Patent Publication Number: US-8992451-B2

Title: Shoulder orthosis having a supportive strapping system

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates generally to orthoses, and more particularly to a shoulder orthosis for supporting and stabilizing the shoulder following surgery or injury. 
     The shoulder is a relatively complex joint of the body which is capable of rotation within multiple planes when the arm is displaced relative to the torso. For example, “external rotation” or “internal rotation” of the shoulder occurs when the forearm is displaced away from or toward the torso while the position of the upper arm is maintained fixed against the side of the torso and the elbow is flexed at 90°. “Abduction” or “adduction” of the shoulder occurs when the upper arm is extended out to the side and is displaced away from or toward the torso. “Flexion” or “extension” of the shoulder occurs when the entire arm is extended out to the front and is displaced toward or away from the torso. 
     Although the rotational capabilities of the shoulder advantageously enhance the function of the joint, the same expansive rotational capabilities also complicate treatment of the shoulder following injury or surgery. Treatment frequently requires determining a desired optimal treatment position of the shoulder and associated arm, placement of the shoulder and arm in the desired treatment position, and immobilization of the shoulder and arm in the desired treatment position. Such a recuperative treatment is particularly applicable to soft tissue injuries involving damage to one or more connective shoulder ligaments and furthermore is oftentimes the treatment of choice following any number of surgical procedures, including surgery for recurrent posterior subluxation, rotator cuff surgery, humeral head or shaft fracture correction, and the like. Healing occurs inter alia through diminution of inflammation and/or regeneration of muscle tissues, which is promoted by removing stress from the injured or surgically corrected joint. 
     Support devices for the shoulder, such as orthopedic braces, rigid casts, slings and the like, are commonly employed to perform the above-recited placement and immobilization function with varying degrees of success. For example, commonly-owned U.S. Pat. No. 7,244,239 to Howard, incorporated herein by reference, discloses a shoulder support which includes a forearm wrap, a pair of adjustable straps and a pillow. The wrap and pillow engage the forearm of a patient and the two straps cooperate with the wrap and pillow to suspend the arm at a relatively fixed position of full shoulder flexion while the elbow is flexed at 90°. One strap circles the waist primarily providing a positioning function and only secondarily providing a weight bearing function with respect to the arm and shoulder of the patient. The other strap extends over the shoulder and assumes the primary weight bearing function of the shoulder support. In particular, the shoulder strap transfers the bulk of the arm weight load borne by the shoulder support to the narrow region on the top of the shoulder where the shoulder intersects the neck. 
     The pillow is cooperatively attachable to the straps and wrap. The pillow, like the waist strap, serves primarily a positioning function with respect to the arm and shoulder of the patient. The pillow is positionable between the elbow and forearm of the patient on one side of the pillow and the torso of the patient on the other side of the pillow to maintain the arm at relatively fixed positions of shoulder abduction/adduction and external/internal rotation. The precise positions of shoulder abduction/adduction and external/internal rotation achieved by the shoulder support of Howard are primarily a function of the specific geometrical configuration and dimensions of the pillow relative to the size and body type of the patient. 
     The present invention recognizes a need for a shoulder orthosis which more evenly, comfortably and adjustably distributes the arm weight load borne by the shoulder orthosis to the torso of the patient than do shoulder supports disclosed by the prior art. The present invention further recognizes a need for a shoulder orthosis which enables more user adjustability in setting the fixed shoulder treatment position than do shoulder supports disclosed by the prior art. The present invention still further recognizes a need for a shoulder orthosis which enables a user to more easily remove the orthosis and to return the orthosis to its original treatment position with minimal readjustment of the fit than do shoulder supports disclosed by the prior art. Accordingly, among the objects of the present invention are fulfillment of the above-recited needs. These objects and others are accomplished in accordance with the invention described hereafter. 
     SUMMARY OF THE INVENTION 
     One characterization of the present invention is a shoulder orthosis comprising an arm retainer, a first strapping segment and a second strapping segment. The arm retainer is configured to engage an arm associated with an affected shoulder opposite an unaffected shoulder. The first strapping segment has a first end and a second end supporting the arm retainer. The first strapping segment has a sufficient length so that it is extendable from its first end across the anterior of the torso, over the unaffected shoulder and across the posterior of the torso to its second end. The second strapping segment has a first end and a second end which are connected to the first strapping segment. The second strapping segment has sufficient length so that it is extendable from its first end across the anterior of the torso, under the arm associated with the unaffected shoulder and across the posterior of the torso to its second end. 
     In accordance with one embodiment, the first strapping segment includes a first support strap extendable across the anterior of the torso and over the unaffected shoulder and further includes a second support strap connected to the first support strap and extendable across the posterior of the torso. The shoulder orthosis preferably further comprises a first connector and a second connector. The first and second support straps are connected to one another and the second end of the second strap segment is connected to the first strap segment across the first connector. The first end of the second strap segment is connected to the first strap segment across the second connector. The second connector preferably includes a strap loop connected to a releasable buckle. 
     In accordance with another embodiment, the arm retainer is configured with a front and a rear for engaging the forearm associated with the affected shoulder. The first end of the first strapping segment is connected to the front of the arm retainer and the second end of the first strapping segment is connected to the rear of the arm retainer. The shoulder orthosis preferably further comprises a connector across which the second end of the first strapping segment is connected to the rear of the arm retainer. 
     Another characterization of the present invention is a shoulder orthosis comprising an arm retainer, a first support strap, a second support strap, a third support strap, a first connector, a second connector and a third connector. The arm retainer is configured to engage an arm associated with an affected shoulder opposite an unaffected shoulder. The first support strap has a sufficient length so that the first support strap is extendable across the anterior of the torso, over the unaffected shoulder and across the posterior of the torso. The second support strap has a sufficient length so that the second support strap is extendable across the anterior of the torso, under the arm associated with the unaffected shoulder and across the posterior of the torso. The third support strap has a sufficient length so that the third support strap is extendable across the posterior of the torso. The first connector connectively engages the first, second and third support straps, the second connector connectively engages the first and second support straps and the arm retainer and the third connector connectively engages the third support strap and arm retainer. 
     In accordance with one embodiment, the arm retainer is configured with a front and a rear for engaging the forearm associated with the affected shoulder. The first connector is posteriorly positioned to connectively engage the first, second and third support straps. The second connector is anteriorly positioned to connectively engage the first and second support straps and the arm retainer at the front of the arm retainer. The third connector is posteriorly positioned to connectively engage the third support strap and the arm retainer at the rear of the arm retainer. The first and third connectors are preferably strap loops and the second connector preferably includes a strap loop connected to a releasable buckle. 
     Another characterization of the present invention is a shoulder orthosis comprising an arm support and an arm spacer connected to the arm support. The arm spacer includes a first individual pillow and a second individual pillow. The first individual pillow preferably has an irregular shape. The first and second individual pillows are attachably combinable with one another at a first face of the first individual pillow and a face of the second individual pillow to form a first combined pillow having a first shape. The first and second individual pillows are alternately attachably combinable with one another at a second face of the first individual pillow and the face of the second individual pillow to form a second combined pillow having a second shape different from the first shape. The first combined pillow preferably has a first horizontal width at a point on the first combined pillow alignable with an engagement point on the torso and the second combined pillow preferably has a second horizontal width different from the first horizontal width at a corresponding point on the second combined pillow alignable with the engagement point on the torso. 
     Another characterization of the present invention is a shoulder orthosis comprising an arm support and an arm spacer connected to the arm support. The arm spacer includes a first individual pillow and a second individual pillow. The first individual pillow preferably has an irregular shape. The first and second individual pillows are attachably combinable with one another at a first face of the first individual pillow and a first face of the second individual pillow to form a combined pillow having a first shape. The first and second individual pillows are alternately attachably combinable with one another at a second face of the first individual pillow and a second face of the second individual pillow to form a combined pillow having a second shape different from the first shape. The first combined pillow preferably has a first horizontal width at a point on the first combined pillow alignable with an engagement point on the torso and the second combined pillow preferably has a second horizontal width different from the first horizontal width at a corresponding point on the second combined pillow alignable with the engagement point on the torso. 
     Another characterization of the present invention is a shoulder orthosis comprising an arm retainer, a pillow, a first strapping segment and a second strapping segment. The arm retainer is configured to engage an arm associated with an affected shoulder opposite an unaffected shoulder. The pillow is connected to the arm retainer and positionable between the arm associated with the affected shoulder and the torso. The first strapping segment has a first end and a second end supporting the arm retainer and the pillow. The first strapping segment has a sufficient length so that the first strapping segment is extendable from its first end across the anterior of the torso, over the unaffected shoulder and across the posterior of the torso to its second end. The second strapping segment has a first end and a second end connected to the first strapping segment. The second strapping segment has a sufficient length so that the second strapping segment is extendable from its first end across the anterior of the torso, under the arm associated with the unaffected shoulder and across the posterior of the torso to its second end. 
     In accordance with one embodiment, the pillow is a first individual pillow and the shoulder orthosis further comprises a second individual pillow. The first and second individual pillows are attachably combinable with one another at a first face of the first individual pillow and a face of the second individual pillow to form a first combined pillow positionable between the arm associated with the affected shoulder and the torso which has a first shape. The first and second individual pillows are alternately attachably combinable with one another at a second face of the first individual pillow and the face of the second individual pillow to form a second combined pillow positionable between the arm associated with the affected shoulder and the torso which has a second shape different from the first shape. 
     In accordance with another embodiment, the first and second individual pillows are attachably combinable with one another at a first face of the first individual pillow and a first face of the second individual pillow to form a combined pillow positionable between the arm associated with the affected shoulder and the torso which has a first shape. The first and second individual pillows are alternately attachably combinable with one another at a second face of the first individual pillow and a second face of the second individual pillow to form a combined pillow positionable between the arm associated with the affected shoulder and the torso which has a second shape different from the first shape. 
     The present invention will be further understood from the drawings and the following detailed description. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  shows a shoulder orthosis of the present invention in a disassembled state. 
         FIG. 2  is a front view of the assembled shoulder orthosis of  FIG. 1  worn by a patient. 
         FIG. 3  is a rear view of the assembled shoulder orthosis of  FIG. 1  worn by a patient. 
         FIGS. 4A-E  show a method for fitting the assembled shoulder orthosis on a patient. 
         FIG. 5  is a perspective view of a shoulder positioning pillow system which is optionally employed with the shoulder orthosis of  FIG. 1 . 
         FIGS. 6A-D  show a method for mounting the shoulder orthosis, which includes a configuration of the pillow system of  FIG. 5 , on a patient to maintain the shoulder in a 45° neutral treatment position. 
         FIGS. 7A and 7B  show a method for mounting the shoulder orthosis, which includes an alternate configuration of the pillow system of  FIG. 5 , on a patient to maintain the shoulder in a 90° neutral treatment position. 
         FIGS. 8A and 8B  show a method for mounting the shoulder orthosis, which includes an alternate configuration of the pillow system of  FIG. 5 , on a patient to maintain the shoulder in a 15° abduction treatment position. 
     
    
    
     Embodiments of the invention are illustrated by way of example and not by way of limitation in the above-recited drawing figures, wherein like reference characters indicate the same or similar elements. It should be noted that common references herein to “an embodiment of the invention”, “one embodiment of the invention”, “an alternate embodiment of the invention”, “a preferred embodiment of the invention”, or similar such language are not necessarily references to the same embodiment of the present invention. 
     DESCRIPTION OF PREFERRED EMBODIMENTS 
     Referring initially to  FIG. 1 , a disassembled shoulder orthosis of the present invention is shown and generally designated  10 . The shoulder orthosis  10  comprises an arm retainer  12  and a supportive strapping system. The supportive strapping system includes two closure straps  14 ,  16 , three support straps  18 ,  20 ,  22 , and three connectors  24 ,  26 ,  28 . Closure strap  14  is termed a front closure strap and closure strap  16  is termed a rear closure strap. Support strap  18  is termed an over-the-shoulder front connective strap insofar as support strap  18  extends over the unaffected shoulder of the user and anteriorly connects to the front of arm retainer  12 . Support strap  20  is termed an under-the-arm front connective strap insofar as support strap  20  extends laterally under the arm of the unaffected shoulder of the user and anteriorly connects to the front of arm retainer  12 . Support strap  22  is termed a rear connective strap insofar as support strap  22  extends across the back of the user and posteriorly connects to the rear of arm retainer  12 . 
     Connector  24  is termed an anterior multi-strap connector insofar as connector  24  effects anterior connection of the ends of support straps  18 ,  20  to the front of arm retainer  12 . Connector  28  is termed a posterior single-strap connector insofar as connector  28  effects posterior connection of the end of support strap  22  to the rear of arm retainer  12 . Connector  26  is termed a posterior multi-strap connector insofar as connector  26  effects the posterior connection of the opposite ends of support straps  18 ,  20 ,  22  to one another. One feature distinguishing support straps  18 ,  20 ,  22  from connectors  24 ,  26 ,  28  is that all support straps  18 ,  20 ,  22  have variable lengths which are selectively adjustable by a user, whereas all connectors  24 ,  26 ,  28  have fixed non-adjustable lengths. 
     Arm retainer  12  is preferably a forearm sleeve fabricated from a strong pliant material such as a cloth, cloth/foam laminate, cloth mesh, combinations thereof, or other similarly strong pliant material. Arm retainer  12  may be constructed by preparing a flat cutout of the sleeve from a sheet of the selected pliant material and sewing the cutout into the desired three-dimensional configuration of the sleeve. Arm retainer  12  generally resembles a six-sided polyhedron with rear side  30 , bottom side  32 , and lateral sides  34 ,  36  all substantially enclosed and top side  38  and front side  40  substantially open. 
     Rear side  30  and lateral sides  34 ,  36  of arm retainer  12  are provided with a fastener  42 , which enables the user to releasably fasten closure straps  14 ,  16  to arm retainer  12  when the shoulder orthosis  10  is assembled in a manner described below. The term “user” is employed herein with reference to either a patient wearing the shoulder orthosis  12  (also termed a wearer), a care provider for the patient, or both. A preferred embodiment of fastener  42  is the hook or loop material of a hook-and-loop fastener commonly known by the trade name VELCRO. The hook or loop material (preferably loop material in this instance) is permanently attached to arm retainer  12  by sewing a continuous strip of the loop material around the outer face of lateral  34 ,  36  sides and rear side  30  of arm retainer  12 . 
     Closure straps  14 ,  16  are each relatively short straps formed from a strong pliant material, such as a cloth mesh or other similarly strong pliant material. Both ends of each closure strap  14 ,  16  are provided with fasteners  44 . Each fastener  44  is a tab of hook or loop material which is the opposite material of fastener  42 . Fasteners  44  (preferably hook material in this instance) are permanently attached to the closure strap end by sewing or the like. Fasteners  44  enable releasable fastening of closure straps  14 ,  16  to fastener  42  as described below. 
     Support straps  18 ,  20  are essentially identically configured with respect to one another. Each support strap  18 ,  20  is preferably formed from one or more strong pliant materials resulting in support straps  18 ,  20  which are not substantially elastically stretchable. The longitudinal midsection  46  of support straps  18 ,  20  is widened and padded to cushion the torso of the patient when support straps  18 ,  20  are resting or pressing against the torso during use of the shoulder orthosis  10  as described below. Each support strap  18 ,  20  is preferably provided with both the hook material and the loop material of a hook-and-loop fastener. In a preferred embodiment, a patch of hook material  48  is permanently attached to the outside face of both ends of each support strap  18 ,  20  by sewing or the like while the remaining outside face of support strap  18 ,  20  is preferably continuously covered with, or integrally formed from, loop material. This enables a user to adjust the length of support straps  18 ,  20  to any desired length shorter than that shown in  FIG. 1  as described below. 
     Connector  24  comprises strap loops  50 ,  52 , connective segments  54 ,  56 , end fasteners  58 ,  60 , a midsection fastener  62 , a connective segment  64 , and a strap loop  66 . Each strap loop  50 ,  52  has a fully enclosed ring-like configuration, but having a rectangular rather than circular shape. Strap loops  50 ,  52  are formed from a substantially rigid material such as a rigid metal or plastic. Each connective segment  54 ,  56  is preferably a short length of strong, pliant, non-stretchable strap material which permanently attaches each strap loop  50 ,  52  to opposing lateral sides  34 ,  36  at the top front of arm retainer  12 . Permanent attachment is effected by looping each connective segment  54 ,  56  through its respective strap loop  50 ,  52  and sewing both ends to arm retainer  12  such that connective segments  54 ,  56  have a non-adjustable fixed length. 
     Each end fastener  58 ,  60  preferably comprises a relatively short length of strong, pliant, non-stretchable strap material having a patch  68  of hook or loop material (preferably hook material in this instance) permanently attached to its outside face by sewing or the like. The remaining outside faces of end fasteners  58 ,  60  are preferably continuously covered with, or integrally formed from, loop material. Strap loops  50 ,  52  and end fasteners  58 ,  60  cooperatively facilitate releasable fastening of connector  24  to arm retainer  12  during assembly of the shoulder orthosis  10  as described below. 
     Midsection fastener  62  is preferably a manually releasable two-piece buckle commonly known as a side release buckle, which comprises two separate pieces, a lower piece  70  and an upper piece  72 , when the buckle is released, but forms a single unitary member when lower and upper pieces  70 ,  72  are buckled together. Connective segment  64  is preferably a relatively short length of strong, pliant, non-stretchable strap material. Strap loop  66  has a fully enclosed circular ring configuration and is formed from a substantially rigid material such as a rigid metal or plastic. 
     End fasteners  58 ,  60  are preferably permanently attached to lower piece  70  of the buckle by looping a single length of strap material through lower piece  70  and sewing it onto itself along a seam immediately adjacent lower piece  70 . As such each end fastener  58 ,  60  has a non-adjustable fixed length and hangs freely below the seam. Connective segment  64  preferably permanently attaches upper piece  72  of the buckle to strap loop  66 . One end of connective segment  64  is looped through upper piece  72  and the other end of connective segment  64  is looped through strap loop  66 . Both ends of connective segment  64  are sewn onto themselves along a seam between upper piece  72  and strap loop  66  such that connective segment  64  has a non-adjustable fixed length. 
     Connectors  26 ,  28  are each a single strap loop having substantially the same construction as strap loop  66 . A connective segment  74  is provided having the same or a similar construction to connective segments  54 ,  56  which preferably permanently attaches connector  28  to arm retainer  12  in substantially the same manner as connective segments  54 ,  56 , but to rear side  30  of arm retainer  12 . Connective segment  74  is looped through connector  28  and both ends of connective segment  74  are sewn to rear side  30  of arm retainer  12  such that connective segment  74  has a non-adjustable fixed length. 
     Support strap  22  is preferably permanently attached to both connector  26  and connector  28 . However, permanent attachment of support strap  22  to connectors  26 ,  28  is effected in a manner which enables the user to adjust the length of support strap  22 . In particular, permanent, yet adjustable, attachment is effected by providing a strap keeper  76  which encircles support strap  22 . One end of support strap  22  is permanently attached to keeper  76 , preferably by sewing. The remaining free end of support strap  22  is displaced in a first direction away from keeper  76  to connector  28 , looped through connector  28 , and displaced back in a second opposite direction toward keeper  76  thereby overlapping itself. The free end is passed through keeper  76  in the second direction, looped through connector  26  and displaced in the first direction again away from connector  26 , thereby overlapping itself. The free end is finally passed through keeper  76  one last time in the first direction. A nub  78  is then formed on the free end of support strap  22 , which extends from keeper  76  in the first direction, by doubling the free end one or more times back over itself and sewing the doubled over segments together. Nub  78  is sized to prevent the free end of support strap  22  from passing back through keeper  76  in the second direction. 
     Support strap  22  is preferably formed from one or more strong pliant materials which are not substantially elastically stretchable, e.g., the same material as support straps  18 ,  20 . Support strap  22  is preferably continuously covered with, or integrally formed from, a hook or loop material (preferably loop material in this instance) in the manner of support straps  18 ,  20 . A fastener  80 , preferably a tab of the hook or loop material (more preferably hook material in this instance) which is opposite the material of support strap  22 , is permanently attached to keeper  76  by sewing or the like and extends away from keeper  76  for releasable fastening to the face of support strap  22 . 
     Fastener  80 , in cooperation with keeper  76 , enables the user to selectively set the length of support strap  22 . In particular, the user decreases the length of support strap  22  by releasing fastener  80  from the face of support strap  22  adjacent to keeper  76  and displacing nub  78  away from keeper  76  in the first direction, thereby drawing a length of support strap  22  behind nub  78  through keeper  76  in the first direction and effectively drawing connectors  26 ,  28  closer together. Once the desired decreased strap length is reached, the user refastens fastener  80  to the face of support strap  22  adjacent to keeper  76 . The user increases the length of support strap  22  by releasing fastener  80  from the face of support strap  22  adjacent to keeper  76  and displacing nub  78  back toward keeper  76  in the second direction, thereby drawing a length of support strap  22  back through keeper  76  in the first direction and effectively distancing connectors  26 ,  28  from one another. Once the desired increased strap length is reached the user refastens fastener  80  to the face of support strap  22  adjacent to keeper  76 . 
       FIGS. 2 and 3  show the assembled shoulder orthosis  10  worn by a patient for effective support and stabilization of the right shoulder of the patient. It is readily apparent to one of ordinary skill in the art that it is also within the scope of the present invention to adapt the shoulder orthosis  10  for effective support and stabilization of the left shoulder. The shoulder orthosis  10  is assembled from its disassembled state shown in  FIG. 1  to its assembled state shown in  FIGS. 2 and 3  by looping an end of support strap  18  and an end of support strap  20  through connector  26  and doubling each of the ends back over itself a relatively short distance. The ends are releasably fastened back onto themselves by means of fasteners  48 , thereby releasably connecting support straps  18 ,  20  to support strap  22 , which in turn is permanently connected to the rear of arm retainer  12  by means of connector  28 . The remaining free end of support strap  18  and remaining free end of support strap  20  are likewise looped through strap loop  66  of connector  24 , similarly doubled back over themselves and releasably fastened to themselves with fasteners  48 , thereby releasably connecting support straps  18 ,  20  to upper piece  72  of buckle  62  on connector  24 . As a result, each support strap  18 ,  20  has been adjusted to an unfitted strap length which is preferably an increased unfitted strap length. Support strap  22  is also adjusted to an unfitted strap length, which is preferably an increased unfitted strap length, in a manner described above specific to support strap  22 . Assembly of the shoulder orthosis  10  continues by releasably fastening end fasteners  58 ,  60  of connector  28  to their corresponding strap loops  50 ,  52  which are attached to opposite lateral sides  34 ,  36  of arm retainer  12  while lower piece  70  of buckle  62  remains uncoupled from upper piece  62 . 
     Once the shoulder orthosis  10  is in a partially assembled state as shown in  FIG. 4A , it is in a condition for fitting on a patient. A method for properly fitting the partially assembled shoulder orthosis  10  on a patient is described below with reference to  FIGS. 4A-E . The method is initiated as shown in  FIG. 4A  by extending the arm associated with the patient&#39;s unaffected shoulder (the left arm in the present illustration) away from the body while the arm associated with the affected shoulder on the opposite side of the body (the right arm in the present illustration) is positioned at the patient&#39;s side, if desired, in a relaxed state. 
     The closed loop formed by the support straps  18 ,  20 , connector  26 , and strap loop  66  of connector  24  is passed around the extended arm toward the patient&#39;s torso. Support strap  18  is positioned above the arm such that support strap  18  extends across both the anterior and posterior of the torso and extends therebetween over the unaffected shoulder. Support strap  20  is positioned below the arm such that support strap  20  likewise extends across both the anterior and posterior of the torso, but extends therebetween laterally beneath the unaffected shoulder. Mounting the strapping system on the patient is completed by extending support strap  22  across the posterior of the torso. As such, the instant strapping system emulates essentially two strapping segments. One strapping segment extends over the shoulder and connects to the front and back of arm retainer  12  as accomplished by support straps  18 ,  22  in combination. The other strapping segment extends under the shoulder and connects posteriorly and anteriorly to the first strapping segment as accomplished by support strap  20 . 
     Once the strapping system is mounted on the patient, the extended arm may be lowered back against the patient&#39;s body. Arm retainer  12  is manually positioned adjacent to the arm which is associated with the affected shoulder and fitting the shoulder orthosis  10  on the patient continues by placing the forearm associated with the affected shoulder in arm retainer  12 . In particular, the patient&#39;s hand associated with the affected shoulder is slipped diagonally into open top side  38  of arm retainer  12  near its midpoint and extended diagonally forward under end fasteners  58 ,  60  as shown in  FIG. 4B  until the forearm is cradled in arm retainer  12 . As such, the forearm engages arm retainer along enclosed bottom side  32  and lateral sides  34 ,  36 , the elbow engages arm retainer at the intersection of rear side  30  and bottom side  32  and the hand extends out open front side  40  of arm retainer  12 . 
     An opening  82  may be provided in arm retainer  12  at the intersection of rear side  30  and bottom side  32  where the elbow engages arm retainer  12 . The elbow opening  82  can be selectively maintained opened or closed by means of a closure strip  84  integrally formed with the arm retainer  12  as shown in  FIG. 1  and shown more fully in  FIG. 4E . The end of closure strip  84  has a fastener  86  which is preferably a tab of hook or loop material (more preferably hook material in this instance) opposite the material of fastener  42 . Fastener  86  is permanently attached to the closure strip end by sewing or the like and enables releasable fastening of closure strip  84  to fastener  42 , thereby covering opening  82  and correspondingly covering the elbow. Conversely, releasably unfastening closure strip  84  from fastener  42  uncovers opening  82  and correspondingly uncovers the elbow. This may be desirable when a wound or any other condition is present on the elbow which would be irritated by contact with arm retainer  12 . 
     In any case, after the forearm is cradled in arm retainer  12  lower and upper pieces  70 ,  72  of buckle  62  are coupled together as shown in  FIG. 4C , thereby releasably connecting support straps  18 ,  20  to the front of arm retainer  12  by means of connector  24 . With support straps  18 ,  20 ,  22  connected to the front and rear of arm retainer  12 , support straps  18 ,  20 ,  22  desirably support the load of arm retainer  12  and the arm cradled therein. Fitting the shoulder orthosis  10  on the patient is completed with reference to  FIGS. 4D  and E by adjusting the lengths of support straps  18 ,  20 ,  22  from the unfitted strap lengths of  FIG. 4A  to fitted strap lengths. 
     The fitted strap lengths are typically, but not necessarily, decreased fitted strap lengths relative to the preferred increased unfitted strap lengths of support straps  18 ,  20 ,  22  described above. In any case, with specific reference to  FIG. 4D , decreasing the strap length of support strap  18 ,  20  from the unfitted strap length to a decreased fitted strap length is effected by releasing fastener  48  on the strap end at the front of the patient proximal to strap loop  66 , pulling on the strap end away from strap loop  66  until fastener  48  aligns with a point on support strap  18 ,  20  corresponding to the desired decreased fitted strap length and refastening fastener  48  to support strap  18 ,  20  at that point. Conversely, increasing the strap length of support strap  18 ,  20  from the unfitted strap length to an increased fitted strap length, if necessary, is effected by releasing fastener  48  on the strap end at the front of the patient proximal to strap loop  66 , drawing the strap end toward strap loop  66  until fastener  48  aligns with a point on support strap  18 ,  20  corresponding to the desired increased fitted strap length and refastening fastener  48  to support strap  18 ,  20  at that point. 
     With specific reference to  FIG. 4E , decreasing the strap length of support strap  22  from the unfitted strap length to a decreased fitted strap length is effected by releasing fastener  80  from support strap  22  and pulling nub  78  away from keeper  76  in the first direction until a point on support strap  22  corresponding to the desired decreased fitted strap length aligns with fastener  80  and refastening fastener  80  to support strap  22  at that point. Conversely, increasing the strap length of support strap  22  from the unfitted strap length to an increased fitted strap length, if necessary, is effected by releasing fastener  80  from support strap  22  and pushing nub  78  toward keeper  76  in the second direction until a point on support strap  22  corresponding to the desired increased fitted strap length aligns with fastener  80  and refastening fastener  80  to support strap  22  at that point. 
     It is noted that the fitted strap lengths of support straps  18 ,  20 ,  22  are selected by the user in accordance with the instant shoulder orthosis fitting method to optimally minimize the weight-bearing load on the affected shoulder. As such, the properly fitted shoulder orthosis  10  preferably distributes most, if not all, of the weight of the arm associated with the affected shoulder to the side of the patient&#39;s torso opposite the affected shoulder. The properly fitted shoulder orthosis  10  also preferably distributes at least a substantial portion of the weight of the arm associated with the affected shoulder away from the intersection of the neck and the unaffected shoulder on opposite the side of the patient&#39;s torso to a region on the shoulder away from the neck, thereby enhancing the comfort of the patient. 
     After the shoulder orthosis  10  has been properly fitted on the patient, assembly of the shoulder orthosis  10  is completed by releasably fastening closure straps  14 ,  16  to the front and rear of arm retainer  12 , respectively, as shown in  FIGS. 2 and 3 . One end of closure strap  16  is releasably fastened by means of fastener  44  to fastener  42  on one lateral side  32  or  34  of arm retainer  12  proximal to rear side  30  and immediately in front of the patient&#39;s upper arm extending upwardly out of arm retainer  12 . The other end of closure strap  16  is pulled comfortably taut over open top side  38  of arm retainer  12  and fastened by means of other fastener  44  to fastener  42  on the opposite lateral side  32  or  34  of arm retainer  12 , thereby substantially closing open top side  38  at that point. Similarly, one end of closure strap  14  is releasably fastened by means of fastener  44  to fastener  42  on one lateral side  32  or  34  of arm retainer  12 , but proximal to open front side  40  of arm retainer  12  and adjacent to the opening between in the patient&#39;s thumb and index finger extending out of arm retainer  12 . The other end of closure strap  14  is pulled comfortably taut over open front side  40  of arm retainer  12 , drawn between the thumb/index finger opening and fastened by means of other fastener  44  to fastener  42  on the opposite lateral side  32  or  34  of arm retainer  12 , thereby substantially closing open front side  40  at that point. As such, closure straps  14 ,  16  effectively secure the patient&#39;s forearm within arm retainer  12 . 
     Advantageous features of the shoulder orthosis  10  include the ability to remove it from its operative fitted position on the patient without requiring the user to substantially disassemble of the shoulder orthosis  10 , without requiring the user to change the length of any support straps  18 ,  20 ,  22  from their adjusted fitted strap lengths, or without requiring the patient to substantially displace the arm associated with the affected shoulder away from the patient&#39;s body and correspondingly without requiring the patient to substantially rotate the affected shoulder. Removal of the shoulder orthosis  10  from its fitted position on the patient is readily effected by performing the steps of  FIGS. 4A-C  in reverse after releasing closure straps  14 ,  16  from arm retainer  12 . In particular, removal is effected by uncoupling lower and upper pieces  70 ,  72  (the reverse of  FIG. 4C ), withdrawing the forearm from arm retainer  12  (the reverse of  FIG. 4B ) and passing the closed loop formed by the support straps  18 ,  20 , connector  26 , and strap loop  66  back over the extended arm associated with the unaffected shoulder away from the patient&#39;s torso (the reverse of  FIG. 4A ). If the user subsequently desires to operatively reposition the shoulder orthosis  10  on the patient, it is apparent that the user need only repeat the steps of  FIGS. 4A-C  and refasten closure straps  14 ,  16 . It is unnecessary to readjust any of the support strap lengths in the manner of  FIGS. 4D and 4E  to restore the proper fit when removing and repositioning the shoulder orthosis  10 . 
     The shoulder orthosis  10  may also optionally comprise a shoulder positioning pillow system which is incorporated into the shoulder orthosis  10  in cooperative association with arm retainer  12  and the supportive strapping system described above with reference to  FIGS. 1-4 . The shoulder positioning pillow system functions as an arm spacer positionable between the arm retainer  12 , intervening forearm and torso of a user to distance the forearm from the torso and position the arm at an angle which effects a desired treatment position of the shoulder in a manner described below with reference to  FIGS. 5-8 . According to one embodiment shown in  FIG. 6 , the shoulder positioning pillow system has one individual shoulder positioning pillow  90  which alone functions as the arm spacer. According to another embodiment, the shoulder positioning pillow system is a modular multi-pillow system having two or more individual pillows which in combination function as the arm spacer. An exemplary embodiment of a modular multi-pillow system shown in  FIG. 5  has two individual pillows  90 ,  92 . When individual pillows  90 ,  92  are combined in releasable attachment as shown in  FIGS. 7 and 8 , individual pillows  90 ,  92  form a single pillow termed a combined shoulder positioning pillow which functions as the arm spacer. 
     Each individual pillow  90 ,  92  preferably has essentially the same configuration and construction as the other. Accordingly, the description of individual pillow  90  set forth below applies likewise to individual pillow  92 . Furthermore, it is understood that pillow elements which are visible on pillow  90  in  FIGS. 5-8 , but which are obscured on pillow  92  or vice versa due to the particular view of a given figure are nevertheless present on both pillows  90 ,  92 . 
     Referring to  FIG. 5 , pillow  90  preferably has a wedge configuration with five faces, i.e., three substantially vertically-oriented faces  94 ,  96 ,  98  and two substantially horizontally-oriented faces  100 ,  102 . The terms “vertical” and “horizontal” are used in the present context with reference to the orientation of faces  94 ,  96 ,  98 ,  100 ,  102  when pillow  90  is operatively mounted on a patient, as will be described below, in cooperative association with the other components of the shoulder orthosis  10  described above. As is characteristic of a wedge configuration, two vertical faces  94 ,  96  of pillow  90  are preferably elongate and converge at one of their aligned ends to a common edge of intersection  104  which is tapered at an acute angle. Two vertical faces  94 ,  96  diverge at their opposite aligned ends to define vertical face  98  which extends between the two divergent edges of vertical faces  94 ,  96  and is relatively shorter in length than elongate vertical faces  94 ,  96 . Vertical face  98  intersects with vertical face  94  preferably at an essentially right angle and intersects with vertical face  96  at an acute angle which is preferably substantially greater than the acute angle of edge  104 . 
     Horizontal faces  100 ,  102  are preferably substantially planar and essentially parallel to one another while being essentially normal to vertical faces  94 ,  96 ,  98 . Vertical faces  94 ,  98  are likewise preferably substantially planar and vertical face  94  has a length which is preferably approximately equal to the length of arm retainer  12  and correspondingly approximately equal to the length of a typical patient&#39;s forearm. Vertical face  96  is preferably at least somewhat arcuate and more preferably has a relatively shallow arc and correspondingly a relatively large radius of curvature to approximately conform to the shallow arcuate contour along an anterior surface of the torso of a patient at or near the waist. As such, vertical face  96 , in gross, approximates a planar rectangle and horizontal faces  100 ,  102  approximate a planar right triangle with the top edge of vertical face  96  defining the hypotenuse of the triangle. 
     Pillow  90  is preferably constructed from a single molded or cut-out piece of shaped foam (not shown) having the above-described configuration. Although the foam of pillow  90  is compressible, it is nevertheless relatively firm so that pillow  90  does not substantially deform when contacted by the forearm during normal use of the shoulder orthosis  10 . However, arcuate vertical face  96  of pillow  92  may deformably flatten somewhat when pillows  90 ,  92  are pressed against one another to form the combined shoulder positioning pillow as described below. The entirety of the foam piece is preferably enclosed in a shell  106  which is constructed from a thin high-strength pliant material, such as a cloth, cloth/foam laminate, cloth mesh, or combinations thereof. Shell  106  can serve multiple functions, e.g., protecting the foam from abrasion or other external degradation, enhancing the comfort of the patient, reducing the surface friction coefficient of pillow  90  and/or providing a substrate or platform for attaching fasteners or other accessories to the face of pillow  90 . 
     Shell  106  is preferably constructed by preparing a flat cutout of the shell from a sheet of the selected pliant material and sewing the cutout into the desired three-dimensional configuration of the shell, but leaving a flap  108  in shell  106  through which to insert the foam piece for final assembly of pillow  90 . A fastener such as a hook-and-loop fastener (not shown) can be provided to internally fasten flap  108  closed during use of pillow  90 . Vertical face  94  is provided with a fastener  110  and vertical faces  96 ,  98  are provided with a fastener  112 , which in combination enable the user to releasably fasten pillow  90  to arm retainer  12  of the shoulder orthosis  10  or releasably fasten individual pillows  90 ,  92  to one another when forming any one of the various alternate configurations of the combined shoulder positioning pillow as described below. A preferred embodiment of fastener  110  is the hook or loop material of a hook-and-loop fastener. The hook or loop material of fastener  110  (preferably hook material in this instance) is permanently attached to vertical face  94  by sewing a continuous strip of the hook material thereto. A preferred embodiment of fastener  112  is likewise the hook or loop material, but the opposite material of fastener  110 . The hook or loop material of fastener  112  (preferably loop material in this instance) is permanently attached to vertical faces  96 ,  98  by sewing a continuous strip of the loop material thereto. 
     The shoulder positioning pillow system preferably further comprises a waist belt  114  as an accessory associated with pillow  90 . Waist belt  114  comprises a waist strap  116 , a midsection fastener  118  and a connective segment  120 . Waist strap  116  and connective segment  120  are preferably formed from one or more strong pliant materials which are not substantially elastically stretchable, e.g., the same material as support straps  18 ,  20 ,  22 . Waist strap  116  and connective segment  120  are preferably continuously covered with, or integrally formed from, a hook or loop material (preferably loop material in this instance) in the manner of support straps  18 ,  20 ,  22 . Three fasteners  122 , each preferably a patch of the hook or loop material (more preferably hook material in this instance) which is opposite the material of waist strap  116  and connective segment  120  are permanently attached to waist belt  114  by sewing or the like. One fastener  122  is attached to the inside face at one end of relatively short connective segment  120 , another fastener  122  is attached to the inside face at one end of relatively long waist strap  116  and another fastener  122  is attached to the outside face at the opposite end of waist strap  116 . 
     Midsection fastener  118  is preferably a two-piece side release buckle which is substantially the same as midsection fastener  62 . Connective segment  120  is preferably permanently attached to one piece  124  of the buckle by looping one end of connective segment  120  through piece  124  and sewing it back onto itself immediately adjacent to piece  124  such that connective segment  120  has a non-adjustable fixed length. Waist strap  116  is preferably slidably attached to the other piece  126  of the buckle by looping the end of waist strap  116  having fastener  122  attached to the outside face thereof through piece  126  and doubling the end back over itself so that both fasteners  122  on waist strap  116  are facing the same direction. This configuration enables the user to releasably adjust the length of waist strap  116 . The user decreases the length of waist by releasing fastener  122  on the end of waist strap  116  looped through piece  126 , pulling the strap end away from piece  126  until fastener  122  aligns with a point on waist strap  116  corresponding to the desired decreased strap length and refastening fastener  122  to waist strap  116  at that point. Conversely, the user increases the length of waist strap  116  by releasing fastener  122  on the end of waist strap  116  looped through piece  126 , pulling the strap end toward piece  126  until fastener  122  aligns with a point on waist strap  116  corresponding to the desired increased strap length and refastening fastener  122  to waist strap  116  at that point. 
     Waist belt  114  is preferably cooperatively assembled with pillow  90  by releasably fastening fastener  122  of connective segment  120  to fastener  112  on vertical face  98  while piece  124  of buckle remains uncoupled from piece  126 . As such, piece  124  is substantially positioned at the intersecting edge of vertical faces  96  and  98  of pillow  90 . Waist strap  116  is set at an unfitted strap length in a manner described above and the free end of waist strap  116  not looped through piece  126  is aligned with flap  108 . The free end of waist strap  116  is tucked beneath flap  108  and releasably fastened to the inside of flap  108  by means of fastener  122  on the strap end such that piece  126  of the buckle is directed toward edge  104  of pillow  90  and away from vertical face  98 . 
     Once the waist belt  114  and pillow  90  are assembled, the shoulder orthosis  10  including the shoulder positioning pillow system is in a condition for mounting on a patient. A method for mounting the shoulder orthosis  10 , which includes the shoulder positioning pillow system, on a patient is described below with reference to  FIGS. 6A-D . The shoulder positioning pillow system shown in  FIG. 6D  has only one individual shoulder positioning pillow which is configured to maintain the affected shoulder of a patient in a desired treatment position. The instant shoulder treatment position is termed a 45° neutral treatment position. When the shoulder is in the 45° neutral treatment position, the forearm is rotated to a 45° external rotation angle while the upper arm is at a 0° (neutral) abduction angle. 
     In accordance with the present method, arm retainer  12  and the strapping system are mounted on the patient as described above and shown in  FIG. 6A . Vertical face  96  is positioned in engagement with the patient&#39;s anterior torso at or near the waist with edge  104  directed posteriorly and vertical face  98  directed anteriorly. Pillow  90  having waist belt  114  assembled thereon is positioned in engagement with arm retainer  12  as shown in  FIG. 6B . More particularly, vertical face  94  is releasably fastened to lateral side  34  by means of fasteners  110  and  42 , respectively. Waist strap  116  is wrapped around the waist of the patient and pieces  124 ,  126  are buckled together as shown in  FIGS. 6B and 6C . Mounting is completed by snugly fitting waist belt  114  to the waist as described above. 
     In accordance with an alternate method, pillow  90  is fastened to arm retainer  12  before mounting arm retainer  12  and the strapping system on the patient. In all other respects, this alternate mounting method is essentially the same as described above. In either case, by posteriorly positioning the narrowest segment of individual shoulder positioning pillow  90  at edge  104  adjacent to the elbow, the shoulder orthosis  10  having the instant individual pillow configuration imposes a neutral treatment position of 0° on the shoulder with respect to abduction. Conversely by anteriorly positioning the widest segment of pillow  90  at vertical face  98  adjacent to the wrist, the shoulder orthosis  10  having the instant individual pillow configuration imposes an angular treatment position of 45° with respect to external rotation. 
     Another method for mounting the shoulder orthosis  10 , which includes an alternate shoulder positioning pillow system, is described below with reference to  FIGS. 7A and 7B . The present method is essentially the same as described above with reference to  FIGS. 6A-D  except that a combined pillow made up of two releasably attached individual pillows is employed as the shoulder positioning pillow system in the instant method. The individual pillows of the combined pillow are alternately aligned in different pillow alignments resulting in different configurations of the combined pillow which correspondingly impose different treatment positions on the affected shoulder. One configuration of the combined pillow is an enhanced shoulder rotation configuration having a corresponding pillow alignment. Another configuration of the combined pillow is an enhanced shoulder abduction configuration having a different corresponding pillow alignment. In accordance with an embodiment of the enhanced shoulder rotation configuration, the combined pillow is configured to maintain the affected shoulder of a patient in a 90° neutral treatment position. The combined pillow is assembled by positioning pillow  92  to the outside of pillow  90  with vertical face  98  of pillow  92  positioned adjacent vertical face  98  of pillow  90  and edge  104  of pillow  92  positioned adjacent edge  104  of pillow  90 . Vertical face  96  of pillow  92  is pressed against vertical face  94  of pillow  90  causing fastener  112  of pillow  92  to engage fastener  110  of pillow  90  and maintain the instant combined pillow configuration. Waist belt  114  is maintained assembled on pillow  90  and fitted in substantially the same manner as described above with respect to the method employing the single individual shoulder positioning pillow. 
     Vertical face  96  of pillow  90  is positioned in engagement with the patient&#39;s anterior torso at or near the waist with edges  104  of both pillows  90  and  92  directed posteriorly and vertical faces  98  of both pillows  90  and  92  directed anteriorly. Vertical face  94  of pillow  92  is positioned in engagement with arm retainer  12  and is releasably fastened to lateral side  34  by means of fasteners  110  and  42 , respectively. The instant configuration of the combined pillow does not significantly increase the overall horizontal pillow width relative to  FIG. 6D  at the segment corresponding to edges  104 , which is termed the posterior width dimension of the combined pillow in the enhanced shoulder rotation configuration. Accordingly, by posteriorly positioning the narrowest segment of the combined pillow adjacent to the elbow, the shoulder orthosis  10  having the instant combined pillow configuration continues to impose a neutral treatment position of 0° on the shoulder with respect to abduction. However, the instant combined pillow configuration effectively doubles the overall horizontal pillow width relative to  FIG. 6D  at the segment corresponding to vertical faces  98 , which is correspondingly termed the anterior width dimension of the combined pillow in the enhanced shoulder rotation configuration. As such, it is apparent from the description above and  FIG. 7B  that the posterior width dimension is substantially less than the anterior width dimension of the combined pillow in the enhanced shoulder rotation configuration. Accordingly, by anteriorly positioning the widest segment of the combined pillow adjacent to the wrist, the shoulder orthosis  10  having the instant combined pillow configuration imposes an increased angular treatment position of 90° with respect to external rotation. 
     Still another method for mounting the shoulder orthosis  10 , which includes an alternate configuration of the shoulder positioning pillow system of  FIGS. 7A and 7B , is described below with reference to  FIGS. 8A and 8B . The present method is essentially the same as described above with reference to  FIGS. 7A and 7B  except that the single combined pillow is configured to maintain the affected shoulder of a patient in a 15° abduction treatment position in accordance with an embodiment of the enhanced shoulder abduction configuration. The present enhanced shoulder abduction configuration of the combined pillow is assembled by positioning pillow  92  to the outside of pillow  90  with vertical face  98  of pillow  90  positioned adjacent vertical edge  104  of pillow  92  and edge  104  of pillow  90  positioned adjacent vertical face  98  of pillow  92 . Vertical face  96  of pillow  92  is pressed against vertical face  94  of pillow  90  causing fastener  112  of pillow  92  to engage fastener  110  of pillow  90  and maintain the instant combined pillow configuration. Waist belt  114  is maintained assembled on pillow  90  and fitted in substantially the same manner as described above with respect to the single individual shoulder positioning pillow shown in  FIG. 6D . 
     Vertical face  96  of pillow  90  is positioned in engagement with the patient&#39;s anterior torso at or near the waist with edge  104  of pillow  90  and vertical face  98  of pillow  92  directed posteriorly and vertical face  98  of pillow  90  and edge  104  of pillow  92  directed anteriorly. Vertical face  94  of pillow  92  is positioned in engagement with arm retainer  12  and is releasably fastened to lateral side  34  by means of fasteners  110  and  42 , respectively. In comparison with the single individual pillow of  FIG. 6D , the instant combined pillow configuration does not significantly increase the overall horizontal pillow width at the segment corresponding to edge  104  of pillow  92  and vertical face  98  of pillow  90 , which is termed the anterior width dimension of the combined pillow in the enhanced shoulder abduction configuration. Furthermore, it is apparent from a comparison of  FIGS. 7B and 8B  that the anterior width dimension of the combined pillow in the enhanced shoulder abduction configuration is substantially less than the anterior width dimension of the combined pillow in the enhanced shoulder rotation configuration. Accordingly, by anteriorly positioning this segment of the combined pillow adjacent to the wrist, the shoulder orthosis  10  having the instant combined pillow configuration continues to impose an angular treatment position of 45° with respect to external rotation. However, the instant combined pillow configuration substantially increases the overall horizontal pillow width at the segment corresponding to vertical face  98  of pillow  92  and edge  104  of pillow  90 , which is termed the posterior width dimension of the combined pillow in the enhanced shoulder abduction configuration. Furthermore, it is apparent from a comparison of  FIGS. 7B and 8B  that the posterior width dimension of the combined pillow in the enhanced shoulder abduction configuration is substantially greater than the posterior width dimension of the combined pillow in the enhanced shoulder rotation configuration. Accordingly, by posteriorly positioning this segment of the combined pillow adjacent to the elbow, the shoulder orthosis  10  having the instant combined pillow in the enhanced shoulder abduction configuration displaces the elbow outward away from the torso, thereby imposing an angular treatment position of 15° on the shoulder with respect to abduction. 
     There are other embodiments of a shoulder orthosis not shown which are readily within the purview of one of ordinary skill in the art following the teaching herein and are within the scope of the present invention. Such embodiments may employ the above-described modular multi-pillow system in combination with any conventional arm support known in the art which includes an arm retainer and a supportive strapping system. For example, it is within the scope of the present invention to substitute all or part of the strapping system and arm retainer (termed a forearm wrap) disclosed in U.S. Pat. No. 7,244,239 for the above-described supportive strapping system and arm retainer  12 . An exemplary alternate strapping system is a single continuous adjustable over-the-shoulder support strap anteriorly connected to the front of the arm retainer and posteriorly connected to the back of the arm retainer, thereby obviating connector  26 . Another exemplary alternate strapping system is one or more support straps which encircle the torso in whole or in part and additionally loop around or otherwise engage the forearm, thereby also functioning as an arm retainer. 
     The present invention also contemplates alternate embodiments of the modular multi-pillow system having multiple (i.e., two or more) individual pillows which are not shown, but are readily within the purview of one of ordinary skill in the art following the teaching herein. A common feature of the specific embodiments of the modular multi-pillow system described above and of alternate modular multi-pillow systems not shown, but also within the scope of the present invention, is that at least one individual pillow of a modular multi-pillow system of the present invention has two or more faces, each of which can be inwardly oriented (with reference to the resulting single combined pillow) to align with, engage and releasably attach to a corresponding attachment face of another individual pillow of the system. The resulting releasably attached pillows in combination form the combined pillow which is positionable as an arm spacer between the arm retainer, intervening forearm and torso of the user to maintain the shoulder in a desired treatment position. The user can readily modify the treatment position effected by the modular multi-pillow system simply by withdrawing the combined pillow from between the forearm and torso, detaching the individual pillows from one another, reorienting the faces of at least one of the pillows so that an alternate face of that pillow is aligned with the corresponding attachment face of the other pillow (or another attachment face of the other pillow), releasably reattaching the individual pillows to one another at the aligned faces and reinserting the resulting combined pillow between the forearm and torso to maintain the shoulder in a new desired treatment position. 
     It is further apparent that the specific shoulder treatment positions described above are merely exemplary. Any number of shoulder treatment positions are attainable by employing different embodiments of the modular multi-pillow system of the present invention and/or by reconfiguring the orientation of the individual pillows within a given embodiment of the modular multi-pillow system of the present invention to achieve an alternate shape of the resulting combined pillow. In any case, it is preferable that the faces of at least one individual pillow of a modular multi-pillow system define an irregular shape for the individual pillow. An “irregular shape”, as the term is used herein, refers to a shape which is other than a parallelogram and, more preferably, which is asymmetrical. As such, it is noted that the wedge shape of individual pillows  90 ,  92  constitutes an irregular shape. By providing the modular multi-pillow system with at least one individual pillow having an irregular shape, the user is able to achieve alternate shapes of the resulting combined pillow simply by reorienting the irregularly-shaped individual pillow with respect to the at least one other individual pillow of the modular multi-pillow system so that a different face of the irregularly-shaped pillow aligns with and releasably attaches to the attachment face of the other individual pillow. 
     While the forgoing preferred embodiments of the invention have been described and shown, it is understood that alternatives and modifications, such as those suggested and others, may be made thereto and fall within the scope of the invention.