You can turn a standard pillowcase into a functional arm sling in under two minutes with just a pair of scissors and a safety pin. The method works the same way as a first-aid triangular bandage, and Harvard Health Publishing lists a pillowcase as one of the go-to materials for an improvised sling. Here’s exactly how to do it.
What You Need
- A pillowcase. A standard or queen-size pillowcase gives you enough fabric. You want a piece of cloth roughly 40 inches square, and most pillowcases get close to that once you cut them open.
- Scissors. You’ll need to cut the pillowcase open and trim it to shape.
- A safety pin. This secures the fabric near your elbow so your arm doesn’t slide out.
- Optional: a small towel or folded washcloth for padding where the strap crosses your neck or shoulder.
Preparing the Pillowcase
Cut along the seams of the pillowcase so you have a single flat rectangle of fabric. If the material is large enough, trim it into a roughly 40-inch square. It doesn’t need to be exact, but bigger is better than too small, especially for a larger arm.
Now cut or fold that square diagonally from one corner to the opposite corner. You should end up with a triangle. This triangle is your sling. The long edge will cradle your forearm, and the two pointed ends will go up and over your shoulders to tie behind your neck.
Putting the Sling On
Start by positioning the triangle so the longest edge hangs straight down in front of you, with one pointed end draped over the shoulder on your uninjured side. Let the rest of the fabric hang down across your chest.
Bend your injured arm at the elbow so your forearm is roughly parallel to the ground. Slide the hanging fabric under your forearm and up toward the shoulder on the injured side. You’re essentially wrapping the triangle around your arm like a pouch. Pull that second pointed end up and over the shoulder on your injured side.
Reach behind your neck and tie the two pointed ends together in a square knot. Adjust the knot so your hand sits slightly higher than your elbow. This gentle upward angle helps reduce swelling by encouraging fluid to drain away from your fingers. If the fabric bunches awkwardly near your elbow, fold the excess neatly against your arm and fasten it with the safety pin. The pin keeps the pocket closed so your elbow can’t slip out the back.
Distributing Weight Off Your Neck
A tied sling puts all the weight of your arm on one narrow strip of fabric behind your neck. Over hours, this can cause real neck and shoulder soreness. Widen the fabric where it crosses your neck as much as possible rather than letting it bunch into a thin rope. If you have a small towel, fold it into a pad and slip it under the knot to cushion the pressure point.
Commercial slings solve this problem by running a broad strap across the back rather than around the neck alone. You can mimic this by tying the ends with a bit of extra length and letting the strap sit lower, closer to the base of your neck and across your upper back, instead of right against your cervical spine. Even a small shift in position makes a noticeable difference over the course of a day.
Checking Circulation
Once the sling is on, look at the fingers on your injured arm. They should be their normal color and feel warm to the touch. Compare them to your other hand. If the fingers look pale, purplish, or bluish, the sling is too tight or is compressing something it shouldn’t. Loosen the knot, readjust the fabric, and check again.
Tingling, numbness, or a “pins and needles” feeling in the fingers is another warning sign. Some mild tingling right after an injury can be normal, but if it gets worse after you put the sling on, the sling itself is likely the problem. You can also do a quick check by pressing on a fingernail until it turns white, then releasing. The color should return within about two seconds. If it takes noticeably longer, blood flow to the hand is restricted and you need to adjust.
Check these signs every couple of hours, especially if swelling in the arm changes throughout the day. Swelling can tighten a sling that fit fine in the morning.
Getting the Right Arm Position
For most arm, wrist, and collarbone injuries, a standard sling holds the elbow bent at about 90 degrees with the hand slightly higher than the elbow. This is the position you’re aiming for with your pillowcase sling. If your hand droops below your elbow, the knot behind your neck needs to be shorter to lift the forearm higher.
Your fingers should be visible and free to move. Don’t tuck them inside the fabric. Being able to see and wiggle your fingers lets you monitor circulation and prevents stiffness. If the weather is cold or you’re outdoors, you can loosely drape a second layer over the hand, but keep it easy to pull back for checking.
Limitations of a Pillowcase Sling
A pillowcase sling is a temporary solution. It does the job of immobilizing your arm and keeping it supported against your body, but it lacks the adjustable straps and reinforced structure of a proper medical sling. For a trip to the emergency room, a drive to urgent care, or a few hours while you figure out next steps, it works well. It’s not a substitute for professional treatment of a fracture, dislocation, or significant soft tissue injury.
The sling also won’t fully immobilize a shoulder injury the way a swathe (a second wrap around the torso) would. If you need more stability, you can tie or pin a second strip of fabric around your chest and over the sling to hold your upper arm snug against your ribs. A second pillowcase, cut into a long strip, works for this purpose.