Patient Information
FAQ
We know from experience and from prior studies that to be effective at preventing your scoliosis from developing, it must be able to apply firm force to your body to realign the spine into a straighter alignment. This means that your brace must be very rigid so that the scoliotic forces do not deform it. In addition the brace must be worn full time (20-23hours/day) and at full tightness. Scoliosis bracing studies have suggested that a minimum of 30% “in-brace correction” is needed and ideally 50% for optimal outcome. The industry average is somewhere between 20% and 30% resulting in poor bracing outcomes.
The LA Brace™ represents probably the most advanced scoliosis brace available. It uses modern computerized modeling technology (AGP and CADCAM) with the latest in our knowledge of force application systems to develop a computer model from which your brace will be fabricated. Recent studies of The LA Brace™ have shown it to average about 50% “in-brace correction” AND be more cosmetically acceptable than other braces
The making of you brace requires several processes. Firstly you will be measured for your brace by your orthotist. Complex mathematical algorithms are then applied to these measurements along with measurements of your X-rays in a process called A.G.P. These complex algorithms accurately predict the size and shape of the brace needed for optimum correction. The resulting data output from the A.G.P. software is then input into the computer modeling program to create a customized 3D computer model (CAD file). This virtual model is then sent to a special computer controlled lathe (CAM file) to “carve” a physical model. From this mold the shell of the brace is fabricated from plastic through a process called “total encapsulation vacuum molding”.
The LA Brace™ is a trademarked brace ONLY available through The L.A. Brace company, certified orthotists. Unfortunately however, with success comes imitation. Nevertheless, any brace NOT made by The LA Brace company and NOT provided by a certified L.A. Brace orthotist is very unlikely to be successful. Firstly, check the Availability page to make sure your provider is listed. If your provider is NOT listed here contact us using the contact section on the Availability page or email us at labrace@TheLABrace.com and we will research it for you.
Typically you will wear your brace until your physician feels the brace can no longer be effective. This will usually be until your spine has stopped growing or until the scoliosis has developed beyond the point where the brace can still help (this is most likely to happen when the child is non-compliant with the wearing schedule).
Brace preparation tips
1. Keep active and do plenty of stretching. The more flexible your spine, the easier it will be for your body to adapt to wearing The LA Brace™.
2. Educate your friends on scoliosis and bracing, your close friends will be a great support to you
Unfortunately, studies have shown that part-time brace wear is not very effective. To get the best outcome from wearing the brace, you should wear the brace between 20-23 hours a day, seven days a week or as instructed by your orthopedic physician.
You will usually have to wear the brace until your physician determines that growth has ended or is close to ending and the risk of progression has diminished. The actual age this occurs can vary from one person to another. By reviewing your x-rays, age, height relative to your parents and start date of menstrual cycles, your physician may be able to estimate when this will be.
The computer takes your dimensions along with measurements of your x-rays and designs a brace that will attempt to position your body in such a way as to generate the 3-Dimensional realignments needed. Hence the brace is not made to the shape of your body but to the dimensions of your body in the shape needed to get the desired results. Often this is an approximate mirror image of your current shape.
Because the brace is rigid and designed to be very tight fitting, initially your body will resist the pressure forces applied to it and the brace will be uncomfortable. The first week of wear is usually the worst. After that it should get progressively less uncomfortable and it will take on average 3-4 weeks for your body to fully adjust.
Undershirts
You must wear an undershirt as an interface between your skin and the brace. This will improve comfort and reduce the risk of skin abrasions and sweat rashes. The shirt should ideally be cotton, tight fitting, long enough to cover the whole brace and be seamless. You can try www.Tillys.com who have a variety of suitable shirts. If you are unable to find suitable shirts, discuss this with your orthotist. He/she can order specially designed undershirts, although these are more expensive.
The LA Brace™ is probably the lowest profile “effective” brace available. It is an “underarm” TLSO brace and is typically only 3/32″ thick. A recent study asked patients who had wore a different brace before using The LA Brace™ questions relating to wearing the different braces. All patients stated that The LA Brace™ was less visible and 75% said they found it more comfortable (Click here to go to the outcomes page). The visibility of the brace will vary depending on how long you have had your brace and what type of clothing you are wearing. In the initial stages, your body will resist the pressure forces applied to it and the brace will tend to sit away from your body. Over time your body will loosen and adapt to the shape of the brace and hence the brace will fit more intimately. Even though the brace is very thin and worn very snug, tight clothing will increased the visibility of the brace. It is better to wear loose clothing that will hang over the brace. In addition tight fitting “skinny” jeans will almost definately not fit over the brace. You will have to wear slightly looser pants OR wear the brace over your skinny jeans and then wear a long loose shirt to cover your hips and therefore the brace.
Click here to go to the LA Brace fashion page.
Recommendations
Wearing schedule
Your body needs time to adjust to the forces the brace is applying to it. Begin with wearing the brace for 2 hours on the first day. Increase wear time by 2 hours/day until you reach the full time wearing schedule (20-23 hours/day).
Tightness
For the brace to be effective it has to physically change the alignment of your spine. To do this the brace has to push on your back, ribs, hips, waist and abdomen to force your spine into a straighter alignment and then maintain this position. Your orthotist will mark the straps to guide you as to how tight the brace needs to be. Please also see this video for how to correctly put on the LA Brace: LA Brace Fitting
Follow up with your orthotist
You will need to return to see your orthotist two weeks after you receive your brace. At this point your body should have started to loosen up and the brace started to become more comfortable. At this appointment your orthotist will make the necessary adjustments to the brace to try to ensure the brace is sufficiently effective.
Follow up with your physician
You will usually need to return to see your orthopedist soon after your 2-week follow up with your orthotist. Your orthopedist may decide to have new x-rays taken while wearing your brace to ensure the brace is working as intended.
Breathing
You may at the beginning experience a feeling of having difficulty breathing in your brace. Rest assured that this is only a temporary sensation and that the brace does not affect your ability to breath. This sensation will subside once you are up to wearing your brace full time.
Eating while wearing your brace
Eating a large meal while wearing the brace will be very difficult. Our recommendation is that you eat small amounts more frequently. If you do intend to eat an average to large sized meal, loosen the straps by about 1″ just before you begin eating. Tighten the straps back up approx 1 hour after you finish.
Exercise
Wearing the brace full time, can result in developing weaker muscles in your stomach and back. It is recommended that you exercise daily in your time out of the brace. Exercises help to keep you healthy and keep your muscles strong. Exercises can also be beneficial in maximizing the effectiveness of your brace. During P.E. and sports activities you will probably need to remove the brace just before and then reapply after you finish.
Therapy
In addition to general core strengthening from PE, new outcomes suggest curve-specific 3-Dimensional scoliosis exercises may improve your results. The only therapy system that currently works in conjunction with the principles of Cheneau Braces and The L.A. BraceTM is the Schroth Method (www.SchrothMethod.com). This therapy system was originally designed back in 1921 by Katharina Schroth from Germany and then developed by her daughter, Christa Lehnert-Schroth. The Asklepios Katharina-Schroth Klinik in Bad Sobernheim, Germany now accommodates 200 patients concurrently and is an international training center for therapists.
Looking after your skin
Due to the amount of pressure applied by the brace, the skin will be subject to irritation. This can be as a result of: 1) direct pressure or 2) friction or 3) sweat. Hard skin will tolerate pressure much better than soft skin. Therefore do NOT use creams, lotions or talc on your body wherever the brace applies pressure. The best solution to these problems are to change your undershirt regularly (2-3 times a day), make sure your undershirt covers the whole of your brace, is tight fitting and made of cotton. There are specialty brace shirts you can purchase that can increase the comfort in a brace. We recommend buying these at BraceShirts.com (affiliated with AmputeeStore.com). In addition you can try applying rubbing alcohol to your skin 3 times a week (unless your skin reacts negatively) to help harden and dry your skin. Also and clean your brace on a regularly basis.
Cleaning your brace
Your brace should be cleaned on a regular basis. The brace should be wiped down with a damp cloth and mild detergent. The straps and pads will absorb moisture and dirt and will discolor with time. Particular attention should be paid to the pads, which will absorb perspiration and can create odor. Other patients have mentioned that alcohol swabs/wipes have been effective.
Repairs & Maintenance
Your brace may need periodical adjustments and repairs. The required tension in the straps may result in occasional breakages in the straps, buckles or rivets. If you need repairs call your orthotist to arrange to have the repairs done promptly. If your orthotist and/or the facility is not available, you can try a shoe repair shop for putting in rivets or, as a temporary fix, try tying a pant belt around the brace until you arrange to get if fixed. In addition you may want to see your orthotist on a regular basis for review of your pressure forces to make sure the tightness and “in-brace correction” is maintained. You may also be instructed by your physician to return to see the orthotist for changes to the pressure force applications
Fashion
Unfortunately the original scoliosis brace, the Milwaukee Brace, was a metal brace that extended up around the neck looking like a torture device and resulted in many social interaction issues. Social stigma of scoliosis still exists resulting from continued negative portrayal of scoliosis within the media including movies such as Romy and Michele’s high school reunion, which continue to portray old fashioned Milwaukee type bracing!
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There are several different designs of LA Brace™ (see Brace Information page), but for most designs, The LA Brace™ is relatively easy to disguise with the right type of clothing.
If you have just been told that you need to wear a brace because you have scoliosis, you may be worried that it will be hard to find clothes that not only disguise the contours of your scoliosis brace, but also make you look and feel good. However, there are a lot of tips and tricks you can use for making clothes work with a brace, and todays styles are particularly brace-friendly.
Fortunately, volume is one of todays top fashion trends. Tops also have a more unconstructed look and are likely to be made of body-skimming, rather than body-hugging, fabrics. Tops and dresses with an empire waist are also popular, as are A-line dresses, which gently flare out from a fitted top.
These looks are ideal for wearing with a brace. They are loose around the brace area, which allows you to hide any extra bulk or straps. Embellishments, such as tiered ruffles, ribbons, flowers, patchwork, embroidery and other frills, also add to the volume and interest of a dress or top, further camouflaging any lumps and bumps you would like to hide.
Another option is to use tiered skirts or anything else that provides extra layering which then helps to hide where the brace may be pressing in, so it looks normal.
Whether you are concerned about your scoliosis brace showing or not, wearing clothes that make you look and feel great can definitely help boost your confidence as you face these and other challenges in life.
More information can be found in an excellent guide written by Moira Lion that is available online at this location
Pictures of patients demonstrating their LA Brace™ fashions:
