C5 – Why you need to wear your brace for 23 hours a day



There are 7 cervical vertebrae, and the progression to bigger and stronger bones continues…….

And before we get to the serious stuff: Allotment news (see my preamble in C1): we think the badgers have got in and demolished most of our sweetcorn. We are VERY upset as the first cobs were almost ready, and of all produce, the difference between shop-bought and fresh, sweetcorn is possibly the greatest improvement, so we are really sad. We might be lucky to get a few, but other allotment owners have suffered a similar fate, and badger-proofing is a serious business! At least we have plenty of other veg to enjoy…..

So, back to scoliosis! I’d like to talk about brace wear and how long you should wear them and why.

RSC braces are clinically proven to be a really effective treatment, allied with Schroth therapy. In a perfect world, you would be wearing yours for 23 out of 24 hours a day. Yes, this is a massive commitment, and yes, it will be a real inconvenience, and yes, you’re allowed to complain about it for a while (but remember, you’re doing this for you, not your Mum and Dad), but study after study (This is the latest from Italy) which prove that adhering to the advised regime is effective. The study concludes that by wearing the brace for 23 hours per day (in this case not an RSC but the approach applies to all scoliosis braces) 55% of wearers will show some sign of improvement, 38% will be stabilised and 11% will progress. Those adhering to less than 94% of advised wearing time or with an inconsistent pattern are more likely to allow the curve to progress.

This abstract from 2009 concludes that we can predict the outcome based on the adherence to the wearing regime. This is a highly theoretical approach, but demonstrated to reinforce that basically, the more you wear your brace, the better the outcome.

Now, the above statements are fairly vague and do not tell the whole story. It’s clear that more research needs to be carried out on this particular subject, but one hypothesis put forward to explain the reason that maximum adherence works, is that the spine ‘collapses’ a little bit when the brace is removed (usually not to the original Cobb angle) but is restored with re-application of the brace. The longer and more frequently the brace is not worn, the the greater the collapse and the harder the restoration, which is why it’s essential to wear your brace as much as possible (and then a little bit more) but your hour out of it per day is also essential! Your RSC brace functioning efficiently with the excellent correction we can achieve is the key to maintaining your curve – the greater the in-brace reduction of Cobb angle and rotation, the better the outcome.

And boys, I’m afraid you generally score lower than girls with regard to compliance (although I have to say, in my personal experience with RSC bracing, the boys are just as committed), so you have your honour to defend!

I’m nearly always asked ‘will the brace be uncomfortable?’, and my standard answer is ‘well, you should always know you are wearing it, but there shouldn’t be localised pressure enough to cause the skin to break down’. Now, this sounds a bit like ‘yes, it will be uncomfortable’, but in reality, the forces required to exert meaningful correction to the spine are, by their very nature, going to be pretty substantial. However, the areas which exert most force should be big enough to spread the load over a wide area, thus reducing the ‘pounds per square inch’. It’s highly likely that you will end up with red marks on your torso, but they should be slightly diffuse and without an ‘angry’ look to them. If you build up the wearing time as instructed, you will actually get used to wearing it fairly quickly.

So, to sum up, we will always try and get you to wear your brace for 23 hours per day – there is good evidence to show that this DOES work (we don’t do it for fun!) and of course, with every RSC brace must come with a bespoke Schroth programme. I’ll be touching on this in a later blog so I hope you have enjoyed the blogs so far, and I look forward to hearing from you if you have any questions or comments

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