1 arm adjustment only. If your hands aren't the size of a 5-year-old, it will cut off blood flow. The bicep area is adjustable, but the armpit area is not. It turns out to be the perfect double-sided tourniquet. I was in the bottom XL so thought it might be the loose side but I was wrong. You can't raise your arms or they will just go up no matter how hard you squeeze your chest. I had to use clamps to hold him up and cut a seam in my forearms to increase blood flow. So in the end it broke. But it supports you well when you are static and not using your hands. If you have a bilateral cuff injury, you will need help with donning and fitting. With the right mods this could be a great product.
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