarring it. Let the arm rest for a few days.

      I would ask the PT to back off a little bit in terms of stretching until the shoulder calms down a bit.

  26. says

    I had shoulder surgery on April 23rd, will not see the doc again till next week. Can I take the surgical strips off at this point? The PA said wait till they start to come off themselves. In PT others are asking why I still have them on. This being a holiday of outdoor events I would like to remove them.

    • says

      Serena the steri-strips are there to protect the scar when it is closing. I highly doubt that your scar lines are still open one month after the surgery. Docs and PA’s always say to let them fall off on their own, but sometimes the adhesive is so darn good on those things that they will stay on for way longer than they need to be there.

      Having said that, I am not allowed to tell you to take off the strips because I am not your treating therapist. I would bet a dollar though that your skin is fully healed.

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