Practical Tips to Help Your Child Wear a Brace for Scoliosis

Practical Tips to Help Your Child Wear a Brace for Scoliosis

by Rosemary Marchese (Physiotherapist, Schroth and SEAS methods for Scoliosis)

Being diagnosed with Idiopathic Scoliosis and needing to wear a brace for scoliosis can be a tricky journey to navigate for children and families. There are also visits to doctors, physiotherapy and orthotists. For some children, being told they need to wear a brace can seem all too overwhelming. Right now the best evidence we have is that bracing is a good option for children with curves that have reached a particular threshold, normally 25 degrees (sometimes earlier if the child is young and the curve is progressive). The guidelines provided by the International Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) support the use of  Physiotherapeutic Scoliosis Specific Exercises (PSSE), for example Schroth and Scientific Exercise Approach to Scoliosis (SEAS) for many instances of Idiopathic Scoliosis. However there are times where a brace is needed. 

Understanding the child from their perspective

While I never try to play the role of a psychologist, and we encourage our patients to use our psychologist, there is no denying the need to take into account the mental and emotional health of a patient. I encourage parents to speak to their child about the need to wear a brace. If the child is feeling apprehensive about it I find it is important to find out why. Not all kids will give you a straight answer of course, but it’s worth a try. For example, some kids are worried about what other children will think and are worried about teasing. Surprisingly and fortunately, I have found this happens rarely, although of course this will vary in different locations and situations. 

Body image can already be an issue for adolescents in particular, even before a scoliosis diagnosis or brace wearing. Providing support in this area is also important. 

Overcoming obstacles with brace wearing

I’ve seen many patients and even their families struggle with brace wearing. It’s not an easy time and empathy is definitely warranted. At times it may be you as the parents really struggling with the idea that your child will be wearing the brace. Sometimes it is the child struggling with it. Sometimes it’s both. Over time I have found the following strategies may be useful to help a child build up their hours so that they eventually reach the amount of hours per day that they need to wear the brace. <wear a brace>

  1. Ensure that the child has appropriate undergarments and clothes to wear the brace with. 
  2. Start with bracing at home, for example two hours on the first day after school. 
  3. Build up by two hours per day if possible, again getting most of these hours in at home. 
  4. I then usually ask the patient to start wearing it at night. the first two or three nights may be a bit of a struggle so I find it’s useful to try this on the weekend when they don’t have to wake up for school the next day. That way if they struggle a little bit with sleep there is the opportunity to ‘catch-up’ a bit on the weekend. 
  5. If there are some struggles and delays with building up hours in the brace, sometimes I ask the child to wear the brace during the day in a lying down position. This allows them to get familiar with the pressures, the spaces and the overall feeling of wearing the brace. 
  6. At some stage they have to try to tackle wearing it at school. Getting support from the school can be helpful. This may include:
    • having a readily accessible area for the child to put the brace safely when they take it off for sport
    • allowing the child a few extra minutes in the bathroom for taking the brace on and off
    • allowing the child the opportunity to show their classmates to answer any questions rather than create secrecy, if the child agrees
    • making sure the uniforms fit with the brace
    • make sure they are comfortable at the computer. <wear a brace> 

Sometimes children will struggle more with the concept of night bracing and are happy to wear it to school. If that is the case, then I encourage it. I have found you cannot apply a ‘one-size-fits-all’ approach for how a child will wear the brace. I also encourage a holistic approach. I like to make sure that children are eating well, and keeping fit. This is important for energy as well as their mental and emotional health. There is even some evidence regarding the support of sport as an adjunct, but not as a treatment, for scoliosis. 

If you have any questions, please call or email us. 

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