Arm Slings

There are many different types of arm slings available, to support the weight of your arm and assist in preventing subluxation of the shoulder joint, or to prevent injury to a very weak arm during walking or moving around.  Here are some tips on what you might want to try, and what you might want to avoid.

For the most part, a sling that holds your arm across your body (a traditional envelope arm sling) is NOT recommended for weakness after a stroke.

These slings generally promote development of contractures by preventing arm movement, and also contribute to learned non-use…..in other words, it just hangs there, so you stop trying to move it, and whatever remaining neural circuits you have controlling that arm fade even further.

The GivMohr sling was designed to hold the arm in a more anatomically correct position than a traditional sling that holds the arm across the stomach with the elbow bent.  The GivMohr provides support of the arm’s weight to prevent subluxation, while positioning the shoulder blade in a retracted position (not pulled forward), the shoulder in a neutrally rotated position (not internally rotated across your stomach), the elbow in a slight bend, and the wrist in a more neutral position.  It also claims to be wearable under clothing, and to improve walking symmetry by allowing a more natural arm swing during walking.

The GivMohr sling pictured is available at www.GivMohrSling.com

Saddle Sling – this one also was designed to support the arm in a more functional position and allow motion, thereby eliminating the promotion of disuse and contracture that is a concern with traditional slings.  I haven’t tried this one personally, but from the picture, it appears that the forearm cuff might not comfortably support all arm sizes….for example, if your forearm is very thin, the cuff might slide up too far near your elbow and become uncomfortable.  But if it looks to be the right style and design for you, give it a shot.  Perhaps you can order from a company that allows returns, in case the forearm cuff is a problem for you.

The saddle sling pictured (and other slings) available at www.alimed.com

MFC Unilateral Shoulder Orthosis – again, has the same  intended design as the GivMohr and the Saddles Sling, but this one only grips the arm around the biceps area (the upper arm), with any control of your elbow or lower arm.  In order to significantly reduce the weight of the arm hanging by the side, and decrease stretch on the shoulder ligaments, the grip around the biceps area would need to be fairly snug…..which could be uncomfortable.  And it’s ability to actually keep the shoulder joint snug in the socket is questionnable.   As I recommended for the Saddle Sling, if it seems to be the right design for you, try ordering from a company that will allow returns.  Try it out for comfort, but also have a PT or OT feel your shoulder while wearing the sling, to determine if it actually is decreasing the downward stretch on the shoulder ligaments.

The sling pictured (and other slings) available at www.allegromedical.com

Hemi-sling, and other slings, available at www.alimed.com

Hemi-Sling – this sling is similar to the MFC unilateral orthosis, but with a design that seems to achieve more comfort with it’s grip on the upper arm.  It’s a little bulkier, but it distributes the weight of the arm comfortably over a broad pad that fits across the collar bone.  This pad needs to be fitted properly.  If it slides too far toward the neck, it could impinge on the brachial plexus (nerves that run from the neck down under the collar bone) and cause some temorary numbness, tingling, or discomfort.  But these symptoms should quickly resolve by adjusting the sling properly.    Again, no elbow and lower arm and hand control with this splint.   Could be a good thing or a bad thing, depending on your individual needs.

There are my types of shoulder braces and supports that are designed more for restricting certain rotational movements of an athlete’s shoulder during activity/sport, or simply for providing warmth and compression of the upper arm.  These are not meant for preventing subluxation of the hemiplegic shoulder.   Here are a few examples:

Sports Brace (and other braces) available at www.supportsusa.com

Sports sling (and other slings) available at www.supportsusa.com

Immobilizer sling (and other slings) available at www.supportsusa.com

Another type of shoulder sling that would probably NOT be appropriate for you after a stroke, is a shoulder immobilizer.  This is basically a sling combined with a strap that secures your arm across your body.  If regaining muscle control over your arm is a goal, this sling is not for you.  However, there might be situations where this is appropriate, if your only concern is protecting a completely flaccid arm from injury during transfers and walking.  Just remember that it would encourage contractures and disuse.