Should I wear a brace?
I have had quite a few patients asking me whether or not a brace is beneficial after sustaining an injury.
A back brace is a device created to limit the range of motion of the cervical or lumbar spine. A brace can be very beneficial in the case of an acute or severe injury to the spine; spinal fracture, severe whiplash, or even with progressive spinal disorders. There are many different types of braces that are designed for specific disorders and injuries that will prescribed by your surgeon or doctor. Scoliosis is a very common reason to use bracing and will not be specifically addressed in this blog.
There is a time and place for a lumbar or cervical back brace. In a lot of cases a brace can actually be detrimental to rehabilitation after injury. A brace can be used for the first couple of days or weeks depending on the extent of injury. The brace will be used primarily as a restriction to movement so that the structures can heal and for pain reduction. After this initial period of rest the brace should be discharged as quickly as possible.
When a brace is utilized it eliminates muscular activity and function around the spine. Over time these muscles become atrophied and weak. If a brace is worn for too long the muscles will atrophy to the point in which they are no longer strong enough to support the spine. In this case, the person then becomes susceptible further spinal injury due to the lack support surrounding the spinal cord. This makes the rehabilitation process significantly longer and more painful for the patient.
After a mild lumbar or cervical injury patients will sometimes purchase a brace at a local drugstore. I strongly encourage you to consult with a physical therapist or your primary care physician.
I have a treated a lot of women who come in wearing lumbar support braces after pregnancy. Unless the woman is experiencing severe low back or has history of spinal injury, the brace can be detrimental to rehabilitation in this case as well. When the woman is wearing the brace she is unable to activate and strengthen the muscles in her abdomen and lumbar region. If she has been diagnosed with diastasis recti then she needs to learn to strengthen the muscles around her core in order to approximate the separation.
Another common example of a device that can be used in the wrong way is a stabilizer or postural support. Some people rely on these supports too much and do not allow the muscles around the affected area to be activated and utilized. If you are thinking about using a device like this, I strongly encourage speaking with a healthcare professional.
This same idea also goes for ankle, knee and other joint braces. It is always best to have a physical therapist or sports doctor evaluate your injury to determine if a brace would be beneficial for you. There are plenty of examples of people who decide to wear a brace after injury BUT have not been evaluated. If your injury is serious enough then the brace may not provide enough support and will lead to further injury. And on the other hand; a brace may be inhibiting your muscles from working enough to support your joint and actually teaching them to become weak.
I cannot urge you enough to seek advice from a trained professional for the decision to utilize a brace.